Suicidal ideation in the perinatal period: findings from the Thailand–Myanmar border

Author:

Fellmeth G1,Nosten S2,Khirikoekkong N2,Oo M M2,Gilder M E3,Plugge E4,Fazel M5,Fitzpatrick R6,McGready R27

Affiliation:

1. National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK

2. Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mae Sot, Thailand

3. Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

4. Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK

5. Department of Psychiatry, University of Oxford, Oxford, UK

6. Nuffield Department of Population Health, University of Oxford, Oxford, UK

7. Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

Abstract

Abstract Background Suicide is a leading cause of maternal death globally. Migrant and refugee populations may experience higher risk of suicide. We report data on suicidal ideation from migrant and refugee women living on the Thailand–Myanmar border. Methods Women were recruited in their first trimester of pregnancy. Depression status was assessed by diagnostic interview in the first, second and third trimesters and at 1 month post-partum. We calculated prevalence of suicidal ideation and used logistic regression to identify associated socio-demographic factors. Results During the perinatal period, 5.3% (30/568) women experienced suicidal ideation. Refugee women were more likely to experience suicidal ideation than migrant women (8.0 versus 3.1%; P = 0.01). Most women with suicidal ideation did not have severe depression. Previous trauma (OR 2.32; 95% CI: 1.70–3.15) and unplanned pregnancy (OR 2.74; 95% CI: 1.10–6.86) were significantly associated with suicidal ideation after controlling for all other variables. Conclusions Suicidal ideation represents an important symptom among migrant and refugee women on the Thailand–Myanmar border. Screening only those with severe depression may be insufficient to identify women at risk of suicide. Community-level interventions addressing social and gender inequalities and prioritization of family planning programmes are needed alongside targeted suicide prevention initiatives to help lower the rates of people dying by suicide.

Funder

Wellcome Trust

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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