Perinatal Depression and Risk of Suicidal Behavior
Hang Yu1, Qing Shen2,3, Emma Bränn1
1Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
JAMA Network Open
|January 9, 2024
Summary
Women with perinatal depression (PND) face a significantly higher risk of suicidal behavior, especially in the first year post-diagnosis. This elevated risk persists for up to 18 years, necessitating ongoing clinical attention for this vulnerable population.
Area of Science:
- Reproductive Medicine
- Psychiatry
- Epidemiology
Background:
- Perinatal depression (PND) affects many women, yet long-term data on suicidal behavior risk are scarce.
- Understanding the long-term risks associated with PND is crucial for effective maternal mental health care.
Purpose of the Study:
- To investigate the association between PND and both short-term and long-term risks of suicidal behavior.
- To quantify the risk of suicide attempts and completed suicides in women with PND.
Main Methods:
- A nationwide population-matched cohort study in Sweden (2001-2017) included over 86,000 women with PND and matched controls.
- Sibling comparison was utilized to control for familial factors.
- Time-to-event analysis estimated hazard ratios (HR) for suicidal behavior.
Main Results:
- Women with PND exhibited a 3.15-fold increased risk of suicidal behavior compared to unaffected women (HR 3.15).
- The risk was substantially higher in the first year post-diagnosis (HR 7.20) but remained significant up to 18 years (HR 2.34).
- The association was stronger for postnatal depression and in women without prior psychiatric history.
Conclusions:
- Perinatal depression significantly elevates the risk of suicidal behavior.
- The increased risk is most pronounced early after diagnosis but persists long-term.
- Vigilant clinical monitoring is essential for women with PND due to sustained suicidal behavior risk.
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