The association between a history of self-harm and mental disorders in pregnancy

Background. Mental disorders are major risk factors for suicide. Not all those who suffer from mental disorders kill themselves. Additional information is required to differentiate higher and lesser risk patients.Methods. Retrospective case–control comparison was made of cases of suicide/undetermined death with living controls using psychological autopsy in South East Scotland. Cases and controls were matched for age, sex and mental disorder. Informants were those closest to cases and controls. The subjects were 45 cases of suicide/undetermined death and 40 living controls.Results. Cases and controls did not differ significantly in severity of mental disorder. The main factors independently associated with undetermined death or suicide were: a history of deliberate self-harm (adjusted OR 4·1); physical ill health (adjusted OR 7·8); and engagement by mental health services (adjusted OR 0·01). Other antecedents associated with increased risk (criminal record, police involvement, financial problems and failure to vote) and those associated with decreased risk (contact with a doctor and in-patient care) did not exert effects after controlling for confounding.Conclusions. Controls were receiving more care of whatever kind. Treatment of mental disorder co-morbid with physical illness and a history of deliberate self-harm may be especially important. Factors that separate those with mental disorder at high risk from those at lesser risk relate to care levels provided, which may be a function of engagement by and with health services. The role of mental health professionals is beneficial in suicide prevention. The focusing of that role towards engaging alienated or ‘difficult’ patients should be addressed.

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Prevalence of self-reported mental disorders in pregnancy and associations with adverse neonatal outcomes: a population-based cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2572-4 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

David Mongan ◽

Janine Lynch ◽

Donncha Hanna ◽

Ciaran Shannon ◽

Shona Hamilton ◽

...

Keyword(s):

Northern Ireland ◽

Mental Disorders ◽

Mental Disorder ◽

Neonatal Outcomes ◽

Maternity Services ◽

Adverse Neonatal Outcomes ◽

History Of ◽

Infant Birth ◽

In Pregnancy ◽

Singleton Pregnancies

Abstract Background Mental disorders in pregnancy are common causes of morbidity and mortality with associated risks of adverse neonatal outcomes. Our aims were to evaluate the prevalence of self-reported mental disorders in women presenting to maternity services and to determine the association between history of self-reported maternal mental disorder and adverse neonatal outcomes. Methods Data on all singleton pregnancies known to maternity services in Northern Ireland over the period 2010 to 2015 were extracted from the Northern Ireland Maternity System (NIMATS), including frequency data for number of pregnancies where the mother reported a history of mental disorder. Odds ratios were derived from logistic regression analyses to determine the associations between self-reported maternal mental disorder and preterm birth, low infant birth weight and APGAR scores. Results In total, 140,569 singleton pregnancies were registered using NIMATS over this period. In 18.9% of these pregnancies, the mother reported a history of at least one mental disorder. After adjustment for potential confounding factors, significant associations were demonstrated between self-reported maternal mental disorder and preterm birth (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.25–1.37), low infant birth weight (OR 1.29, 95% CI 1.21–1.38) and APGAR score < 7 at 1 min (OR 1.14, 95% CI 1.10–1.19) and 5 min (OR 1.23, 95% CI 1.12 to 1.34). Conclusions These findings emphasise the critical importance of routine enquiry regarding psychiatric history when women present to maternity services and the impact of maternal mental illnesses upon outcomes for their infants.

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Parental bonding and personality characteristics of first episode intention to suicide or deliberate self-harm without a history of mental disorders

BMC Public Health ◽

10.1186/1471-2458-13-421 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 18

Author(s):

Ya-Fen Hsu ◽

Po-Fei Chen ◽

For-Wey Lung

Keyword(s):

Mental Disorders ◽

Parental Bonding ◽

Personality Characteristics ◽

First Episode ◽

Deliberate Self Harm ◽

History Of ◽

Self Harm

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Ischemic Complications of Pregnancy: Who is at Risk?

