The role of personality dimensions, depressive symptoms and other psychosocial variables in predicting postpartum suicidal ideation: a cohort study

Abstract

Suicidability has been associated with neuroticism and psychoticism, but its role during perinatal period has not been analyzed. We explore the association between personality dimensions, depressive symptoms, and other psychosocial variables in postpartum suicidal ideation. A cohort of 1795 healthy Spanish women from the general population was assessed for suicidal ideation (EPDS-Item10) in early postpartum, 8 and 32 weeks postpartum. Sociodemographic, obstetric, and reproductive variables, psychiatric history, social support, stressful life-events during pregnancy, depressive symptoms (EPDS), and the Eysenck’s personality dimensions (EPQ-RS) were also assessed at baseline. A major depressive episode (DSM-IV) was confirmed in women with EPDS>10 at follow-up assessments. Descriptive, bivariate, and multivariate analyses were conducted. Adjusted logistic regression analysis was reported as odds ratio (ORs) with 95% confidence intervals (CIs). Seven percent of mothers reported suicidal ideation during the first 8 months postpartum. Sixty-two percent of women with suicidal ideation had a major depressive episode at 8 weeks, and 70% at 32 weeks postpartum. Neuroticism and psychoticism predicted suicidal ideation throughout the first 2 weeks after delivery (OR, 1.03; 95%CI 1.01–1.06; and OR, 1.03; 95%CI 1.01–1.05 respectively). Early postpartum depressive symptoms (OR 1.2; 95%CI 1.11–1.26), personal psychiatric history (OR 2.1; 95%CI 1.33–3.27), and stressful life events during pregnancy (OR 1.88; 95%CI 1.12–3.16) also emerged as predictors of postpartum suicidal ideation. Analysis of women for postpartum suicidal ideation should include not only psychiatric symptoms but also psychosocial assessment (i.e., covering psychiatric history, stressful events, or long-standing personality vulnerabilities) in order to identify those in need of early psychosocial or psychiatric care.

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Acknowledgements

This work was carried out with the Instituto Carlos III (Spanish Ministry of Health) grants, FIS (PI041635, PI041783, PI041779, PI041761, PI041791, PI041766 and PI041782), as well as the Spanish Psychiatric Genetics and Genotyping network GO3/184. We also acknowledge the support of the Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto Carlos III (Spanish Ministry of Health) and the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement, Generalitat de Catalunya (SGR2014/1114; SGR2017/1798). We would like to thank all women who agreed to participate in the study.

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E. Gelabert and A. Gutierrez-Zotes both are first authors.

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Gelabert, E., Gutierrez-Zotes, A., Navines, R. et al. The role of personality dimensions, depressive symptoms and other psychosocial variables in predicting postpartum suicidal ideation: a cohort study. Arch Womens Ment Health 23, 585–593 (2020). https://doi.org/10.1007/s00737-019-01007-w

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Keywords

  • Suicidal ideation
  • Postpartum
  • Depression
  • Neuroticism
  • Psychoticism
  • Personality dimensions