Citation

Ongeri L, McCulloch CE, Neylan TC, Bukusi E, Macfarlane SB, Othieno C, Ngugi AK, Meffert SM. J. Affect. Disord. 2017; 225: 413-421.

Affiliation

Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.jad.2017.08.059

PMID

28850856

Abstract

BACKGROUND: Low-and-Middle-Income-Countries (LMICs) account for 75% of global suicides. While primary care populations in high-income countries (HIC) typically have higher prevalence of suicidal behavior relative to general populations, few studies have explored suicidal behavior among general medical outpatients in LMICs. This study addresses the research gap by characterizing potential risk factors for suicidal ideation in a large general medical outpatient setting in rural Kenya.

METHODS: A cross-sectional study of adult general medical outpatients attending a rural sub-county hospital in Kaloleni, Kenya. Primary outcomes included major depressive disorder (MDD), posttraumatic stress disorder (PTSD) and suicidal behavior measured by the Mini International Neuropsychiatric Interview (MINI 5.0). We use binary logistic regression to model suicidality, mental disorders, intimate partner violence, and lifetime abuse.

RESULTS: 394 outpatients completed the assessment. The prevalence of SI over the past month was 20%. 18% of those with suicidal ideation over the past month also attempted suicide in the past month. Participants who met criteria for MDD (suicidality item removed) were 19 times [CI: 4.56, 79.05] more likely to report suicidal ideation compared to those without MDD (adjusted odds ratio 12.15 [CI: 2.66, 55.49]). LIMITATIONS: This was a cross sectional study design with convenience sampling and hence vulnerable to selection and recall bias.

CONCLUSION: The prevalence of SI and its strong association with actual suicide attempt in this population, make an urgent public health case for intervention. These data identify MDD as a highly significant correlate of SI.

Copyright © 2017 Elsevier B.V. All rights reserved.

Language: en

Keywords

Depression; Global mental health; Posttraumatic stress disorder (PTSD); Sub-Saharan Africa; Suicidal ideation; Suicide