Non-fatal self-harm and suicide following postpartum psychiatric emergency department visits: A population-based retrospective cohort study

Lucy C Barker; Hilary K Brown; Susan E Bronskill; Kinwah Fung; Paul Kurdyak; Juveria Zaheer; Simone N Vigod

doi:10.1016/j.psychres.2024.115856

Non-fatal self-harm and suicide following postpartum psychiatric emergency department visits: A population-based retrospective cohort study

Psychiatry Res. 2024 May:335:115856. doi: 10.1016/j.psychres.2024.115856. Epub 2024 Mar 11.

Authors

Lucy C Barker¹, Hilary K Brown², Susan E Bronskill³, Kinwah Fung⁴, Paul Kurdyak⁵, Juveria Zaheer⁶, Simone N Vigod⁷

Affiliations

¹ Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; ICES, Toronto, Canada; Women's College Hospital, Toronto, Canada. Electronic address: [email protected].
² Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; ICES, Toronto, Canada; Women's College Hospital, Toronto, Canada; Department of Health & Society, University of Toronto Scarborough, Toronto, Canada.
³ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; ICES, Toronto, Canada; Women's College Hospital, Toronto, Canada.
⁴ ICES, Toronto, Canada.
⁵ Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; ICES, Toronto, Canada; Centre for Addiction and Mental Health, Toronto, Canada.
⁶ Department of Psychiatry, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health, Toronto, Canada.
⁷ Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; ICES, Toronto, Canada; Women's College Hospital, Toronto, Canada.

PMID: 38484607
DOI: 10.1016/j.psychres.2024.115856

Abstract

In a population-based cohort of postpartum individuals in Ontario, Canada, this study aimed to determine the risk of non-fatal self-harm and suicide within one year of an initial postpartum psychiatric emergency department (ED) visit (2008-2020), and the key associated factors. Of 16,475 postpartum individuals with psychiatric ED visits, 714 (4.3 %) had non-fatal self-harm within one year, and 23 (0.15 %) died by suicide. Risk was substantially higher for those with self-harm at the initial presentation. Further efforts to connect individuals with postpartum psychiatric ED visits with needed inpatient care and outpatient follow-up are required to reduce non-fatal self-harm and suicide risk.

Keywords: Postpartum period; Self-injurious behavior; Suicide.

MeSH terms

Emergency Room Visits
Emergency Service, Hospital
Female
Humans
Ontario / epidemiology
Postpartum Period
Retrospective Studies
Self-Injurious Behavior* / epidemiology
Self-Injurious Behavior* / psychology
Suicide* / psychology