Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
J Clin Psychiatry. 2020 May 5;81(3):19m12993. doi: 10.4088/JCP.19m12993.
To describe the demographic and clinical characteristics of pregnant and postpartum women in Japan with psychoneurological disorders who attempt suicide.
A nationwide retrospective cohort study was conducted using the Diagnosis Procedure Combination database, a national database on acute-care inpatients in Japan. All pregnant and postpartum women who had psychoneurological disorders (ICD-10 codes: O993, F530, F531) and were admitted to participating hospitals from January 2016 to March 2018 were identified. Among eligible patients, the prevalence of suicide attempts, risk factors for suicidal behaviors, maternal outcomes, and other characteristics were investigated.
Among the 3,286 eligible patients (3,026 pregnant women and 260 postpartum women), 22 pregnant women and 16 postpartum women had attempted suicide. The prevalence of suicide attempts was significantly higher among postpartum women (6.2%) than among pregnant women (0.7%; P < .001). Postpartum patients were more likely to be aged 30 years or older and to have depression. Wrist cutting was the main method of suicide attempt among pregnant patients, whereas hanging was the main method among postpartum patients. Three postpartum patients died during hospitalization.
Postpartum patients were more likely to be in critical condition and to use fatal suicide attempt methods compared with pregnant women.
描述日本患有精神神经障碍并企图自杀的孕妇和产后女性的人口统计学和临床特征。
采用全国回顾性队列研究,使用日本急性住院患者全国诊断程序组合数据库。从 2016 年 1 月至 2018 年 3 月,确定所有患有精神神经障碍(ICD-10 编码:O993、F530、F531)并入住参与医院的孕妇和产后女性。在合格的患者中,调查了自杀企图的发生率、自杀行为的危险因素、母婴结局和其他特征。
在 3286 名合格患者中(3026 名孕妇和 260 名产后女性),有 22 名孕妇和 16 名产后女性企图自杀。产后女性自杀企图的发生率(6.2%)显著高于孕妇(0.7%;P<.001)。产后患者更可能年龄在 30 岁或以上且患有抑郁症。手腕切割是孕妇自杀企图的主要方法,而悬挂是产后患者的主要自杀方法。3 名产后患者在住院期间死亡。
与孕妇相比,产后患者的病情更危急,且更倾向于使用致命的自杀企图方法。