Suicidality in perinatal and non-perinatal women in two regions of India: a validation study of three self-report measures

Objectives 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 NCT05485701 .