US Cardiology Review ◽

10.15420/usc.2016.10.1.14 ◽

2016 ◽

Vol 10 (1) ◽

pp. 14

Author(s):

Sara C Martinez ◽

◽

Sharonne N Hayes ◽

Keyword(s):

Artery Dissection ◽

Cardiac Events ◽

Coronary Artery Dissection ◽

Reduction Strategies ◽

Ischemic Complications ◽

Substantial Risk ◽

History Of ◽

Invasive Management ◽

In Pregnancy

The physiologic demands of pregnancy may either trigger or uncover ischemic heart disease (IHD) via largely unknown mechanisms, leading to an increased mortality compared with nonpregnant individuals. Risk factors for IHD in pregnancy are age, smoking, multiparity, and prior cardiac events. A multidisciplinary team at a referral center is key to coordinating medical or invasive management and inpatient observation. Etiologies may be revealed by experienced angiographers, and are predominantly spontaneous coronary artery dissection, followed by atherosclerotic disease and thrombus, while a significant percentage of women are found to have normal coronary arteries by angiogram. The management of these conditions is varied and, in general, conservative management is preferred with adequate coronary flow and stable hemodynamics. A woman with a history of IHD in pregnancy is at a substantial risk for further complications in future pregnancies and beyond; therefore, aggressive risk factor-reduction strategies and regular cardiology follow-up are imperative to decrease adverse events.

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Tobacco smoking and mental disorders in Australian adolescents

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211009617 ◽

2021 ◽

pp. 000486742110096

Author(s):

David Lawrence ◽

Sarah E Johnson ◽

Francis Mitrou ◽

Sharon Lawn ◽

Michael Sawyer

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Tobacco Smoking ◽

Mental Health Problems ◽

Health Problems ◽

Major Depressive ◽

Current Smoking ◽

Self Harm ◽

Current Tobacco

Objectives: This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. Methods: The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. Results: In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. Conclusion: While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.

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Informal psychiatric patients requesting discharge

Psychiatric Bulletin ◽

10.1192/pb.18.4.209 ◽

1994 ◽

Vol 18 (4) ◽

pp. 209-211

Author(s):

Robin McGilp ◽

Brian Kidd ◽

Cameron Stark ◽

Tom Henderson

Keyword(s):

Substance Abuse ◽

Psychiatric Patients ◽

Medical Advice ◽

Psychotic Illness ◽

Against Medical Advice ◽

The Past ◽

History Of ◽

Self Harm ◽

Discharge Against Medical Advice ◽

Retrospective Investigation

A retrospective investigation of case-notes compared 54 incidents of informal psychiatric in-patients being detained in hospital on an emergency basis with 66 incidents of discharge against medical advice (AMA). The characteristics of the two groups were compared. Detained patients were more likely to have been detained previously, to be suffering from a psychotic illness, and to have threats of violence or self-harm mentioned in their case-notes. AMA patients were more likely to have a history of substance abuse but were no more likely than the detained group to have been discharged AMA in the past. The results suggest that psychiatrists in this hospital are using current legislation on detention appropriately.

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Effect of Marriage on Pre-existing Psychoses: A Convenient or Futile Solution for Severe Mental Disorders?

Journal of Psychosexual Health ◽

10.1177/2631831820971738 ◽

2020 ◽

Vol 2 (3-4) ◽

pp. 273-276

Author(s):

Prakash B. Behere ◽

Aniruddh P. Behere ◽

Debolina Chowdhury ◽

Amit B. Nagdive ◽

Richa Yadav

Keyword(s):

Mental Disorders ◽

Age Of Onset ◽

Social Stigma ◽

Positive Family History ◽

Mental Illnesses ◽

Psychotic Symptoms ◽

Antipsychotic Treatment ◽

Contractual Relationship ◽

History Of ◽

Paranoid Type

Marriage can be defined as the state of being united as spouses in a consensual and contractual relationship recognized by law. The general population generally believes marriage to be a solution to mental illnesses. It can be agreed that mental disorders and marital issues have some relation. Parents of patients with psychoses expect that marriage is the solution to the illness and often approach doctors and seek validation about the success of the marriage of their mentally ill child, which is a guarantee no doctor can give in even normal circumstances. Evidence on sexual functioning in patients of psychosis is limited and needs further understanding. Studies show about 60%–70% women of the schizophrenia spectrum and illness to experience sexual difficulties. Based on available information, sexual dysfunction in population with psychosis can be attributed to a variety of psychosocial factors, ranging from the psychotic symptoms in itself to social stigma and institutionalization and also due to the antipsychotic treatment. Despite the decline in sexual activity and quality of life in general, it is very rarely addressed by both the treating doctor and by the patient themselves hence creating a lacuna in the patient’s care and availability of information regarding the illness’ pathophysiology. Patients become noncompliant with medications due to this undesirable effect and hence it requires to be given more attention during treatment. It was also found that paranoid type of schizophrenia patient had lower chances of separation than patients with other types of schizophrenia. The risk of relapse in cases with later age of onset of the disease, lower education, a positive family history of psychosis or a lower income increased more than other populations.

