Summary: Pregnant women and new mothers with schizophrenia are three times more likely to visit the emergency room after experiencing interpersonal violence, according to a new study.
Source: CMY
According to a new study carried out in CMY.
Interpersonal violence can include physical, sexual and psychological abuse by a family member, intimate partner, acquaintance or stranger.
“While we found a three-fold increased risk for people with schizophrenia, we also found that the majority of people, with and without schizophrenia, are screened for interpersonal violence during pregnancy,” says lead author Kelly. Leslie, a fourth-year psychiatry resident at the University of Toronto. “This suggests that there are many opportunities for healthcare providers to intervene and prevent harm to these patients and their children.”
About 1 in 5 women with schizophrenia (20.7%) experience physical or sexual abuse in their lifetime, about 9 times the risk for those without serious mental illness. However, little is known about their risk during the perinatal period.
Led by researchers from ICES and Women’s College Hospital, the study included more than 1.8 million pregnant women between the ages of 15 and 49, 4,470 of whom had been diagnosed with schizophrenia. People with schizophrenia were more likely to live in a low-income neighborhood, to have other psychiatric and chronic health conditions, and to have had an emergency department visit for interpersonal violence in the 2 years before their pregnancy.
Main findings:
- Overall, 3.1% of people with schizophrenia had an ED visit for interpersonal violence during pregnancy and the first year postpartum, compared to 0.4% of people without schizophrenia.
- Pregnant women with schizophrenia were equally likely to be screened (74.3% versus 73.8%), but more likely to self-report (10.2% versus 2.4%), interpersonal violence.
- Among study participants who were screened and doesn’t disclose interpersonal violence during pregnancy, schizophrenia was associated with a six-fold increase in the risk of experiencing an emergency department visit for interpersonal violence during pregnancy and postpartum.
The study suggests “that routine screening for violence in antenatal care settings is an important opportunity for intervention to prevent serious physical, psychological and social harm to these patients and their children,” writes Dr. Simone Vigod, Chief of Psychiatry, Women’s College Hospital and a Professor at the Temerty Faculty of Medicine, University of Toronto, with co-authors.
About this research news on interpersonal violence and schizophrenia
Author: Kim Barnhardt
Source: CMY
Contact: Kim Barnhardt – CMAJ
Picture: Image is in public domain
Original research: Access closed.
“Risk of interpersonal violence during and after pregnancy in people with schizophrenia: a population-based cohort study” by Simone Vigod et al. CMY
See also
Abstract
Risk of interpersonal violence during and after pregnancy in people with schizophrenia: a population-based cohort study
Background: Schizophrenia is associated with an increased risk of experiencing interpersonal violence. Little is known about the risk specifically at the time of pregnancy.
Methods : This population-based cohort study included all people (ages 15-49) listed as female on their health cards who had a single birth in Ontario, Canada, between 2004 and 2018. We compared people with and without schizophrenia about their risk of an emergency department (ED) visit for interpersonal violence during pregnancy or within a year of giving birth. We adjusted relative risks (RRs) for demographics, history of substance use disorders before pregnancy, and history of interpersonal violence. In a subcohort analysis, we used linked clinical registry data to assess screening for interpersonal violence and self-reported interpersonal violence during pregnancy.
Results: We included 1,802,645 pregnant people, of whom 4,470 had a diagnosis of schizophrenia. Overall, 137 (3.1%) of people with schizophrenia had a perinatal ED visit for interpersonal violence, compared to 7,598 (0.4%) of people without schizophrenia, for a RR of 6 .88 (95% confidence interval (CI) 5.66 to 8.37) and an adjusted RR of 3.44 (95% CI 2.86–4.15). The results were similar when calculated separately for the period of pregnancy (adjusted RR 3.47, 95% CI 2.68–4.51) and the first year postpartum (adjusted RR 3.45, 95% CI). 95% 2.75–4.33). Pregnant women with schizophrenia were just as likely to be screened for interpersonal violence (74.3% versus 73.8%; adjusted RR 0.99, 95% CI 0.95-1.04), but more likely to self-report (10.2% versus 2.4%; adjusted RR 3.38, 95% CI 2.61–4.38), compared with people without schizophrenia. Among patients who did not self-report interpersonal violence, schizophrenia was associated with an increased risk of perinatal emergency department visit for interpersonal violence (4.0% versus 0.4%; adjusted RR 6.28, CI to 95% 3.94–10.00).
Interpretation: Pregnancy and postpartum are periods of higher risk for interpersonal violence in people with schizophrenia compared to people without schizophrenia. Pregnancy is a key period for implementing violence prevention strategies with this population.