Suicidality in perinatal and non-perinatal women in two regions of India: a validation study of three self-report measures
Gracia Fellmeth, Diksha Sharma, Neha DasGupta, Emily C Jose, Chandrakant ‐, Shreyash Chhajed, Pankaj Kanwar, Komal Chawla, Anita Thakur, Vikesh Gupta, Jennifer J Kurinczuk, Sukhjit Singh, Omesh Kumar Bharti, Geetha Desai, Harish Thippeswamy, Prabha S Chandra, Manisha Nair, Fiona Alderdice, Ashok Verma, M Thomas KishoreObjectives
To determine the prevalence of suicidality among perinatal and non-perinatal women in two settings in India, identify associated factors and assess the validity of three self-report measures against a diagnostic interview.
Design
Cross-sectional validation study.
Settings
Rural Kangra, Himachal Pradesh, northern India; and urban Bengaluru, Karnataka, southern India.
Participants
Perinatal women (currently pregnant or had given birth within the last 12 months) and non-perinatal women (not currently pregnant and had not given birth within the last 12 months) aged ≥18 years.
Main outcome measures
Prevalence of past-week active suicidal ideation, prevalence of lifetime passive suicidal ideation, factors associated with suicidal ideation and psychometric validity of self-report measures for past-week active suicidal ideation.
Results
Among 894 participants, prevalence of past-week active suicidal ideation and lifetime passive suicidal ideation was 2.4% (95% CI 1.4% to 3.6%) and 6.5% (95% CI 5.0% to 8.3%), respectively. Prevalence of past-week active suicidal ideation was lower in perinatal (1.5%; 95% CI 0.7% to 2.8%) compared with non-perinatal (4.1%; 95% CI 2.1% to 7.0%) women (p=0.02). Self-report measures demonstrated good discriminant validity (area under the receiver operating characteristic curve >0.8) but missed a substantial proportion of women with clinically diagnosed suicidality.
Conclusions
In our study settings, 1 in 40 women reported past-week suicidality, with higher prevalence among non-perinatal women and socioeconomically disadvantaged groups. These findings are exploratory and setting-specific and should be interpreted with caution. In settings with limited mental health infrastructure, potential benefits of screening must be considered carefully against potential risks.
Trial registration number