Suicide and other causes of mortality after post-partum psychiatric admission
Suicide and other causes of mortality after post-partum psychiatric admission
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DOI：
10.1192/bjp.173.3.209
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发表时间：
1998-09-01
影响因子：
10.5
通讯作者：
Faragher, EB
中科院分区：
文献类型：
--
作者：
Appleby, L;Mortensen, PB;Faragher, EB
背景：产后妇女自杀的风险较低，而且这些自杀的发生似乎与严重的精神疾病有关。此前没有研究专门研究产后精神障碍后的自杀风险。方法计算自杀的标准化死亡率（SMRs）。利用丹麦精神病病例登记册与1973-1993年丹麦出生和死亡原因登记册之间的计算机交叉联系，统计分娩后第一年住院精神病医院的妇女的非自然死亡和自然死亡情况。结果在研究期间，1567名妇女在精神病院住院，其中107人（6.8%）死亡。自杀的smr（与100相比）为1719 （95% CI 1284-2254）。1329 （95% Ci 1038-1676）为所有非自然原因，238 （95% Ci 167-329）为自然原因。自杀和所有非自然原因导致的死亡最有可能发生在分娩后的第一年，一年内自杀的SMR为7216 （95% CI 3945-12 108）。结论：虽然总体而言，产后妇女的自杀率似乎较低，但严重的产后精神障碍与自然和非自然原因，特别是自杀导致的高死亡率有关。产后第一年的自杀风险尤其高，自杀风险增加了70倍。此时需要密切的临床监护。
Background The risk of suicide in postnatal women is low and those suicides that occur appear to be associated with severe psychiatric illness. No previous study has specifically studied the risk of suicide following post-partum psychiatric disorder.Method We calculated standardised mortality ratios (SMRs) for suicide. unnatural deaths and deaths from natural causes for women admitted to psychiatric hospital in the first year after childbirth, using computerised cross-linkages between the Danish Psychiatric Case Register and the Danish registers of birth and causes of death for 1973-1993.Results During the study period 1567 women were admitted to psychiatric hospital of whom 107 (6.8%) died. The SMRs (compared with 100) were 1719 (95% CI 1284-2254) for suicide. 1329 (95% Cl 1038-1676) for all unnatural causes and 238 (95% Ci 167-329) for natural causes. Suicides and deaths from all unnatural causes were most likely to occur in the first year after childbirth, the SMR for suicide within one year being 7216 (95% CI 3945-12 108).Conclusions Although postnatal women as a whole appear to have a low rate of suicide, severe post-partum psychiatric disorder is associated with a high rate of deaths from natural and unnatural causes, particularly suicide. The risk is especially high in the first postnatal year, when the suicide risk is increased 70-fold. Close clinical superivision at this time is indicated.