Ideación suicida durante el embarazo

  1. CASTELAO LEGAZPI, PILAR CAROLINA
Dirigida por:
  1. María de la Fe Rodríguez Muñoz Directora

Universidad de defensa: UNED. Universidad Nacional de Educación a Distancia

Fecha de defensa: 28 de junio de 2022

Tribunal:
  1. Miguel Ángel Vallejo Pareja Presidente
  2. Susana Al-Halabi Díaz Secretario/a
  3. Pluvio Jesus Coronado Martin Vocal

Tipo: Tesis

Teseo: 740137 DIALNET lock_openTESEO editor

Resumen

 Introducción: motivación de la Tesis El embarazo puede ser una experiencia increíblemente hermosa para algunas mujeres. Hay quienes disfrutan de este periodo de sus vidas. Otras, por múltiples circunstancias, como pueden ser experimentar malestar y cansancio o cambios en el estado de ánimo, quizá necesiten cierta ayuda a la hora de gestionar sus emociones y pensamientos asociados a la gestación, así como a todos los cambios actuales y venideros que experimentan.  Desarrollo teórico El objetivo principal de esta Tesis Doctoral fue estudiar la Ideación Suicida durante el Embarazo. Para ello, se han abordado varios aspectos. En primer lugar, se hizo una revisión narrativa para conocer la realidad internacional de esta cuestión. A continuación, un segundo estudio se elaboró con el objetivo de conocer la prevalencia de la ideación suicida durante el embarazo y los factores de riesgo asociados en nuestro contexto. Tras estudiar lo anterior con una muestra amplia de embarazadas en España, el foco de atención se centró en examinar cómo funciona el apoyo social percibido en relación a la aparición de ideación suicida durante el embarazo. Posteriormente, se abordó la elaboración de un protocolo de identificación y manejo de caso ante la ideación suicida en mujeres embarazadas en nuestro contexto.  Conclusión Las conclusiones obtenidas se pueden sintetizar en que es necesario: (1) identificar la Ideación Suicida en las primeras semanas de Embarazo, mediante screening adecuados; (2) reconocer los Factores de Riesgo que hacen vulnerables a las mujeres embarazadas a la hora de la aparición de Ideación Suicida; (3) identificar los Factores Protectores de la misma; e (4) incorporar Intervenciones Preventivas, como protocolos estandarizados, en el Sistema Nacional de Salud [SNS], para mitigar los efectos negativos de la Ideación Suicida en Embarazadas. Llevando a cabo lo anterior, se favorece la Salud Mental Materna, se contribuye positivamente al entorno de la mujer y al desarrollo del bebé, se optimizan los recursos del sistema de salud y se obtienen beneficios socioeconómicos a medio y largo plazo.  Bibliografía Al-Halabi, S., Mayoral, M., Corcoran, P., Brodsky, B., y Stanley, B. (2019). Suicidio durante el embarazo y el posparto. [Suicide during pregnancy and postpartum]. En M.F. Rodríguez-Muñoz (Ed.). Psicología Perinatal. Teoría y práctica (pp. 259 – 273). Pirámide. Alhusen, J. L., Frohman, N., y Purcell, G. (2015). Intimate partner violence and suicidal ideation in pregnant women. Archives of women's mental health, 18(4), 573–578. https://doi.org/10.1007/s00737-015-0515-2 Beck, C., Records, K., y Rice, M. (2006). Further development of the Postpartum Depression Predictors Inventory-Revised. Journal of obstetric, gynecologic, and neonatal nursing: JOGNN, 35(6), 735–745. https://doi.org/10.1111/j.1552-6909.2006.00094.x 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), 28. https://doi.org/10.1186/s12978-019-0690-0 Brodsky, B., Spruch-Feiner, A., y Stanley, B. (2018). The Zero Suicide Model: Applying evidence-based suicide prevention practices to clinic care. Frontiers in Psychiatry, 9, 33. https://doi.org/10.3389/fpsyt.2018.00033 Centre for Women's Mental Health (2022, Febrero 20). Suicidal ideation in pregnant women not always