Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates

Abstract

Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers’ mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors, and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk factors, and an overview about the main clinical correlates associated with the suicidal behavior during the pregnancy and postpartum period. Practical recommendations have been provided as well.

Understanding the Complex of Suicide in Depression: from Research to Clinics

“…Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions, particularly amongst special population. 183,184 Therefore, authors here propose a stratification model of suicide risk accompanied with a list of suggested recommendations regarding interventions and treatments to be planned, useful for clinical practice, particularly for those working in Mental Health (Table 3). Table 3.…”

Delayed sleep timing and circadian rhythms in pregnancy and transdiagnostic symptoms associated with postpartum depression

“…There is overlap between the sleep alterations of pregnancy and the sleep alterations found in psychiatric disorders. Depression, mania, and obsessive-compulsive disorder (OCD) are particularly important disorders in perinatal women because they occur frequently in this population 22,23 , commonly overlap 24 , and are related to suicide in new mothers 25 . For example, sleep disturbances found both in pregnancy and depression include decreased sleep quality and sleep efficiency and increased sleep onset latency 26 .…”

The prevalence and correlates of self-harm ideation trajectories in Australian women from pregnancy to 4-years postpartum

“…In their recent review of 57 studies into suicidal ideation among women during pregnancy, Gelaye et al (2016) identified several key risk factors including comorbid psychiatric and substance use disorders, intimate partner violence, low educational attainment (i.e., high school or less), childhood physical or sexual abuse, low social support, unplanned pregnancy, being from a non-English speaking background, and multiparity. In another review of 129 studies into suicidal ideation during pregnancy and the postpartum period, Orsolini et al (2016), risk factors identified included younger maternal age, having a past history of suicidal attempt or ideation, experiencing social or racial discrimination, living in a rural area, crowded or inadequate housing, and prior exposure to disaster, conflict or war. Whilst these risk factors reflect social disadvantage and trauma, the evidence generated to date primarily comes from small clinical samples, and is based on retrospective and cross-sectional studies.…”