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Self-Harm Thoughts Postpartum as a Marker for Long-Term Morbidity.

Stavros I Iliadis1, Alkistis Skalkidou1, Hanna Ranstrand1

  • 1Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden.

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|March 9, 2018
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Summary

Postpartum self-harm thoughts (SHTs) indicate higher 7-year somatic and psychiatric morbidity, even without depression. Early screening for SHTs is crucial for identifying at-risk mothers needing specialized postpartum care.

Keywords:
maternal morbiditypostpartum depressionpostpartum periodpregnancypsychiatric morbidityself-harm

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Area of Science:

  • Perinatal mental health
  • Reproductive psychiatry
  • Public health

Background:

  • Postpartum depression (PPD) increases risks for maternal affective and somatic disorders.
  • Identifying women at high risk for morbidity and needing intensified follow-up is critical.
  • Self-harm thoughts (SHTs) may predict long-term maternal health beyond PPD.

Purpose of the Study:

  • To investigate the 7-year somatic and psychiatric morbidity in postpartum women experiencing SHTs, with or without other depressive symptoms.

Main Methods:

  • A Swedish population-based cohort study included 107 women with SHTs, 94 with depressive symptoms (EPDS ≥ 12), and 104 controls.
  • Data collected via Edinburgh Postnatal Depression Scale (EPDS) at 5 days, 6 weeks, and 6 months postpartum.
  • Morbidity (diagnostic codes), medical interventions, antidepressant prescriptions, and sick leave were tracked for 7 years.

Main Results:

  • The SHT group exhibited the highest psychiatric morbidity and greater somatic morbidity than controls.
  • Affective disorders, antidepressant prescriptions, and sick leave were more prevalent in SHT and DEP groups versus controls.
  • A fifth of women with SHTs had no concurrent depressive symptoms but still showed increased somatic and psychiatric morbidity.

Conclusions:

  • Postpartum self-harm thoughts are linked to increased 7-year somatic and psychiatric morbidity, independent of depressive symptoms.
  • Results highlight the importance of postpartum screening for self-harm symptoms.
  • Individualized postpartum follow-up is recommended for women reporting SHTs.