Perceived Social Support as a Protective Factor for Suicidal Ideation in Pregnant Women

Authors

  • Pilar Carolina Castelao Legazpi Universidad Nacional de Educación a Distancia
  • Maria Fe Rodriguez-Muñoz FACULTAD PSICOLOGÍA UNED https://orcid.org/0000-0002-1908-0405
  • María Eugenia Olivares Hospital Clínico San Carlos, Universidad Complutense de Madrid
  • Cristina Soto Balbuena Hospital Universitario Central de Asturias
  • Nuria Izquierdo Méndez Hospital Clínico San Carlos, Universidad Complutense de Madrid http://orcid.org/0000-0002-5099-5849

DOI:

https://doi.org/10.5944/ap.18.2.29517

Keywords:

Suicidal ideation, Perceived Social Support, Prevention, Pregnancy

Abstract

Introduction: Motherhood is a time in women's lives when support from the social environment is especially needed to mitigate the demands required by the gestation period and the immediate postpartum period. 

Methods: In this multicentre study, the sample includes 1524 pregnant women recruited from the obstetric area of two Spanish tertiary care hospitals. We compare the responses of women who report suicidal ideation with those who report no suicidal ideation. We analyzed their responses to item 9 of the Patient Health Questionnaire (PHQ-9) and comparing the differences in the different dimensions of the PHQ-9 (cognitive-affective, psychomotor and pregnancy-related somatic).  Analysing their responses on the Postpartum Depression Predictors Inventory (PDPI-R), we also studied which components of perceived social support worked as predictors of prenatal suicidal ideation. 

Results: Women with suicidal ideation have higher pregnancy-related cognitive-affective, psychomotor and somatic burden compared to those without suicidal ideation. Perceived lack of emotional support from partners or friends and perceived lack of practical support from family are predictors of suicidal ideation. 

Introduction: Maternity is a time in women's lives when the support of the social environment is especially needed to mitigate the demands required by the gestation period and the immediate postpartum period. 

Methods: In this multicentre study, the sample includes 1524 pregnant women recruited from the obstetric area of two Spanish tertiary care hospitals. We compare the responses of women who report suicidal ideation with those who report no suicidal ideation, analysing their responses to item 9 of the Patient Health Questionnaire (PHQ-9) and comparing the differences in the different dimensions of the PHQ-9 (cognitive-affective, somatic and puerperal). 

We analysed which components of perceived social support functioned as predictors of prenatal suicidal ideation by analysing their responses on the Postpartum Depression Predictors Inventory (PDPI-R). Results: Women with suicidal ideation have higher cognitive-affective, somatic and puerperal burden compared to those without suicidal ideation. Perceived lack of emotional support from partners or friends and perceived lack of practical support from family are predictors of suicidal ideation. 

Discussion: Providing women with effective social support is important to prevent suicidal ideation.

 

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References

Alexander, L., Rodríguez, M., Perry D. y Le H. (2014). The Latent Symptom Structure of the Beck Depression Inventory: Second edition in Latina Pregnant Women. Maternal and Child Health Journal, 18, 1132–1141. https://doi.org/10.1007/s10995-013-1343-5

Arachchi, N., Ganegama, R. y Husna, A. (2019). Suicidal Ideation and Intentional Self-Harm in Pregnancy as a Neglected Agenda in Maternal Health: An Experience From Rural Sri Lanka. Reproductive Health, 16, Artículo 166. https://doi.org/10.1186/s12978-019-0823-5

Barra, E. (2004). Apoyo social estrés y salud [Social Support, Stress, and Health]. Psicología y Salud, 14, 237–243. https://doi.org/10.25009/pys.v14i2.848

Barrón, A. y Chacón, F. (1992). Apoyo social percibido: su efecto protector frente a los acontecimientos vitales estresantes [Perceived Social Support: Its Protective Effect in Stressful Events]. Revista de Psicología Social, 7(1), 53–59. https://doi.org/10.1080/02134748.1992.10821654

Beck, C. (2002). Revision of the Postpartum Depression Predictors Inventory. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(4), 394–402. https://doi.org/10.1111/j.1552-6909.2002.tb00061.x

Biaggi, A., Conroy, S., Pawlby, S. y Pariante, C. (2016). Identifying the Women at Risk of Antenatal Anxiety and Depression: A Systematic Review. Journal of Affective Disorders, 191, 62–77. https://doi.org/10.1016/j.jad.2015.11.014

Bitew, T., Hanlon, C., Medhin, G. y Fekadu, A. (2019). Antenatal Predictors of Incident and Persistent Postnatal Depressive Symptoms in Rural Ethiopia: A Population-based Prospective Study. Reproductive Health, 16(1), Artículo 28. https://doi.org/10.1186/s12978-019-0690-0

Billings, A. y Moss, T. (1981). The Role of Coping Responses and Social Resources in Attenuating the Impact of Stressful Life Events. Journal of Behavioral Medicine, 4, 139–157. https://doi.org/10.1007/BF00844267

Brown, J., Harris, S., Woods, E., Buman, M. y Cox, J. (2012). Longitudinal Study of Depressive Symptoms and Social Support in Adolescent Mothers. Maternal and Child Health Journal, 16(4), 894–901. https://doi.org/10.1007/s10995-011-0814-9

Brown, S. L. (2000). The Effect of Union Type on Psychological Well-being. Depression among Cohabitors versus Married. Journal of Health and Social Behavior, 41, 241–255. https://doi.org/10.2307/2676319

Casey, P., Dunn, G. y Kelly, B. (2006). Factors Associated with Suicidal Ideation in the General Population: Five-centre Analysis from the ODIN Study. The British Journal of Psychiatry, 189, 410–415. https://doi.org/10.1192/bjp. bp.105.017368

Chen, R., Ben-Haroush, A., Weismann-Brenner, A., Melamed, N., Hod, M. y Yogev, Y. (2007). Level of Glycemic control and Pregnancy Outcome in Type 1 Diabetes: A Comparison between Multiple Daily Insulin Injections and Continuous Subcutaneous Insulin Infusions. American Journal of Obstetrics and Gynecology, 197(4), 404.e1-5.. https://doi.org/10.1016/j.ajog.2007.06.007

Coelho, F., Pinheiro, R., Silva, R., de Ávila, L., de Mattos, L. y de Matos, M. (2014). Parental Bonding and Suicidality in Pregnant Teenagers: A Population-based Study in Southern Brazil. Social Psychiatry and Psychiatric Epidemiology, 49(8), 1241–1248. https://doi.org/10.1007/s00127-014-0832-1

Field, T. (2010). Postpartum Depression Effects on Early Interactions, Parenting, and Safety Practices: A Review. Infant Behavior & Development, 33, 1–6. https://doi.org/10.1016/j.infbeh.2009.10.005

Flynn, H., Sexton, M., Ratliff, S., Porter, K., y Zivin, K. (2011). Comparative performance of the Edinburgh Postnatal Depression Scaleand the Patient Health Questionnaire-9 in pregnant and postpartum women seeking psychiatric services. Psychiatry Research, 187, 130–134. https://doi.org/10.1016/j.psychres.2010.10.022

Fuhr, D., Calvert, C., y Ronsmans, C. (2014). Contribution of Suicide and Injuries to Pregnancy-Related Mortality in Low-income and Middle-Income Countries: A Systematic Review and Meta-analysis. The Lancet Psychiatry, 1, 213–225. https://doi.org/10.1016/S2215-0366(14)70282-2

Gan, Y., Xiong, R., Song, J., Xiong, X., Yu, F., Gao, W., Hu, H., Zhang, J., Tian, Y., Gu, X., Zhang, J. y Chen, D. (2019). The Effect of Perceived Social Support during Early Pregnancy on Depressive Symptoms at 6 weeks Postpartum: A Prospective Study. BMC Psychiatry, 19, Artículo 232. https://doi.org/10.1186/s12888-019-2188-2

Gavin, A., Tabb, K., Melville, J., Guo, Y. y Katon, W. (2011). Prevalence and Correlates of Suicidal Ideation during Pregnancy. Archives of Womens Ment Health, 14(3), 239–246. https://doi.org/10.1007/s00737-011-0207-5

Gómez, L., Pérez, M. y Vila, J. (2001). Problemática actual del apoyo social y su relación con la salud: una revisión [Current Issuess on Social Support and their Relationships with Health: A Review]. Psicología Conductual, 9(1), 5-8.

Guarino, L., Scremín, F. y Borrás, S. (2013). Nivel de información y apoyo social como predictoras de la salud y calidad de vida durante el embarazo [Level of Information and Social Support as Predictors of Health and Quality of Life during Pregnancy]. Psychologia Avances de la Disciplina, 7(1), 13–21. https://doi.org/10.21500/19002386.1190

Heisel, M., Flett, G. y Besser, A. (2002). Cognitive Functioning and Geriatric Suicide Ideation: Testing a Mediational Model. The American Journal of Geriatric Psychiatry, 10(4), 428–436. https://doi.org/10.1097/00019442-200207000-00009

Huang, H., Faisal-Cury, A., Chan, Y., Tabb, K., Katon, W., y Menezes, P. (2012). Suicidal Ideation during Pregnancy: Prevalence and Associated Factors among Low-income Women in Sao Paulo, Brazil. Archives of Womens Mental Health, 15, 135–138. https://doi.org/10.1007/s00737-012-0263-5

Ibarra-Yruegas, B., Lara, M. A., Navarrete, L., Nieto, L. y Kawas, O. (2018). Psychometric Properties of the Post-partum Depression Predictors Inventory-Revised for Pregnant Women in Mexico. Journal of Health Psychology, 23(11), 1415–1423. https://doi.org/10.1177/1359105316658969

Ikeda, M. y Kamibeppu, K. (2013). Measuring the Risk Factors for Postpartum Depression: Development of the Japanese version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R-J). BMC Pregnancy Childbirth, 13, Artículo 112. https://doi.org/10.1186/1471-2393-13-112

Kitamura, T., Shima, S., Sugawara, M. y Toda, M. (1996). Clinical and Psychosocial Correlates of Antenatal Depression: A Review. Psychother Psychosom, 65(3), 117–123. https://doi.org/10.1159/000289062

Kroenke, K., Spitzer, R. y Williams, J. (2001). The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Lara, A. y Letechipía, G. (2009). Ideación y comportamiento suicida en embarazadas [Suicidal Ideation and Suicidal Behavior in Pregnancy]. Salud Mental, 32(5), 381–387.

Lara, A., Navarro, C., Navarrete, L., Cabrera, M. y Almanza, J. (2006). Sintomatología depresiva en el embarazo y factores asociados en tres instituciones de salud de la ciudad de México. Salud Mental, 29(4), 55-62.

Lazarus, R. y Folkman, S. (1984). Coping and Adaptation. En W.D. Gentry (Ed.), The Handbook of Behavioral Medicine (pp. 282–325). Guildford. https://doi.org/10.1002/9781118453940

Leis, P. y Gallegos, R. (2018). Relación entre apoyo social, estrés, ansiedad y depresión durante el embarazo en una población Mexicana [elationship between social support, stress, anxiety and depression during pregnancy in a specific mexican population]. Ansiedad y Estrés, 24(2–3), 67–72. https://doi.org/10.1016/j.anyes.2018.03.003

Lotero, H., Villa, I. y Torres, L. (2018). Afectividad y apoyo social percibido en mujeres gestantes: un análisis comparativo [Affectivity and Perceived Social Support in Pregnant Women: A Comparative Analysis]. Revista Colombiana de Psicología, 27(2), 85–101. https://doi.org/10.15446/rcp.v27n2.65584

Manea, L., Gilbody, S. y McMillan, D. (2015). A Diagnostic Meta-analysis of the Patient Health Questionnaire-9 (PHQ-9) Algorithm Scoring Method as a Screen for Depression. General Hospital Psychiatry, 37, 67–75. https://doi.org/10.1016/j.genhosppsych.2014.09.009

Marcos-Nájera, R., Huynh-Nhu, L., Rodríguez-Muñoz, M., Olivares, M. e Izquierdo N. (2018). The Structure of the Patient Health Questionnaire-9 in Pregnant Women in Spain. Midwifery, 62, 36–41. https://doi.org/10.1016/j.midw.2018.03.011

Matvienko-Sikar, K., Pope, J., Cremin, A., Carr, H., Leitao, S., Olander, E. K. y Meaney, S. (2020). Differences in Levels of Stress, Social Support, Health Behaviours, and Stress-Reduction Strategies for Women Pregnant before and during the COVID-19 Pandemic, and Based on Phases of Pandemic Restrictions, in Ireland. Women and Birth: Journal of the Australian College of Midwives, 34(5), 447–454. https://doi.org/10.1016/j.wombi.2020.10.010

Mella-Morambuena, J., López-Angulo, Y., Sáez-Delgado, Y. y Del Valle, M. (2020). Estrategias de afrontamiento en apoderados durante el confinamiento por la COVID-19 [Coping Strategies for the Powerful during the COVID-19 Confinement]. Cienciamérica, 9(2), 322–333. https://doi.org/10.33210/ca.v9i2.324

Melville, J., Gavin, A., Guo, Y., Fan, M. y Katon, W. (2010). Depressive Disorders during Pregnancy: Prevalence and Risk Factors in a Large Urban Sample. Obstetrics & Gynecology, 116(5), 1064–1070. https://doi.org/10.1097/AOG.0b013e3181f60b0a

Myer, L., Stein, D. y Grimsrud, A. (2008). Social Determinants of Psychological Distress in a Nationally-Representative Sample of South African Adults. Social Science & Medicine, 66, 1828–1840. https://doi.org/10.1016/j.socscimed.2008.01.025

National Institute for Health and Clinical Excellence [NICE]. (2014). Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance–Updated Edition. NICE Clinical Guidelines. https://www.nice.org.uk/guidance/cg192

Nnachebe, M., Field, S., Bantjes, J. y Honikman, S. (2017). Perinatal Suicidal Ideation and Behavior: Psychiatry and Adversity. Archives of Womens Mental Health, 20, 321–331. https://doi.org/10.1007/s00737-016-0706-5

Newport, D., Levey, L., Pennell, P., Ragan, K. y Stowe, Z. (2007). Suicidal Ideation in Pregnancy: Assessment and Clinical Implications. Archives of Women's Mental Health, 10(5), 181–187. https://doi.org/10.1007/s00737-007-0192-x

Pérez, S., Marco, J. H. y García-Alandete, J. (2017). The Role of Hopelessness and Meaning in Life in a Clinical Simple with Non-suicidal Self-injury and Suicide Attempts. Psicothema, 29(3), 323–328. https://doi.org/10.7334/psicothema2016.284

Rodriguez-Marin, J., Pastor, A. y Lopez-Roig, S. (1993). Afrontamiento, apoyo social, calidad de vida y enfermedad [Coping, Social Support, Quality of the Life and Diesease]. Psicothema, 5, 349–372.

Rodríguez-Marín, J., Terol, M., López-Roig, S., Martín-Aragón, M., Neipp, M. y Pastor, M. (2003). Apoyo social, afrontamiento y estado de salud en los pacientes oncológicos. Revista de Psicología Universitas Tarraconensis, 25, 37–51. https://doi.org/10.11144/Javerianacali.PPSI15-2.rase

Rodríguez-Muñoz, M., Vallejo, L., Olivares, M., Izquierdo, N., Soto, C., y Le, H. (2017). Propiedades psicométricas del Postpartum Depression Predictors Inventory-Revised, Versión Prenatal en una muestra española de mujeres embarazadas [Psychometric Properties of Postpartum Depression Predictors Inventory- revised- Prenatal version in a Sample of Spanish Pregnant Women]. Revista Española de Salud Pública, 91, Artículo e201712047.

Sandín, B. (2003). El estrés: un análisis basado en el papel de los factores sociales. Journal of Clinical and Health Psychology, 3(1), 141–157.

Sit, D., Luther, J., Buysse, D., Dills, J. L., Eng, H. y Okun, M. (2015). Suicidal Ideation in Depressed Postpartum Women: Associations with Childhood Trauma, Sleep Disturbance and Anxiety. Journal of Psychiatric Reserch, 6, 95–104. https://doi.org/10.1016/j. jpsychires.2015.04.021

Smith, M., Sanchez, S., Rondon, M., Gradus, J. y Gelaye, B. (2020). Validation of the Patient Health Questionnaire-9 (PHQ-9) for Detecting Depression among Pregnant Women in Lima, Peru. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological, 41(6), 3797–3805. https://doi.org/10.1007/s12144-020-00882-2

Tambelli, R., Trentini, C., Trovato, A. y Volpi, B. (2019). Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy. Infant Mental Health Journal, 40(4), 541–556. https://doi.org/10.1002/imhj.21791

Turecki, G. y Brent, D. A. (2016). Suicide and Suicidal Behaviour. Lancet, 387(10024), 1227–1239. https://doi.org/10.1016/S0140-6736(15)00234-2

U. S. Preventive Services Task Force. (USPSTF). (2002). Screening for Depression: Recommendations and Rationale. Annals of Internal Medicine, 136(10), 760–764. https://doi.org/10.7326/0003-4819-136-10-200205210-00012

Valdés, M. y García-Esteve, Ll. (2016). Manual de psiquiatría perinatal. Guía para el manejo de los trastornos mentales durante el embarazo, posparto y lactancia. Panamericana.

Velloza, J., Njoroge, J., Ngure, K., Thuo, N., Kiptinness, C., Momanyi, R., Ayub, S., Gakuo, S., Mugo, N., Simoni, J. y Heffron, R. (2020). Cognitive Testing of the PHQ-9 for Depression Screening among Pregnant and Postpartum Women in Kenya. BMC Psychiatry, 20(1), Artículo 31. https://doi.org/10.1186/s12888-020-2435-6

World Health Organization. (2014). Preventing suicide: A global imperative. Autor. http://apps.who.int/iris/bitstream/10665/131056/1/9789241564779_eng.pdf

Zhong, Q., Gelaye, B., Rondom, M., Sánchez, S., Simon, G., Henderson, D., Barrios, Y., Mascaro, P. y Williams, M. (2015). Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to Assess Suicidal Ideation among Pregnant Women in Lima, Peru. Archives of Womens Mental Health, 18, 783–792. https://doi.org/10.1007/s00737-014-0481-0

Zhong, Q., Gelaye, B., Fann, J. R., Sanchez, S. E. y Williams, M. A. (2014). Cross-cultural Validity of the Spanish version of PHQ-9 among Pregnant Peruvian women: a Rasch item Response Theory Analysis. Journal of Affective Disorders 158, 148–153. https://doi.org/10.1016/j.jad.2014.02.012

Published

2023-03-30

How to Cite

Castelao Legazpi, P. C., Rodriguez-Muñoz, M. F., Olivares, M. E., Soto Balbuena, C., & Izquierdo Méndez, N. (2023). Perceived Social Support as a Protective Factor for Suicidal Ideation in Pregnant Women. Acción Psicológica, 18(2), 77–88. https://doi.org/10.5944/ap.18.2.29517

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Section

Artículos de temática libre [Selection of articles]