Association between perinatal depressive symptoms and suicidal risk among low-income South African women: a longitudinal study.

Journal: Social psychiatry and psychiatric epidemiology

Volume: 54

Issue: 10

Year of Publication: 2020

Affiliated Institutions:  Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, Sawkins Road, Rondebosch, Cape Town, , South Africa. emily.garman@uct.ac.za. Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, Sawkins Road, Rondebosch, Cape Town, , South Africa.

Abstract summary 

The aim of this study was to assess the association between depressive symptoms and suicidal risk over time among perinatal women at risk for depression antenatally, and assess modifying effects of age, perinatal stage and depressive symptom trajectory.A total of 384 adult pregnant women were recruited from two antenatal clinics in an informal settlement near Cape Town, South Africa, and followed up at eight months gestation, and at 3- and 12-month postpartum. The MINI 6.0 Suicidality module and the Hamilton Depression Rating Scale (HDRS) were used to measure suicidal risk and depression, respectively. Generalised Estimating Equations were used to assess the association between change in depressive symptoms from one assessment to the next (predictor) and change in suicide score or change in suicidal risk (score ≥ 9) (outcomes).HDRS scores were positively correlated with suicide score (95% CI 0.35, 0.78; p < 0.001), and with odds of being at moderate risk for suicide, after controlling for risk of suicide at the previous assessment (adjusted odds ratio = 1.15; 95% CI 1.09, 1.22; p < 0.001). Age was a significant effect modifier: change in HDRS scores was not associated with change in suicide scores among participants aged 35-45 years. Secondary analyses indicated that a decrease in HDRS score was associated with a decrease in suicide scores, but an increase in HDRS score was not associated with change in suicide score.Depression and suicide are overlapping but relatively independent phenomena, especially among older or more chronically depressed perinatal women.

Authors & Co-authors:  Garman Emily C EC Cois Annibale A Schneider Marguerite M Lund Crick C

Study Outcome 

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Statistics
Citations :  World Health Organization (2018) Global Health Estimates 2016: Deaths by cause, age, sex, by country and by region, 2000–2016. World Health Organization, Geneva, Switzerland
Authors :  4
Identifiers
Doi : 10.1007/s00127-019-01730-w
SSN : 1433-9285
Study Population
Women
Mesh Terms
Adolescent
Other Terms
Depression;Longitudinal;Perinatal;South Africa;Suicide
Study Design
Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
Germany