Journal
AMERICAN JOURNAL OF PSYCHIATRY
Volume 173, Issue 6, Pages 635-642Publisher
AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.ajp.2015.14121510
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Funding
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, MEPRICA (Mental Health in Primary Care)
- NIMH [R01MH104468]
- Lundbeck Foundation [R155-2012-11280]
- NIH [1R01MH104468-01]
- Foundation of Hope
- Sage Therapeutics
- Lundbeck Foundation [R155-2014-1724, R155-2012-11280] Funding Source: researchfish
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Objective: The postpartum period is associated with a high risk of psychiatric episodes. The authors studied mortality in women with first-onset severe psychiatric disorders following childbirth and compared their mortality rates with those in women from the background population including other female psychiatric patients (mothers and childless women). Method: In a register-based cohort study with linked information from Danish population registers, the authors identified women with first psychiatric inpatient or outpatient contacts 0-3 months postpartum. The main outcome measure was mortality rate ratios (MRRs): deaths from natural causes (diseases and medical conditions) or unnatural causes (suicides, accidents, and homicides). The cohort included 1,545,857 women representing 68,473,423 person-years at risk. Results: In total, 2,699 women had first-onset psychiatric disorders 0-3 months postpartum, and 96 of these died during follow-up. Women with postpartum psychiatric disorders had a higher MRR (3.74; 95% CI=3.06-4.57) than non postpartum-onset mothers (MRR=2.73; 95% CI=2.67-2.79) when compared with mothers with no psychiatric history However, childless women with psychiatric diagnoses had the highest MRR (6.15; 95% CI=5.94-6.38) Unnatural cause of death represented 40.6% of fatalities among women with postpartum psychiatric disorders, and within the first year after diagnosis, suicide risk was drastically increased (MRR=289.42; 95% CI=144.02-581.62) when compared with mothers with no psychiatric history. Conclusions: Women with severe postpartum psychiatric disorders had increased MRRs compared with mothers without psychiatric diagnoses, and the first year after diagnosis represents a time of particularly high relative risk for suicide in this vulnerable group.
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