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Self-Harm Thoughts Postpartum as a Marker for Long-Term Morbidity
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden..ORCID iD: 0000-0002-4935-7532
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, Athens, Greece.
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2018 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 6, article id 34Article in journal (Refereed) Published
Abstract [en]

Introduction: Postpartum depression predisposes to maternal affective and somatic disorders. It is important to identify which women are at an increased risk of subsequent morbidity and would benefit from an intensified follow-up. Self-harm thoughts (SHTs), with or without other depressive symptomatology, might have prognostic value for maternal health beyond the postpartum period. Aim: This study is to investigate the somatic and psychiatric morbidity of postpartum women with SHTs, with or without other depressive symptoms, over a 7-year follow-up period. Materials and methods: The subjects for this study are derived from a population based Swedish cohort of women who gave birth at Uppsala University Hospital (May 2006-June 2007) and who answered the Edinburgh Postnatal Depression Scale (EPDS) at 5 days, 6 weeks, and 6 months postpartum. Three groups were included: women reporting SHTs (SHT group, n = 107) on item 10 of the EPDS; women reporting depressive symptoms, i.e., EPDS >= 12 at 6 weeks and/or 6 months postpartum, without SHTs (DEP group, n = 94); and randomly selected controls screening negatively for postpartum depression (CTL group, n = 104). The number of diagnostic codes for somatic and psychiatric morbidity according to the International Statistical Classification of Diseases and Related Health Problems system, and the number of medical interventions were retrieved from medical records over 7 years following childbirth and were used as the outcome measures, together with any prescription of antidepressants and sick leave during the follow-up. Results: The SHT group had the highest psychiatric morbidity of all groups and more somatic morbidity than controls. Affective disorders were more common in the SHT and the DEP groups compared with controls, as well as antidepressant prescriptions and sick leave. One-fifth of women with SHTs did not screen positive for depressive symptoms; nevertheless, they had more somatic and psychiatric morbidity than the control group. Conclusion: Women reporting thoughts of self-harm in the postpartum period are at an increased risk of somatic and psychiatric morbidity during a follow-up of 7 years after delivery, and this increased risk may not be fully attributed to depressive symptoms. Results underline the importance of screening for self-harm symptoms postpartum and point to a need for individualized follow-up.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA , 2018. Vol. 6, article id 34
Keywords [en]
self-harm, postpartum depression, maternal morbidity, pregnancy, postpartum period, psychiatric morbidity
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-348914DOI: 10.3389/fpubh.2018.00034ISI: 000425815300001OAI: oai:DiVA.org:uu-348914DiVA, id: diva2:1201283
Funder
Swedish Research Council, 523-2014-2342Swedish Society for Medical Research (SSMF), SLS-250581Marianne and Marcus Wallenberg Foundation, MMW2011.0115Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-25Bibliographically approved

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Iliadis, Stavros ISkalkidou, AlkistisAxfors, CathrinePapadopoulos, Fotios

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Iliadis, Stavros ISkalkidou, AlkistisAxfors, CathrinePapadopoulos, Fotios
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Obstetrics and Reproductive Health ResearchDepartment of Women's and Children's HealthPsychiatry, University Hospital
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Frontiers In Public Health
Public Health, Global Health, Social Medicine and EpidemiologyObstetrics, Gynecology and Reproductive Medicine

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