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Fogarty A, McMahon G, Findley H, Hosking C, Schulz M, Seymour M, Leach L, Borschmann R, Garfield CF, Giallo R. Prevalence of suicidal and self-harm ideation in fathers during the perinatal and early parenting period: A systematic review and meta-analysis. Aust N Z J Psychiatry 2024:48674241267896. [PMID: 39118251 DOI: 10.1177/00048674241267896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Suicide is a leading cause of death in males aged 25-44 years, an age which often coincides with becoming a father. This review aims to synthesise the evidence of the prevalence of suicidal and self-harm ideation in fathers during the perinatal, postnatal and early parenting period. METHODS Five databases were searched (PsycINFO, Medline, Web of Science, PubMed and the Cochrane Database of Systematic Reviews) to identify papers published between 1 January 2000 and 9 March 2023. A meta-analysis was conducted to estimate the prevalence of suicidality and self-harm ideation across the included studies. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity. RESULTS A total of 4215 articles were identified, with 14 studies included in the review. The combined pooled prevalence of suicidal and self-harm ideation was 4.2% (95% CI [2.6%, 6.2%]). Prevalence estimates were higher for self-harm ideation at 5.1% (95% CI [2.6%, 6.2%]) than for suicidality at 3% (95% CI [0.9%, 6.1%]). CONCLUSIONS This review found that a considerable proportion of fathers experience suicidal and self-harm ideation during the early years of parenting. However, the paucity of rigorous prevalence studies indicates that further research in this area is needed urgently.
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Affiliation(s)
- Alison Fogarty
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Grace McMahon
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Helen Findley
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Casey Hosking
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Madison Schulz
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Monique Seymour
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Liana Leach
- The National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Craig F Garfield
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Lurie Children's Hospital, Chicago, IL, USA
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
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Clapp MA, Castro VM, Verhaak P, McCoy TH, Shook LL, Edlow AG, Perlis RH. Stratifying Risk for Postpartum Depression at Time of Hospital Discharge. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.27.24307973. [PMID: 38854098 PMCID: PMC11160818 DOI: 10.1101/2024.05.27.24307973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Objective Postpartum depression (PPD) represents a major contributor to postpartum morbidity and mortality. Beyond efforts at routine screening, risk stratification models could enable more targeted interventions in settings with limited resources. Thus, we aimed to develop and estimate the performance of a generalizable risk stratification model for PPD in patients without a history of depression using information collected as part of routine clinical care. Methods We performed a retrospective cohort study of all individuals who delivered between 2017 and 2022 in one of two large academic medical centers and six community hospitals. An elastic net model was constructed and externally validated to predict PPD using sociodemographic factors, medical history, and prenatal depression screening information, all of which was known before discharge from the delivery hospitalization. Results The cohort included 29,168 individuals; 2,703 (9.3%) met at least one criterion for postpartum depression in the 6 months following delivery. In the external validation data, the model had good discrimination and remained well-calibrated: area under the receiver operating characteristic curve 0.721 (95% CI: 0.707-0.734), Brier calibration score 0.088 (95% CI: 0.084 - 0.092). At a specificity of 90%, the positive predictive value was 28.0% (95% CI: 26.0-30.1%), and the negative predictive value was 92.2% (95% CI: 91.8-92.7%). Conclusions These findings demonstrate that a simple machine-learning model can be used to stratify the risk for PPD before delivery hospitalization discharge. This tool could help identify patients within a practice at the highest risk and facilitate individualized postpartum care planning regarding the prevention of, screening for, and management of PPD at the start of the postpartum period and potentially the onset of symptoms.
