Drug abuse linked to postpartum suicidal ideation.

WASHINGTON -- Current major depressive episode and drug abuse appear to be significant predictors of suicidal ideation in postpartum women, according to a study of 400 women with a history of neuropsychiatric illness who were followed before and after delivery.

Women with a current major depressive episode had an almost 11-fold increased risk of suicidal ideation in the postpartum period, based on multivariate analysis (odds ratio 10.8). Women with a history of opioid abuse or dependence had an almost 30-fold increased risk (odds ratio 29.6), and those with a history of polydrug dependence had a 64-fold increased risk (odds ratio 64.4), reported Dr. Tamara E. Weiss of the women's mental health program at Emory University, Atlanta.

A history of eating disorders or miscarriage also were significant predictors of postpartum depression, with odds ratios of 6.5 and 7.5, respectively.

Dr. Weiss and her colleagues included women from a cohort participating in a prospective observational study of perinatal psychiatric illness. In all, 400 women were included, with a mean age of 24 years. Most (91%) were white; 5% were black, and 4% were of other races. Major depressive disorder was diagnosed in 70% of the women, and 40% were diagnosed with any substance abuse or dependence, Dr. Weiss said in a poster presented at the annual meeting of the American Psychiatric Association.

The identification of major depressive disorder and history of substance abuse as risk factors for suicidal ideation is consistent with extant data. "The strong association between major depressive episode and postpartum suicidal ideation reinforces the importance of early detection and treatment of puerperal depression," she noted.

BY KERRI WACHTER

Senior Writer