Poor Sleep and Decision-Making Disturbance Are Associated With Suicidal Ideation in Pre-natal Depression

Abstract

Although many risk factors for suicidal ideation have been identified, few studies have focused on suicidal ideation and pre-natal depression. The purpose was to investigate the relationship between decision-making (DM) dysfunction and sleep disturbance on suicidal ideation in pre-natal depression. Participants included 100 women in the third trimester of pregnancy, including pregnant women with pre-natal depression who had recent suicidal ideation (n = 30), pre-natal depression without SI (n = 35) and healthy controls (n = 35). The Iowa Gambling Task (IGT) was used to evaluate the DM function and the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep index. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess suicidal ideation and the seriousness of depression. Overall, the two groups with pre-natal depression showed worse sleep quality and decreased DM function compared with healthy controls. The pre-natal depression with suicidal ideation group showed a significantly higher score in subjective sleep quality and a lower score in block 5 of IGT than the pre-natal depression without suicidal ideation group. Further correlation analysis showed that suicidal ideation positively correlated with subjective sleep quality, sleep duration, and daytime function, and negatively correlated with IGT scores. Sleep disturbance and impaired DM function may be risk factors for suicidal ideation in pre-natal depression.

Suicidal ideation and behavior among perinatal women and their association with sleep disturbances, medical conditions, and known risk factors

“…They found that the first group reported more depression and anxiety and were more likely to endorse SI than the second group. Lastly, Bao et al ( 35 ) found that SI correlated with subjective sleep quality, duration, and daytime dysfunction among 100 pregnant women in the third trimester. It was also found that women who suffered from depression and SI indicated significantly poorer sleep quality than women who suffered from depression without SI.…”

“…Thirty-six studies of 26,035 participants reported present or past psychopathology as a risk factor for suicidality during pregnancy and the postpartum period. Most studies, reported that present or past depression ( 21 , 32 , 34 , 35 , 40 – 42 , 46 , 48 , 49 , 51 , 53 – 67 ), anxiety ( 34 , 38 , 45 , 48 , 53 , 58 , 63 ), and past suicidality ( 45 – 48 , 53 , 54 ) are significant risk factors for suicidality during pregnancy and the postpartum period. While two referred to psychiatric comorbidity as a significant risk factor ( 22 , 68 ), two studies referred to family psychopathology as such a factor ( 47 , 68 ).…”

Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors

“…A range of cognitive factors was investigated in seven studies ( 54 , 63 , 64 , 82 , 90 – 92 ). These studies’ methodological quality ratings ranged from 33 to 71%, with six of the seven studies considered “good” quality and one study was of “moderate” quality.…”

“…In a sample of 100 pregnant women, the association between decision-making function, assessed using the Iowa Gambling Task ( 93 ) and self-harm ideation was investigated ( 90 ). The participants were allocated to one of three groups: those who reported self-harm ideation, those who scored highly for depressive symptoms on the EPDS ( 33 ), but reported no self-harm ideation, and those who reported no self-harm ideation and did not score highly on the EPDS .…”

The circadian rhythm and sleep disorders in pregnant women

“…Restricția somnului poate duce la o perturbare a neuroplasticității, declanșând astfel unele dintre mecanismele fiziopatologice responsabile de dezvoltarea depresiei [20].…”