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Affiliation(s)
- Mark A. Clapp
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Victor M. Castro
- Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Research Information Science and Computing, Mass General Brigham, Somerville, MA
| | - Pilar Verhaak
- Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Thomas H. McCoy
- Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Lydia L. Shook
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Andrea G. Edlow
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Roy H. Perlis
- Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Yang Y, Zheng R, Yang L, Huang X, Zhang T. Decision tree-Markov model of perinatal depression screening: a cost-utility analysis. Front Public Health 2024; 12:1308867. [PMID: 38832225 PMCID: PMC11144866 DOI: 10.3389/fpubh.2024.1308867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 04/29/2024] [Indexed: 06/05/2024] Open
Abstract
Background Perinatal depression affects the physical and mental health of pregnant women. It also has a negative effect on children, families, and society, and the incidence is high. We constructed a cost-utility analysis model for perinatal depression screening in China and evaluated the model from the perspective of health economics. Methods We constructed a Markov model that was consistent with the screening strategy for perinatal depression in China, and two screening strategies (screening and non-screening) were constructed. Each strategy was set as a cycle of 3 months, corresponding to the first trimester, second trimester, third trimester, and postpartum. The state outcome parameters required for the model were obtained based on data from the National Prospective Cohort Study on the Mental Health of Chinese Pregnant Women from August 2015 to October 2016. The cost parameters were obtained from a field investigation on costs and screening effects conducted in maternal and child health care institutions in 2020. The cost-utility ratio and incremental cost-utility ratio of different screening strategies were obtained by multiplicative analysis to evaluate the health economic value of the two screening strategies. Finally, deterministic and probabilistic sensitivity analyses were conducted on the uncertain parameters in the model to explore the sensitivity factors that affected the selection of screening strategies. Results The cost-utility analysis showed that the per capita cost of the screening strategy was 129.54 yuan, 0.85 quality-adjusted life years (QALYs) could be obtained, and the average cost per QALY gained was 152.17 yuan. In the non-screening (routine health care) group, the average cost was 171.80 CNY per person, 0.84 QALYs could be obtained, and the average cost per QALY gained was 205.05 CNY. Using one gross domestic product per capita in 2021 as the willingness to pay threshold, the incremental cost-utility ratio of screening versus no screening (routine health care) was about -3,126.77 yuan, which was lower than one gross domestic product per capita. Therefore, the screening strategy was more cost-effective than no screening (routine health care). Sensitivity analysis was performed by adjusting the parameters in the model, and the results were stable and consistent, which did not affect the choice of the optimal strategy. Conclusion Compared with no screening (routine health care), the recommended perinatal depression screening strategy in China is cost-effective. In the future, it is necessary to continue to standardize screening and explore different screening modalities and tools suitable for specific regions.
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Affiliation(s)
- Yehuan Yang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruimin Zheng
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Yang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xing Huang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tong Zhang
- Capital Institute of Pediatrics, Beijing, China
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Radoš SN, Akik BK, Žutić M, Rodriguez-Muñoz MF, Uriko K, Motrico E, Moreno-Peral P, Apter G, den Berg MLV. Diagnosis of peripartum depression disorder: A state-of-the-art approach from the COST Action Riseup-PPD. Compr Psychiatry 2024; 130:152456. [PMID: 38306851 DOI: 10.1016/j.comppsych.2024.152456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice. METHODS To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis. RESULTS When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications. CONCLUSION There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maria F Rodriguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Kristiina Uriko
- Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| | - Gisèle Apter
- Child and Perinatal Psychiatric Department, Le Havre University Hospital, University Rouen Normandie, Le Havre, France
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Vidyasagaran AL, McDaid D, Faisal MR, Nasir M, Muliyala KP, Thekkumkara S, Wright J, Huque R, Benkalkar S, Siddiqi N. Prevalence of mental disorders in South Asia: A systematic review of reviews. Glob Ment Health (Camb) 2023; 10:e78. [PMID: 38161740 PMCID: PMC10755414 DOI: 10.1017/gmh.2023.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024] Open
Abstract
Mental disorders are increasing in South Asia (SA), but their epidemiological burden is under-researched. We carried out a systematic umbrella review to estimate the prevalence of mental disorders and intentional self-harm in the region. Multiple databases were searched and systematic reviews reporting the prevalence of at least one mental disorder from countries in SA were included. Review data were narratively synthesised; primary studies of common mental disorders (CMDs) among adults were identified from a selected subset of reviews and pooled. We included 124 reviews. The majority (n = 65) reported on mood disorders, followed by anxiety disorders (n = 45). High prevalence of mental disorders and intentional self-harm was found in general adult and vulnerable populations. Two reviews met our pre-defined criteria for identifying primary studies of CMDs. Meta-analysis of 25 primary studies showed a pooled prevalence of 16.0% (95% CI = 11.0-22.0%, I 2 = 99.9%) for depression, 12.0% (5.0-21.0%, I 2 = 99.9%) for anxiety, and 14.0% (10.0-19.0, I 2 = 99.9%) for both among the general adult population; pooled estimates varied by country and assessment tool used. Overall, reviews suggest high prevalence for mental disorders in SA, but evidence is limited on conditions other than CMDs.