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Common Mental Disorders and Substance Use in School Children of Eastern Nepal

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v8i1.26331 ◽

2019 ◽

Vol 8 (1) ◽

pp. 17-21

Author(s):

P Sharma ◽

N Thakur ◽

S Sharma ◽

M Pokharel

Keyword(s):

Mental Health ◽

Substance Use ◽

Mental Disorders ◽

Mental Health Problems ◽

Common Mental Disorders ◽

School Mental Health ◽

Prevalence Studies ◽

Common Mental Health Problems ◽

Current Scenario ◽

History Of

Introduction: School mental health is one of the important areas where early detection can lead to appropriate early intervention and burden of disease can be minimized. There is dearth of prevalence studies of common mental disorders on school going adolescents in Nepal. Considering this we aimed to study the prevalence of common mental health problems and substance use in school going adolescents. Material And Method: We evaluated 240 students for common mental disorders (depression and anxiety) using translated version of PHQ-4 and substance use single validated question after taking consent from school authorities and assent from students. Results: It was seen that 68.8 % students had psychological distress. 22.9 % and 27.5% of students had anxiety and depression respectively on screener and 23.3% students had use of substance at least once within a year. When compared male had significantly higher number of substance use as compared to female but no difference in PHQ-4 scores were seen when compared between gender and history of substance use. Conclusion: The study shows the current scenario of school going adolescents in Nepal and highlights the need of prevalence data on more generalizable setting.

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Some Risk Factors for Low Birthweight Infants at Manado Hospital

Paediatrica Indonesiana ◽

10.14238/pi35.3-4.1995.94-100 ◽

2018 ◽

Vol 35 (3-4) ◽

pp. 94-100

Author(s):

S. M. Salendu W. ◽

Sutomo Raharjo ◽

Immanuel Mustadjab ◽

Nan Warouw

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Intrauterine Growth Retardation ◽

Maternal Education ◽

Low Birthweight ◽

Term Infants ◽

Intrauterine Growth ◽

Hypertension In Pregnancy ◽

History Of ◽

In Pregnancy

The risk factors of low birthweight infants were assessed in a retrospective study covering 3607 singleton livebirth infants at Manado Hospital from January until December 1993. The analysis confirmed that patterns of risk birthweight hypertension in pregnancy (P<0.01), maternal education (P<0.01), maternal age (P<0.05), and parity (P<0.01), marital status (P<0.01), history of abortion (P<0.05), and parity (P<0.01). Anemia in pregnancy was also associated with birthweight in low birth weight (P<0.05). Asymetric intrauterine growth retardation (Ponderal Index below 2.32) was found both in premature and term infants.

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Latent profiles of early developmental vulnerabilities in a New South Wales child population at age 5 years

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417740208 ◽

2017 ◽

Vol 52 (6) ◽

pp. 530-541 ◽

Cited By ~ 6

Author(s):

Melissa J Green ◽

Stacy Tzoumakis ◽

Kristin R Laurens ◽

Kimberlie Dean ◽

Maina Kariuki ◽

...

Keyword(s):

Mental Illness ◽

Mental Disorders ◽

Mental Disorder ◽

Early Development ◽

Latent Class ◽

New South ◽

Criminal Offending ◽

Parental History ◽

South Wales ◽

History Of

Objective: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. Methods: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census–defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models. Results: Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ ( N = 4368; 6.5%); (2) ‘pervasive risk’ ( N = 2668; 4.0%); (3) ‘mild generalised risk’ ( N = 7822; 11.6%); and (4) ‘no risk’ ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates. Conclusion: Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

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