Suicidal behaviour in childbearing women

Abstract

The first postnatal year is a period when the rate of psychiatric disorder is high, and a correspondingly high rate of suicide might be expected. Age-adjusted mortality ratios for suicide by women in the first postnatal year were therefore calculated from population data for England and Wales for a twelve-year period. The overall mortality ratio was found to be 17-that is, the actual total was one sixth of that expected. The low rate was not found after stillbirth which was associated with a rate of suicide six times that in all women after childbirth. Women who committed suicide after childbirth most often did so in the first postnatal month and there was a tendency to use violent methods. One explanation of the low rate of suicide is that motherhood exerts a protective effect, and further studies were carried out to explore this possibility. In study two, the age-standardised mortality ratio for suicide during pregnancy was calculated by the same method to be 5-that is, the actual rate was one twentieth of that expected. In study three, the rate of parasuicide by women in the first postnatal year was calculated from catchment area data to be less than half that of age-matched women (odds ratio 0.43). In study four, a cognitive explanation for these results was studied. Women with postnatal depression were found to score less on a questionnaire measuring cognitions related 1 to worthlesness, hopelessness and self-harm than women with depression arising at other times. This result suggests that childbearing women, despite their risk of psychiatric disorder, are protected against suicide and self-harm by their relative absence of suicide-related cognitions, and that such cognitions should be a focus for the treatment of other groups at risk of suicide.

Gender in elderly suicide: analysis of coroners inquests of 200 cases of elderly suicide in Cheshire 1989–2001

“…The study found no significant gender difference in childlessness in elderly suicide victims which may imply that the protective effect of having children appears to diminish in old age. The lack of evidence for the protective effect of child bearing for elderly women in terms of suicide risk (Appleby, 1996;Catalan, 2000;Quin, 2000) is not surprising and could be explained by loss of maternal role due to children growing up and moving away from home. Of those not known to service, nearly half of men and women did not have GP contact in the 3 months prior to committing suicide.…”

Maternal Deaths in NSW (2000–2006) from Nonmedical Causes (Suicide and Trauma) in the First Year following Birth

“…Factors associated with nonmedical death include intimate partner violence (IPV), which is reported to occur in 17%–27% of Australian pregnancies [12, 13], and perinatal anxiety and depression, with one in eight Australian women reporting depressive symptoms in the year following birth, and rates of diagnosed postnatal depression (PND) are reported to be 10% of Australian postnatal women [14]. Other contributing factors include mental health disorders and substance abuse [15, 16]. …”

Wochenbettpsychosen – klinische, neurobiologische und psychosoziale Aspekte

“…Obsessive Ruminationen, das Kind verletzen zu können oder zu müssen, infantizide Vorstellungen, sind bei einigen Frauen aufzudecken, wenngleich das tatsächliche Risiko eines Infantizids als wohl sehr niedrig einzustufen, dann oft im Kontext einer erweiterten Suizidalität zu begreifen ist [15][16][17]. Das Suizidrisiko ist hoch, in einem Vergleich mit einer Kontrollgruppe von psychotischen Frauen in Nicht-Indexepisoden aber nicht signifikant erhöht [18]. Es muss insgesamt aber beachtet werden, dass das Suizidrisiko für Frauen mit postpartalen Psychosen im 1. postnatalen Jahr um das ca.…”