Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Obstetrics and Gynecology, University of Washington Medicine, Seattle, Washington, USA.
J Womens Health (Larchmt). 2022 Oct;31(10):1481-1489. doi: 10.1089/jwh.2021.0646. Epub 2022 Aug 18.
Suicide is a public health issue, and there are differences between men and women in terms of suicide ideation, behavior, and completion. Obstetrician/gynecologists (OB/GYNs) are uniquely positioned to assess women's suicide risk. A 53-question survey was distributed to the Pregnancy-Related Care Research Network, assessing practice, attitudes, and knowledge regarding suicide risk assessment and management, and personal experience with suicide. Wilcoxon signed-rank tests with paired samples were used to compare the frequency of screening and interventions for different groups of women, and practices of those with and without suicide experience. Significance was set at < 0.05. Response rate was 31.9%. Respondents were largely White females. OB/GYNs reported more frequently screening for suicide ideation/intent/behavior among pregnant and postpartum patients than nonpregnant/nonpostpartum patients of childbearing age. The most common assessment tool was the Edinburgh Postnatal Depression Scale; half ask about past suicide ideation/behavior or current thoughts/plans. The most common intervention for at-risk patients was a mental health referral; all interventions were reported more frequently for pregnant patients. Common barriers to screening were inadequate mental health services, time constraints, and inadequate training. Most agreed suicide screening is within their purview, and were knowledgeable about the topic, although gaps were identified. Few reported adequate training in suicide risk assessment, and believed continuing education would be beneficial. A majority endorsed experience with suicide and some practice differences emerged. OB/GYNs view suicide risk assessment in their scope. Some knowledge gaps were identified, and respondents believe additional training would be beneficial.
自杀是一个公共卫生问题,男性和女性在自杀意念、行为和完成方面存在差异。妇产科医生(OB/GYN)在评估女性自杀风险方面具有独特的地位。我们向妊娠相关护理研究网络分发了一份包含 53 个问题的调查,评估了他们在自杀风险评估和管理方面的实践、态度和知识,以及他们个人的自杀经历。采用配对样本的 Wilcoxon 符号秩检验比较了不同女性群体的筛查和干预频率,以及有和没有自杀经历的医生的实践。设定显著性水平为 < 0.05。应答率为 31.9%。应答者主要是白人女性。OB/GYN 报告说,在妊娠和产后患者中筛查自杀意念/意图/行为的频率高于育龄期非妊娠/非产后患者。最常用的评估工具是爱丁堡产后抑郁量表;一半的医生询问过去的自杀意念/行为或当前的想法/计划。对于高危患者最常见的干预措施是心理健康转介;所有干预措施在妊娠患者中报告的频率更高。筛查的常见障碍包括心理健康服务不足、时间限制和培训不足。大多数人认为自杀筛查是他们的职责范围,并对该主题有一定的了解,但也发现了一些差距。很少有人报告在自杀风险评估方面有足够的培训,他们认为继续教育培训将是有益的。大多数人赞同他们有自杀经验,并且出现了一些实践差异。OB/GYN 认为自杀风险评估在他们的职责范围内。虽然发现了一些知识差距,但受访者认为额外的培训将是有益的。