SUICIDE AND OTHER CAUSES OF MORTALITY AFTER POSTPARTUM PSYCHIATRIC ADMISSION

Background The risk of suicide in postnatal women is low and those sui cides that occur appear to be associated with severe psychiatric illne ss. No previous study has specifically studied the risk of suicide fol lowing post-partum psychiatric disorder. Method We calculated standard ised 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 birt h and causes of death for 1973-1993. Results During the study period 1 567 women were admitted to psychiatric hospital of whom 107 (6.8%) die d. The SMRs (compared with 100) were 1719 (95% CI 1284-2254) for suici de. 1329 (95% Cl 1038-1676) for all unnatural causes and 238 (95% Ci 1 67-329) for natural causes. Suicides and deaths from all unnatural cau ses 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). Concl usions Although postnatal women as a whole appear to have a low rate o f 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.