Mental health, substance use and intimate partner problems among pregnant and postpartum suicide victims in the National Violent Death Reporting System

Abstract

Objectives Suicide during pregnancy and the postpartum is a tragic event for the victim and profoundly impacts the baby, the family, and the community. Prior efforts to study risks for pregnancy-associated suicide have been hampered by the lack of data sources which capture pregnancy and delivery status of victims. Introduction of the United States National Violent Death Reporting System (NVDRS) offers new insights into violent deaths by linking multiple data sources and allowing better examination of psychosocial risk factors. Methods The analysis used data from 17 states reporting to the NVDRS from 2003–2007 to evaluate suicide patterns among pregnant, postpartum, and non-pregnant or postpartum women. Demographic factors, mental health status, substance use, precipitating circumstances, intimate partner problems, and suicide methods were compared among groups. Results The 2083 female suicide victims of reproductive age demonstrated high prevalence of existing mental health diagnosis and current depressed mood with depressed mood significantly higher among postpartum women. Substance use and presence of other precipitating factors were high and similar among groups. Intimate partner problems were higher among pregnant and postpartum victims. Postpartum women were more likely die via asphyxia as cause of death compared to poisoning or firearms Conclusions These findings describe important mental health, substance use, and intimate partner problems seen with pregnancy-associated suicide. The study highlights mental health risk factors which could potentially be targeted for intervention in this vulnerable population.

Perinatal suicide in Ontario, Canada: a 15-year population-based study

“…2,[28][29][30][31] These findings suggest that perinatal women who are suicidal may be at higher risk for suicide completion than women outside the perinatal period. Similar to research in other countries, 32 most of the women who died perinatally had a mood or anxiety disorder, rather than a psychotic disorder. This serves as a reminder not to underestimate the possible serious consequences of nonpsychotic postpartum mental disorders.…”

Factors influencing attitude toward intimate partner violence

“…It is responsible for both women's adverse physical (Ford-Gilboe et al, 2009;Stein & Kennedy, 2001) and mental health (Lindhorst & Oxford, 2008). Studies have demonstrated relationships between IPV and physical injuries (Macy, Giattina, Sangster, Crosby, & Montijo, 2009), homicide (McLaughlin, O'Carroll, & O'Connor, 2012), deliberate self-harm (Jaquier, Hellmuth, & Sullivan, 2013), depression (Huang, Yang, & Omaye, 2011;Taft, Bryant-Davis, Woodward, Tillman, & Torres, 2009), post-traumatic stress disorders (Nixon, Resick, & Nishith, 2004;Peltzer, Pengpid, McFarlane, & Banyini, 2013), suicide thoughts and behaviors (Devries et al, 2011;Gold, Singh, Marcus, & Palladino, 2012) and human immunodeficiency virus (HIV) (El-Bassel, Gilbert, Wu, Go, & Hill, 2005;Sareen, Pagura, & Grant, 2009). Research has also proved that IPV had profound harmful effect on woman's well-being (Beccaria et al, 2013).…”

Is Screening for Depression in the Perinatal Period Enough? The Co-Occurrence of Depression, Substance Abuse, and Intimate Partner Violence in Culturally Diverse Pregnant Women

“…29 Further, depression and suicidal ideation have been identified as common sequelae of IPV. 17,21,30 Data also show there are associations between IPV in the perinatal period and poor maternal health behaviors, such as greater use of ATOD, a lower likelihood of ceasing substance use during pregnancy, and delay in prenatal care. 31,32 Substance abuse by women of childbearing age (8%-18% prevalence) is problematic because it poses hazards to women's health and reproductive health.…”