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Suicide and other causes of mortality after post-partum psychiatric admission

  • Louis Appleby (a1), Preben B. Mortensen (a2) and E. Brian Faragher (a3)

Abstract

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% CI 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.

Copyright

Corresponding author

Louis Appleby, School of Psychiatry and Behavioural Sciences, University of Manchester, Withington Hospital, West Didsbury, Manchester M20 8LR

References

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Suicide and other causes of mortality after post-partum psychiatric admission

  • Louis Appleby (a1), Preben B. Mortensen (a2) and E. Brian Faragher (a3)
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