associated with depression. Women’s Mental Health. https://www.womensmentalhealth.org/posts/suicidal-ideation-in-pregnant-women/ Centre of Perinatal Excellence [COPE] (2022, Febrero 20). Mental health care in the perinatal period: Australian clinical practice guideline. Centre of Perinatal Excellence. https://www.cope.org.au/wp-content/uploads/2018/05/COPE-Perinatal-MH-Guideline_Final-2018.pdf Centro de Psicología Aplicada [CPA] de la Universidad Autónoma de Madrid (2022, Febrero 20). Protocolo para la Detección y Manejo Inicial de la Ideación Suicida. CPA. https://psicologosemergenciasbaleares.files.wordpress.com/2018/01/protocolo_ideacion_suicida.pdf Copersino, M., Jones, H., Tuten, M., y Svikis, D. (2008). Suicidal Ideation Among Drug-Dependent Treatment-Seeking Inner-City Pregnant Women. Journal of maintenance in the addictions, 3(2-4), 53–64. https://doi.org/10.1300/J126v03n02_07 COST Association (2022, Febrero 20). Memorandum of Understanding for the implementation of the COST Action “Research Innovation and Sustainable Pan-European Network in Peripartum Depression Disorder” - Riseup-PPD (CA18138). COST. https://e-services.cost.eu/files/domain_files/CA/Action_CA18138/mou/CA18138-e.pdf Daset, L. R., y Cracco, C. (2013). Psicología basada en la evidencia: algunas cuestiones básicas y una aproximación a través de una revisión bibliográfica sistemática. Ciencias Psicológicas, 7(2), 209-220. https://doi.org/10.22235/cp.v7i1.53 Dunlap, L. J., Orme, S., Zarkin, G. A., Arias, S. A., Miller, I. W., Camargo, C. A., Jr, Sullivan, A. F., Allen, M. H., Goldstein, A. B., Manton, A. P., Clark, R., y Boudreaux, E. D. (2019). Screening and intervention for suicide prevention: a cost-effectiveness analysis of the ED-SAFE Interventions. Psychiatric Services, 70(12), 1082–1087. https://doi.org/10.1176/appi.ps.201800445 Earls, M., y The Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics (2010). Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics, 126(5), 1032–1039. https://doi.org/10.1542/peds.2010-2348 Esscher, A., Essén, B., Innala, E., Papadopoulos, F., Skalkidou, A., Sundström-Poromaa, I., y Högberg, U. (2016). Suicides during pregnancy and 1 year postpartum in Sweden, 1980-2007. British Journal of Psychiatry, 208(5), 462-469. https://doi.org/10.1192/bjp.bp.114.161711 Fisher, J. (2016). Perinatal psychiatric care needs of women who die by suicide. The Lancet Psychiatry, 3(3), 191-192. https://doi.org/10.1016/S2215-0366(16)00025-0 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 Garman, E. C., Cois, A., Schneider, M., y Lund, C. (2019). Association between perinatal depressive symptoms and suicidal risk among low-income South African women: a longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 54(10), 1219–1230. https://doi.org/10.1007/s00127-019-01730-w Gavin, A., Tabb, K., Melville, J., Guo, Y., y Katon, W. (2011). Prevalence and correlates of suicidal ideation during pregnancy. Archives of Women's Mental Health, 14(3), 239–246. https://doi.org/10.1007/s00737-011-0207-5 Gelabert, E., Gutierrez-Zotes, A., Navines, R., Labad, J., Puyané, M., Donadon, M., Guillamat, R., Mayoral, F., Jover, M., Canellas, F., Gratacós, M., Guitart, M., Gornemann, I., Roca, M., Costas, J., Ivorra, J., Subirà, S., de Diego, Y., Osorio, F., Garcia-Esteve, L., Sanjuan, J., Vilella, E., y Martin-Santos, R. (2020). The role of personality dimensions, depressive symptoms and other psychosocial variables in predicting postpartum suicidal ideation: a cohort study. Archives of Women's Mental Health, 23(4) 585-593. https://doi.org/10.1007/s00737-019-01007-w Gelaye, B., Addae, G., Neway, B., Larrabure-Torrealva, G., Qiu, C., Stoner, L., Luque, M., Sánchez, S., y Williams, M. (2017). Poor sleep