title: Self-harm in postpartum depression and referrals to a perinatal mental health team: an audit study.
abstract: There is a paucity of research on self-harm during pregnancy and the postpartum period despite suicide being a leading cause of death and high rates of mental disorder during this time. This audit describes a cohort of women referred to a new perinatal mental health team (PMHT) based in a large maternity hospital in the UK over a 12-month period. The audit was conducted in two stages. Stage one describes the clinical and socio-demographic characteristics of 225 pregnant women referred to the team after screening positive for a significant mental health history. Stage two determines the veracity of data on a subgroup of 73 pregnant women referred for previous postpartum depression (PPD), 58 % of whom disclosed an episode of self-harm with the 'intent to kill themselves' to the maternity staff when they first booked in for antenatal care. Previous PPD accounted for the largest majority of referrals (32 %) to the PMHT followed by depression (27 %) and self-harm (10 %). The majority of women (85 %) referred to the PMHT were engaged. Eight percent were so unwell at the point of referral they required an admission to the hospital. Attempted suicide in the subgroup of 73 women with previous PPD ranged from 24-49 %. The findings from this audit suggest that self-harm in PPD warrants further investigation.
authors: University of Liverpool, Waterhouse Building, Block B, 2nd Floor, Liverpool, UK, chealey@liverpool.ac.uk.
authors: Christine
authors: C
authors: Healey
authors: Richard
authors: R
authors: Morriss
authors: Carol
authors: C
authors: Henshaw
authors: Ovais
authors: O
authors: Wadoo
authors: Aamer
authors: A
authors: Sajjad
authors: Helen
authors: H
authors: Scholefield
authors: Peter
authors: P
authors: Kinderman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008485:Medical Audit; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult