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Self-harm in women with postpartum mental disorders.

Authors
  • Johannsen, Benedicte Marie1
  • Larsen, Janne Tidselbak1, 2
  • Laursen, Thomas Munk1, 2
  • Ayre, Karyn3
  • Howard, Louise M3
  • Meltzer-Brody, Samantha4
  • Bech, Bodil Hammer5
  • Munk-Olsen, Trine1
  • 1 National Center for Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210Aarhus, Denmark. , (Denmark)
  • 2 CIRRAU, Centre for Integrated Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210Aarhus, Denmark. , (Denmark)
  • 3 Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • 4 Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA.
  • 5 Department of Public Health, Research Unit of Epidemiology, Aarhus University, Aarhus, Denmark. , (Denmark)
Type
Published Article
Journal
Psychological Medicine
Publisher
Cambridge University Press
Publication Date
Jul 01, 2020
Volume
50
Issue
9
Pages
1563–1569
Identifiers
DOI: 10.1017/S0033291719001661
PMID: 31298172
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Women suffering from first onset postpartum mental disorders (PPMD) have a highly elevated risk of suicide. The current study aimed to: (1) describe the risk of self-harm among women with PPMD and (2) investigate the extent to which self-harm is associated with later suicide. We conducted a register-based cohort study linking national Danish registers. This identified women with any recorded first inpatient or outpatient contact to a psychiatric facility within 90 days after giving birth to their first child. The main outcome of interest was defined as the first hospital-registered episode of self-harm. Our cohort consisted of 1 202 292 women representing 24 053 543 person-years at risk. Among 1554 women with severe first onset PPMD, 64 had a first-ever hospital record of self-harm. Women with PPMD had a hazard ratio (HR) for self-harm of 6.2 (95% CI 4.9-8.0), compared to mothers without mental disorders; but self-harm risk was lower in PPMD women compared to mothers with non-PPMD [HR: 10.1, (95% CI 9.6-10.5)] and childless women with mental disorders [HR: 9.3 (95% CI 8.9-9.7)]. Women with PPMD and records of self-harm had a significantly greater risk for later suicide compared with all other groups of women in the cohort. Women with PPMD had a high risk of self-harm, although lower than risks observed in other psychiatric patients. However, PPMD women who had self-harmed constituted a vulnerable group at significantly increased risk of later suicide.

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