quality, antepartum depression and suicidal ideation among pregnant women. Journal of Affective Disorders, 209, 195-200. https://doi.org/10.1016/j.jad.2016.11.020 Gelaye, B., Kajeepeta, S., y Williams, M. (2016). Suicidal ideation in pregnancy: an epidemiologic review. Archives of Women's Mental Health, 19(5), 741–751. https://doi.org/10.1007/s00737-016-0646-0 Gjerdingen, D. y Yawn, B. (2007). Postpartum depression screening: importance, methods, barriers, and recommendations for practice. Journal of the American Board of Family Medicine, 20(3), 280-288. https://doi.org/10.3122/jabfm.2007.03.060171 Goodman, J. (2009). Women's attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth: Issues in Perinatal Care, 36(1), 60–69. https://doi.org/10.1111/j.1523-536X.2008.00296.x Grigoriadis, S., Wilton, A., Kurdyak, P., Rhodes, A., VonderPorten, E., Levitt, A., Cheung, A., y Vigod, S. (2017). Perinatal suicide in Ontario, Canada: a 15-year population-based study. CMAJ: Canadian Medical Association journal, 189(34), 1085–1092. https://doi.org/10.1503/cmaj.170088 Healey, C., Morriss, R., Henshaw, C., Wadoo, O., Sajjad, A., Scholefield, H., y Kinderman, P. (2013). Self-harm in postpartum depression and referrals to a perinatal mental health team: A audit study. Archives of Women’s Mental Health, 16(3), 237-245. https://doi.org/10.1007/s00737-013-0335-1 Howard, L., Flach, C., Mehay, A., Sharp, D., y Tylee, A. (2011). The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial. BMC Pregnancy and Childbirth, 11, 57. https://doi.org/10.1186/1471-2393-11-57 Huerta, R. (2015). Conducta suicida en población general adulta española: un estudio epidemiológico. Tesis doctoral. Universidad Autónoma de Madrid. Ibarra-Yruegas, B., Lara, M.A., Navarrete, L., Nieto, L., y Kawas, O. (2016). 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, 112. https://doi.org/10.1186/1471-2393-13-112 Instituto Nacional de Estadística [INE] (2022, Febrero 20). Anuario estadístico de España 2019. INE. https://www.ine.es/prodyser/pubweb/anuario19/anu19_completo.pdf Khalifeh, H., Hunt, I., Appleby, L., y Howard, L. (2016). Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15-year findings from a UK national inquiry. The Lancet Psychiatry, 3(3), 233–242. https://doi.org/10.1016/S2215-0366(16)00003-1 Knight, M., Nair, M., Tuffnell, D., Shakespeare, J., Kenyon, S., y Kurinczuk, J. (2022, Febrero 20). Saving Lives, Improving Mothers’ Care – Lessons learned to inform maternity care from the UKK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2013-15. National Perinatal Epidemiology Unit, University of Oxford. https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202017%20-%20Web.pdf 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 Labouliere, C., Vasan, P., Kramer, A., Brown, G., Green, K., Rahman, M., Kammer, J., Finnerty, M., y Stanley, B. (2018). "Zero Suicide" - A model for reducing suicide in United States behavioural healthcare. Suicidologi, 23(1), 22–30. https://doi.org/10.5617/suicidologi.6198 Lara, M. A., y Letechipía, G. (2009). Ideación y comportamiento suicida en embarazadas. Salud Mental, 32(5), 381-387 Liberto, T. (2012). Screening for depression and help-seeking in postpartum women during well-baby pediatric visits: an integrated review. Journal of Pediatric Health Care, 26(2), 109–117. https://doi.org/10.1016/j.pedhc.2010.06.012 Lindahl, V., Pearson, J., y Colpe, L. (2005). Prevalence of suicidality during pregnancy and the postpartum. Archives of Women's Mental Health, 8(2), 77–87. https://doi.org/10.1007/s00737-005-0080-1 Luoma, I., Tamminen, T., Kaukonen, P., Laippala, P., Puura, K., Salmelin, R., y Almqvist, F. (2001). Longitudinal study of maternal depressive symptoms and child well-being. Journal of the American Academy of Child and Adolescent Psychiatry, 40(12), 1367–1374. https://doi.org/10.1097/00004583-200112000-00006 Lysell, H., Dahlin, M., Viktorin, A., Ljungberg, E., D’Onofrio, B., Dickman, P., y Runeson, B. (2018). Maternal suicide-Register based study of all suicides occurring after delivery in Sweden 1974-2009. PLoS One, 13(1). http://doi.org/10.1371/journal.pone.0190133 Marcos-Nájera, R., Le, H., 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 Melville, J., Gavin, A., Guo, Y., Fan, M., y Katon, W. J. (2010). Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstetrics and Gynecology, 116(5), 1064–1070. https://doi.org/10.1097/AOG.0b013e3181f60b0a Mental Health First Aid Australia. (2022, Febrero 20). Suicidal thoughts and behaviours: first aid guidelines. Mental Health First Aid Australia. https://mhfa.com.au/sites/default/files/MHFA_suicide_guidelinesA4%202014%20Revised.pdf Miller, L. J., Gupta, R. y Scremin, A. M. (2011). The evidence for perinatal depression screening and treatment. En A. Handler, J. Kennelly y N. Peacock (Eds.). Reducing racial/ethnic disparities in reproductive and perinatal outcomes: The evidence from population-based interventions (pp. 301-327). Springer. https://doi.org/10.1007/978-1-4419-1499-6 Ministerio de Derechos Sociales y Agenda 2030 (2022, Febrero 22). Objetivo salud y bienestar. Agenda 2030. https://www.agenda2030.gob.es/objetivos/objetivo3.htm Ministerio de Sanidad, Servicios Sociales e Igualdad (2022, Febrero 20). Guía de práctica clínica de atención en el embarazo y puerperio. Ministerio de Sanidad, Servicios Sociales e Igualdad.https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/pdf/GPC_de_embarazo_y_puerperio.pdf Möller, H. (2003). Suicide, suicidality and suicide prevention in affective disorders. Acta Psychiatrica Scandinavica, 108(418), 73–80. https://doi.org/10.1034/j.1600-0447.108.s418.15.x National Institute for Health and Clinical Excellence [NICE] (2022, Febrero 20). Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance —Updated Edition. NICE Clinical Guidelines. https://www.nice.org.uk/guidance/cg192 Navío, M. y Pérez, V. (2022, Febrero 20). Depresión y Suicidio 2020. Documento Estratégico para la Promoción de la Salud Mental. Wecare-u Healthcare Communication Group. http://www.sepsiq.org/file/Publicaciones/LibroBlancoDepresionySuicidio2020.pdf 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 Oates, M. (2003). Suicide: the leading cause of maternal death. British Journal of Psychiatry, 183(4), 279-281. https://doi.org/10.1192/bjp.183.4.279 O'Carroll, P., Berman, A., Maris, R., Moscicki, E., Tanney, B., y Silverman, M. (1996). Beyond the Tower of Babel: a nomenclature for suicidology. Suicide & Life-Threatening Behaviour, 26(3), 237–252. O'Connor, E., Rossom, R., Henninger, M., Groom, H., y Burda, B. (2016). Primary Care Screening for and Treatment of Depression in Pregnant and Postpartum Women: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 315(4), 388–406. https://doi.org/10.1001/jama.2015.18948 Orsolini, L., Valchera, A., Vecchiotti, R., Tomasetti, C., Iasevoli, F., Fornaro, M., De Berardis, D., Perna, G., Pompili, M., y Bellantuono, C. (2016). Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates. Frontiers in Psychiatry, 7, 138. https://doi.org/10.3389/fpsyt.2016.00138 Paulden, M., Palmer, S., Hewitt, C., y Gilbody, S. (2009). Screening for postnatal depression in primary care: cost effectiveness analysis. BMJ: British Medical Journal, 339. https://doi.org/10.1136/bmj.b5203 Pereira, A., Marques, M., Soares, M., Maia, B., Bos, S., Valente, J., Nogueira, V., Roque, C., Madeira, N., y Macedo, A. (2014). Profile of depressive symptoms in women in the perinatal and outside the perinatal period: similar or not? Journal of Affective Disorders, 166, 71–78. https://doi.org/10.1016/j.jad.2014.04.008 Records, K., Rice, M., y Beck, C. (2007). Psychometric assessment of the Postpartum Depression Predictors Inventory-Revised. Journal of Nursing Measurement, 15(3), 189–202. https://doi.org/10.1891/106137407783095775 Rodríguez-Muñoz, M., Le, H., de la Cruz, I., Crespo, M., y Izquierdo, N. (2017). Feasibility of screening and prevalence of prenatal depression in an obstetric setting in Spain. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 215, 101–105. https://doi.org/10.1016/j.ejogrb.2017.06.009 Rodríguez-Muñoz, M. F., Vallejo Slocker, L., Olivares Crespo, M. E., Izquierdo Méndez, N., Soto, C., & Le, H. N. (2017). Propiedades psicométricas del Postpartum Depression PredictorsIinventory- 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 espanola de salud publica, 91, e201712047. Servicio Andaluz de Salud (2022, Febrero 20). Recomendaciones sobre la Detección, Prevención e Intervención de la Conducta Suicida. Área de Dirección de Organizaciones Sanitarias. Escuela Andaluza de Salud Pública. https://consaludmental.org/publicaciones/Recomendacionesprevencionsuicidio.pdf Servicio de Salud del Principado de Asturias [SESPA] (2022, Febrero 20). Protocolo de Detección y Manejo de Caso en Personas con Riesgo de Suicidio. Unidad de Coordinación del Programa Marco de Salud Mental – SESPA -. https://www.astursalud.es/categorias/-/categorias/profesionales/01000practica-clinica/08000salud-mental/01000protocolo-de-deteccion-y-manejo-personas-con-riesgo-de-suicidio Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., y Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(20), 22–57. Sheehan, D., Janavs, J., Harnett-Sheehan, K., Sheehan, M., Gray, C., Lecrubier, Y., Weiller, E., Hergueta, T., Allgulander, C., Kadri, N., Baldwin, D., y Even, C. (2010). MINI Entrevista Neuropsiquiátrica Internacional (Spanish for US Translation Version 6.0.0). Shigemi, D., Ishimaru, M., Matsui, H., Fushimi, K., y Yasunaga, H. (2020). Suicide attempts among pregnant and postpartum women in Japan: a nationwide retrospective cohort study. The Journal of Clinical Psychiatry, 81(3). https://doi.org/10.4088/JCP.19m12993 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 Issues. https://doi.org/10.1007/s12144-020-00882-2 Sociedad Española de Ginecología y Obstetricia [SEGO] (2022, Febrero 20). Área de la mujer. SEGO. https://sego.es/Area_de_la_Mujer Sociedad Marcé Española [MARES] (2022, Febrero 20). El suicidio durante el embarazo y el posparto, ¿son estos los momentos más vulnerables? MARES. http://www.sociedadmarce.org/detall.cfm/ID/14426/ESP/el-suicidio-durante-embarazo-y-posparto-son-estos-los-momentos-mas-vulnerables-.htm Stanley, B., y Brown, G. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001 The American College of Obstetricians and Gynecologists [ACOG] (2018). Screening for perinatal depression. Obstetrics and gynecology, 132(5), 208–212. https://doi.org/10.1097/AOG.0000000000002927 The Australian Institute of Health and Welfare [AIHW] (2022, Febrero 20). Maternal deaths in Australia 2012–2014. AIHW. https://www.aihw.gov.au/getmedia/a8ff4563-b8f6-43b4-826e-a861522d825a/aihw-per-92.pdf 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 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, 31. https://doi.org/10.1186/s12888-020-2435-6 World Health Organisation [WHO] (2022, Febrero 20). Preventing suicide: a global imperative. World Health Organization. https://www.who.int/publications/i/item/9789241564779 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 Women’s Mental Health, 18, 783 – 792. https://doi.org/10.1007/s00737-014-0481-0