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Affiliation(s)
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Muhammad Nasir
- Department of Economics, Institute of Business Administration (IBA), Karachi, Pakistan
| | - Krishna P. Muliyala
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | | | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Najma Siddiqi
- Department of Health Sciences, University of York, Heslington, UK
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Llosa JA, Agulló-Tomás E, Menéndez-Espina S, Oliveros B. Revisiting the work-suicide link: renewed evidence and models of analysis in workplace contexts. Front Psychol 2023; 14:1290079. [PMID: 37928562 PMCID: PMC10620721 DOI: 10.3389/fpsyg.2023.1290079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
Suicide is a priority public health problem for the World Health Organization. It is a multifactorial phenomenon, for which there is no effective strategy for prevention and reduction. The scientific knowledge generated has not paid much attention to the differentiating role of work and employment on the phenomenon of suicide. This article first presents Abrutyn's recent conceptual model of suicide, which has a psychosocial, holistic and integrated approach. Based on this model, it examines the most recent and solid evidence and trends linking working conditions and phenomenon of suicide, identifying the most relevant findings in work stress theories. It concludes by pointing out avenues of development for a more holistic and ecological understanding of suicide.
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Affiliation(s)
- José Antonio Llosa
- Faculty of P. Ossó, Department of Social Education, University of Oviedo, Oviedo, Spain
| | - Esteban Agulló-Tomás
- Faculty of Pyschology, Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Sara Menéndez-Espina
- Faculty of P. Ossó, Department of Social Education, University of Oviedo, Oviedo, Spain
| | - Beatriz Oliveros
- Faculty of P. Ossó, Department of Social Education, University of Oviedo, Oviedo, Spain
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Manolova G, Waqas A, Chowdhary N, Salisbury TT, Dua T. Integrating perinatal mental healthcare into maternal and perinatal services in low and middle income countries. BMJ 2023; 381:e073343. [PMID: 37220917 PMCID: PMC10203867 DOI: 10.1136/bmj-2022-073343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Gergana Manolova
- Brain Health Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Ahmed Waqas
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, UK
| | - Neerja Chowdhary
- Brain Health Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Tarun Dua
- Brain Health Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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Dudeney E, Coates R, Ayers S, McCabe R. Measures of suicidality in perinatal women: A systematic review. J Affect Disord 2023; 324:210-231. [PMID: 36584713 DOI: 10.1016/j.jad.2022.12.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Suicide is a leading cause of death for perinatal women. Identifying women at risk of suicide is critical. Research on the validity and/or reliability of measures assessing suicidality in perinatal women is limited. This review sought to: (1) identify; and (2) evaluate the psychometric properties of suicidality measures validated in perinatal populations. METHODS Nine electronic databases were systematically searched from inception to January 2022. Additional articles were identified through citation tracking. Study quality was assessed using an adapted tool, and the psychometric properties of measures were reviewed and presented using a narrative synthesis. RESULTS A total of 208 studies were included. Thirty-five studies reported psychometric data on ten suicidality measures. Fifteen studies reported both validity and reliability data, 12 reported more than one type of validity, seven validated more than one measure and four only reported reliability. Nearly all measures primarily screened for depression, with an item or subscale assessing suicidal ideation and/or behaviours. Three measures were specifically developed for perinatal women, but only two were validated in more than one study. The Postpartum Depression Screening Scale (PDSS), suicidal thoughts subscale, was validated most frequently. LIMITATIONS Methodological differences and variability between the measures (e.g., suicidality construct assessed, number of items and administration) precluded direct comparisons. CONCLUSION Further validation of suicidality measures is needed in perinatal women. Screening for perinatal suicidality often occurs in the context of depression. The development of a standalone measure specifically assessing suicidality in perinatal women may be warranted, particularly for use in maternity care settings.
