The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial
The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial
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DOI：
10.1186/1471-2393-11-57
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发表时间：
2011-08-03
影响因子：
3.1
通讯作者：
Tylee, Andre
中科院分区：
文献类型：
--
作者：
Howard, Louise M.;Flach, Clare;Tylee, Andre
1.1 背景：自杀是工业化国家围产期孕产妇死亡的主要原因，但很少有研究调查产后自杀的患病率或相关性。爱丁堡产后抑郁量表广泛用于初级和产科服务，以筛查围产期抑郁症，并包括一个关于自杀意念的问题（问题 10）。我们的目的是在一项产后抑郁症治疗随机对照试验的背景下调查产后妇女自杀念头的患病率、持续性和相关性。1.2 方法：在纳入随机对照试验之前，我们会在产后 6 周向初级保健中的妇女发送邮寄问卷，以筛查产后抑郁症。爱丁堡产后抑郁量表（EPDS）用于筛查产后抑郁症，对于症状严重的患者，使用临床访谈时间表修订版（CIS-R）进行家访并进行标准化精神病学访谈。测量了其他社会人口统计和临床变量，包括功能（SF12）和婚姻关系质量（GRIMS）。参加试验的女性接受了 18 周的随访。 1.3 结果：4,150 名完成与自杀意念相关的 EPDS 问题的女性中，9% 报告有一些自杀意念（包括几乎没有）； 4% 的人表示，他们有时或经常想到要伤害自己。在参加随机试验并完成与自杀意念相关的 EPDS 问题的女性 (n = 253) 中，多变量分析显示，自杀意念与年龄较小、胎次较高和抑郁症状水平较高相关。对 EPDS 问题 10 的认可“是的，经常”与确认至少两项有关自杀的 CIS-R 项目有关。我们发现自杀意念与 SF-12 身体或心理健康或 18 周时 EPDS 总分之间没有关联。1.4 结论：使用 EPDS 的医疗保健专业人员应该意识到对 EPDS 问题 10 表示“是的，经常”的女性可能存在显着的自杀倾向。然而，自杀意念似乎并不能预测接受产后抑郁症治疗的女性的不良结局。
1.1 Background: Suicide is a leading cause of perinatal maternal deaths in industrialised countries but there has been little research to investigate prevalence or correlates of postpartum suicidality. The Edinburgh Postnatal Depression Scale is widely used in primary and maternity services to screen for perinatal depressive disorders, and includes a question on suicidal ideation (question 10). We aimed to investigate the prevalence, persistence and correlates of suicidal thoughts in postpartum women in the context of a randomised controlled trial of treatments for postnatal depression.1.2 Methods: Women in primary care were sent postal questionnaires at 6 weeks postpartum to screen for postnatal depression before recruitment into an RCT. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for postnatal depression and in those with high levels of symptoms, a home visit with a standardised psychiatric interview was carried out using the Clinical Interview Schedule-Revised version (CIS-R). Other socio-demographic and clinical variables were measured, including functioning (SF12) and quality of the marital relationship (GRIMS). Women who entered the trial were followed up for 18 weeks.1.3 Results: 9% of 4,150 women who completed the EPDS question relating to suicidal ideation reported some suicidal ideation (including hardly ever); 4% reported that the thought of harming themselves had occurred to them sometimes or quite often. In women who entered the randomised trial and completed the EPDS question relating to suicidal ideation (n = 253), suicidal ideation was associated with younger age, higher parity and higher levels of depressive symptoms in the multivariate analysis. Endorsement of 'yes, quite often' to question 10 on the EPDS was associated with affirming at least two CIS-R items on suicidality. We found no association between suicidal ideation and SF-12 physical or mental health or the EPDS total score at 18 weeks.1.4 Conclusions: Healthcare professionals using the EPDS should be aware of the significant suicidality that is likely to be present in women endorsing 'yes, quite often' to question 10 of the EPDS. However, suicidal ideation does not appear to predict poor outcomes in women being treated for postnatal depression.