0910 Does Antenatal Anxiety Place Women at Greater Suicide Risk, and Could Poor Sleep Play a Role?

Abstract

The reciprocal relationship between poor sleep and clinical depression as risk factors for suicidal ideation (SI) is well-established. While recent recognition has led to increased screening for antenatal depression, the same focus has not been given to anxiety disorders. This study investigated whether sleep could be implicated in a potential relationship between antenatal anxiety and SI. Four-hundred and twenty-five pregnant and postpartum women completed an online survey on sleep and various risk factors that included the General Anxiety Disorder-7 (GAD-7) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Edinburgh Postnatal Depression Scale (EPDS), the tenth question of which was used as a single-item SI screen. The relationship between GAD-7 and SI was quantified by Spearman correlations. Multiple regression evaluated the influence of possible coexisting depression. Two-way ANOVA assessed whether sleep moderated against SI. One-hundred and forty-five participants completed the GAD-7 and SI screen. Nine (6.2%) endorsed some degree of SI within the past week. Increased GAD-7 scores correlated positively with SI (r=.30, p<.001). GAD-7 scores after multiple regression predicted SI severity at p<.05, while EPDS scores predicted SI at a p<.01. PSQI results displayed the strongest correlation with the GAD-7 (r=.325, p<.001) and the weakest with SI (r=.131, p=.135). This sample’s one-week SI prevalence surpassed the annual prevalence in the general US population (~4%). Impaired sleep was significantly correlated with anxiety and depression but was not significantly correlated with SI; better sleep did not have a protective role against SI for those with anxiety. Anxiety, after multiple regression, was found to have a significant association with SI severity independent of depression. This finding is notable because it suggests that anxiety may be its own risk factor in the development of SI among women in the antenatal period. While more research is needed to duplicate and further understand this data, what is clear is that healthcare providers should be strongly encouraged to screen their antenatal patients for anxiety disorders in addition to depression. NIMH (1R36MH118000-01)