A study just published in the August 2008 issue of the American Journal of Obstetrics & Gynecology, found that a history of psychiatric disorders or substance abuse was a strong predictor of post-partum suicide attempts.

After adjusting for fetal or infant death and other variables, women who had been previously hospitalized for psychiatric disorders were more than 27 times as likely to attempt suicide as women without this medical history. Women with a history of substance abuse were six times as likely to attempt suicide, while psychiatric hospitalization and substance abuse together increased the risk by 11 times.

A recent recommendation from The American College of Obstetricians and Gynecologists suggested screening for psychosocial risk factors, including depression during prenatal care. This article emphasizes the need for more careful follow-up of postpartum women with current or past psychiatric diagnoses or substance use. The authors state, "Future studies should evaluate the effectiveness of screening for psychiatric and substance use disorders on decreasing adverse outcomes such as suicide attempts during the postpartum period. If found to be effective, such interventions may prevent the devastating impact associated with postpartum suicide attempt."

The article is "Psychiatric risk factors associated with postpartum suicide attempt in Washington State, 1992-2001" by Katherine A. Comtois, PhD; Melissa A. Schiff, MD, MPH; and David C. Grossman, MD, MPH. This study was supported by a grant from the American Foundation for Suicide Prevention.

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