Rating scale item assessment of self-harm in postpartum women: a cross-sectional analysis

• Published in: Archives of women's mental health 2017-10, Vol.20 (5), p.687-694
• Main Authors: Coker, Jessica L., Tripathi, Shanti P., Knight, Bettina T., Pennell, Page B., Magann, Everett F, Newport, D. Jeffrey, Stowe, Zachary N.
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Care and treatment; Children; Complications and side effects; Cross-Sectional Studies; Demographic aspects; Depression - diagnosis; Depression - psychology; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Diagnosis; Drug therapy; Female; Follow-Up Studies; Georgia - epidemiology; Gestation; Humans; Medicine; Medicine & Public Health; Mental depression; Mothers - psychology; Original Article; Postpartum; Postpartum depression; Postpartum period; Postpartum Period - psychology; Pregnancy; Pregnancy - psychology; Pregnancy Trimesters; Pregnant Women - psychology; Psychiatric Status Rating Scales; Psychiatry; Psychometrics; Psychotherapy; Reproducibility of Results; Risk Factors; Self destructive behavior; Self injurious behavior; Self-Injurious Behavior - epidemiology; Self-Injurious Behavior - psychology; Sensitivity and Specificity; Suicidal Ideation; Suicide; Suicides & suicide attempts; Surveys and Questionnaires; Trauma; Womens health; Young Adult
• ISSN: 1434-1816; 1435-1102
• DOI: 10.1007/s00737-017-0749-2

We examined the utility of screening instruments to identify risk factors for suicidal ideation (SI) in a population of women with neuropsychiatric illnesses at high risk for postpartum depression. Pregnant women with neuropsychiatric illness enrolled prior to 20 weeks of gestation. Follow-up visits at 4–8-week intervals through 13 weeks postpartum included assessment of depressive symptoms with both clinician and self-rated scales. A total of 842 women were included in the study. Up to 22.3% of postpartum women admitted SI on rating scales, despite the majority (79%) receiving active pharmacological treatment for psychiatric illness. Postpartum women admitting self-harm/SI were more likely to meet criteria for current major depressive episode (MDE), less than college education, an unplanned pregnancy, a history of past suicide attempt, and a higher score on the Childhood Trauma Questionnaire. In women with a history of neuropsychiatric illness, over 20% admitted SI during the postpartum period despite ongoing psychiatric treatment. Patient-rated depression scales are more sensitive screening tools than a clinician-rated depression scale for +SI in the postpartum period.