Over a period spanning four decades, a total of eight Danish women committed suicide within a year of being diagnosed with a birth-related psychiatric disorder, including severe episodes of postpartum depression or psychosis. Despite the modest number, statistical evidence of a causal link between postpartum disorder and suicide is extremely strong, highlighting the need for medical staff to be aware of the risk, according to the researchers who carried out the study.
The findings have been published in the paper "All-Cause Mortality in Women With Severe Postpartum Psychiatric Disorders" in the American Journal of Psychiatry and are the result of an ambitious research project carried out by a team of epidemiologists at Aarhus BSS, Denmark, in cooperation with colleagues in the Netherlands and the United States.
The study demonstrates that overall, mothers with postpartum psychological disorders have a four times higher risk of death from natural or unnatural causes during the follow-up period, than mothers without postpartum disorders. At the same time, mothers with postpartum disorders face roughly the same mortality rates as mothers with psychological disorders unrelated to childbirth.
Crucially, however, even compared with that group, mothers with postpartum disorders are more likely to commit suicide during the first 12 months after giving birth. The high suicide risk among women with postpartum psychiatric disorders has been described before, but this study is the first to carry out a comprehensive comparison with other categories of women, enabling the researchers to focus on the exact causal link between birth and suicide risk.
"The suicide cases are very rare, but when they do happen, they are of course extremely tragic. And it's not what people expect. The general belief is that a new mother doesn't take her own life, and that she ought to be enjoying motherhood, but the reality isn't always like that. We think it's important that women with postpartum psychiatric disorders are properly diagnosed and get the treatment they need, which possibly can prevent that they commit suicide," said Trine Munk-Olsen, a senior researcher at the Department of Economics at Aarhus BSS and one of the lead authors of the paper.
The researchers employed the data of a total of 1,545,857 Danish women, covering all or most of the period between 1970 and 2011. This could not have been possible without the existence of rich data sets maintained by various government agencies in Denmark. Only a small number of countries have data this deep and detailed, providing social scientists with a goldmine of information to test their hypotheses.
"The data give us the option of following the mothers over the very long term, almost 40 years, which is extremely helpful in putting the statistics into perspective. We've been able to track all the women over the years, the only exception being if they emigrated. Denmark is in a group of countries, especially in the Nordic region, that maintain detailed population registers. In addition, Denmark is unique in having psychiatric data reaching back so many years in time," said Munk-Olsen.
The researchers received financial support from iPSYCH (Lundbeck Foundation Initiative for Integrative Psychiatric Research), MEPRICA (Mental Health in Primary Care), NIMH, The Foundation of Hope, and Sage Therapeutics.
American Journal of Psychiatry