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Affiliation(s)
- Elizabeth Dudeney
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK.
| | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Rose McCabe
- Centre for Mental Health Research, School of Health and Psychological Sciences, University of London, UK
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Zungu P, Louw KA, Slabbert P, Bantjes J. 'They Sent Me Out to School, and I Came Back with a Baby': Perinatal Women's Experiences of Biographical Disruption and Nonfatal Suicidal Behaviour. QUALITATIVE HEALTH RESEARCH 2022; 32:1767-1779. [PMID: 35938716 DOI: 10.1177/10497323221119314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Exploring perinatal women's experience of nonfatal suicidal behaviour (NFSB) could help illuminate the contexts in which perinatal suicide occurs and new ways to conceptualise maternal suicide prevention. Our aim was to explore perinatal women's subjective experience of NFSB in South Africa. Data were collected via in-depth interviews with seven perinatal women hospitalised following NFSB. Thematic analysis showed how poverty and gender norms shape experiences of pregnancy and highlighted the need for eco-systemic interventions for perinatal women in resource scarce environments to increase social support, assist with childcare, improve educational retention, challenge gender norms and increase paternal involvement. Pregnancy can precipitate biographical disruption by disturbing women's view of themselves and their futures. An inability to reconstruct a coherent narrative and re-imagine the future impedes the transition to motherhood and provides a context for suicide. Using the concept of biographical disruption to frame perinatal suicide, could identify novel approaches to suicide prevention.
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Affiliation(s)
- Pamela Zungu
- Department of Psychiatry, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, South Africa
| | - Kerry-Ann Louw
- Department of Psychiatry, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, South Africa
| | - Philip Slabbert
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- Alcohol, Tobacco and Other Drug Research Unit, 59097South African Medical Research Council, South Africa
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Arditi-Arbel B, Hamdan S, Winterman M, Gvion Y. Suicidal ideation and behavior among perinatal women and their association with sleep disturbances, medical conditions, and known risk factors. Front Psychiatry 2022; 13:987673. [PMID: 36741562 PMCID: PMC9893018 DOI: 10.3389/fpsyt.2022.987673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Suicide is considered one of the leading causes of maternal mortality, especially among women with postpartum depression. In the current systematic review, we conducted a qualitative data synthesis of recent studies exploring novel risk factors including sleep disturbances and medical conditions, alongside known and significant risk factors for perinatal suicidality. EVIDENCE ACQUISITION We conducted a systematic search of the literature according to PRISMA guidelines on PubMed, PsycNET, and Scopus databases. Search terms were "pregnancy" "OR" "postpartum" "OR" "peripartum" "OR" "perinatal" "OR" "postnatal" combined with the Boolean "AND" operator with "suicide" "OR" "suicidality" "OR" "suicidal ideation" "OR" "suicidal behavior." EVIDENCE SYNTHESIS The initial search yielded 1,458 records, of which 51 research reports that met inclusion criteria were analyzed. These 51 studies sampled a total of 45,942 participants. Clinically, sleep disturbance, psychopathology, and social support have been identified as dominant risk factors for suicidal behavior among pregnant and postpartum women, as well as medical conditions and aversive life events. CONCLUSION Monitoring sleep disturbance, depression, and perceived social support is critical given that they are significant risk factors for suicide among perinatal women. Early identification of perinatal women who may be at risk of suicide, although not depressed, is crucial. LIMITATIONS The use of tools designed to identify depression to identify suicidal risk, fail to identify women who are at risk but who do not suffer from depression. Other methodological limitations are the lack of longitudinal studies and the complexity of examining suicidal behavior in sample studies.
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Affiliation(s)
- Bar Arditi-Arbel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Sami Hamdan
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
| | - May Winterman
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Yari Gvion
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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