Determinants of suicidal ideation and suicide attempt among former and currently homeless individuals

Purposes

This study identified determinants associated with suicidal ideation, suicide attempt and no suicidal behavior in a 12-month period among 455 former or currently homeless individuals in Quebec (Canada).

Methods

Study recruitment took place in 27 organizations located in two major Quebec urban areas, where services for homelessness are offered. Independent variables including clinical, socio-demographic, and service use/outcome variables were measured with eight standardized instruments. Significant associations between these variables and suicidal ideation or attempt in bivariate analyses were produced to build a multinomial logistic regression model using a block approach.

Results

Of 455 participants, 72 (15.8%) reported suicidal ideation and 30 (6.6%) suicide attempt, while 353 (77.6%) had not experienced suicidal behavior. Suicide ideation was particularly high among those with generalized anxiety disorder and substance use disorders, and suicide attempt even higher. Participants with higher functional disability and hospitalizations had a higher incidence of suicide attempt, whereas participants with schizophrenia spectrum and other psychotic disorders, those placed in foster care during childhood and with higher stigma scores experienced more suicidal ideation.

Conclusions

Suicidal ideation and suicide attempt among currently or recently homeless individuals were both strongly associated with clinical variables. Based on the study results, specific interventions may be promoted to improve screening of homeless individuals with suicidal behavior and prevent hospitalization such as training programs and brief care management interventions, addiction liaison nurses, improved access to primary or specialized ambulatory services, and further development of case management and outreach programs for homeless individuals, especially those with functional disabilities.

     

Impulsivity,hostility and suicidality in patients diagnosed with obsessive compulsive disorder

Abstract

Background: There are limited data on suicidal behaviour in obsessive-compulsive disorder (OCD). This study aimed to evaluate several aspects affecting suicidality in OCD patients and determine whether impulsivity or hostility are associated with suicide attempts in this vulnerable group.

Methods: Eighty-one patients with OCD were assessed by structured clinical interview for DSM-IV (SCID I), Yale-Brown Obsessive–Compulsive Scale (Y-BOCS), Suicide Probability Scale (SPS), Barratt impulsivity scale-11 (BIS) and Scale for suicide ideation (SSI).

Results: Of the 81 patients, 22 (27%) had suicide ideation, 29 (33%) attempted suicides with OCD and 30 (37%) OCD patients who never experienced suicide ideation nor attempted suicide. Suicide ideation was associated with high hopelessness, higher severity of OCD and the presence of aggressive obsessions. On the other hand, suicide attempts were associated with longer duration of untreated illness, cognitive impulsivity, higher severity of OCD symptoms and the presence of religious obsessions.

Conclusion: Higher severity of OCD symptoms is associated with both suicide ideation and attempts. And while hopelessness was related to suicidal thoughts, cognitive impulsivity may have acted as a facilitating factor for suicide attempts. Higher frequency of symptoms like religious/ aggressive obsessions was also associated with suicidality. It is vital that patients with OCD undergo detailed assessment for suicide risk.

• Key points

• OCD is associated with a high risk for suicidal behaviour.

• Suicide ideation was associated with high levels of hopelessness, OCD severity, and the presence of aggressive obsessions.

• Suicide attempts were associated with longer duration of untreated illness, cognitive impulsivity, severity of OCD, and the presence of religious obsessions.

     

Psychotic experiences and suicidal behavior: testing the influence of psycho-socioenvironmental factors

Purpose

Research has produced inconsistent results with respect to whether the association between psychotic experiences and suicidal behavior is independent of co-occurring clinical and socioenvironmental factors, despite substantial evidence linking the two phenomena. This study tests whether a comprehensive set of demographic, socioenvironmental, and clinical variables account for the statistical association between psychotic experiences and suicidal behaviors.

Methods

We utilized blocked multivariable logistic regression models to analyze the association between 12-month psychotic experiences and 12-month suicide behaviors (ideation, plan, and attempt) on a subsample (N = 2307) of the National Comorbidity Survey Replication. The models adjusted for socio-demographic characteristics, environmental factors in the form of childhood adversity, mental health service utilization, and psychiatric and substance abuse disorders.

Results

Psychotic experiences were significantly associated with suicidal ideation, even after adjusting for socio-demographics, childhood adversity. However, the significant association between psychotic experiences and suicidal ideation was not robust to the inclusion of mental health service utilization and psychiatric disorders. There was no significant association between psychotic experiences and suicide plan. Psychotic experiences were associated with a significantly increased risk of reporting suicide attempts (OR 6.52; 95% CI 1.36–31.11), even after adjusting for the full set of variables.

Conclusions

Although psychotic experiences were not associated with suicidal ideation after statistical adjustments, psychotic experiences were associated with a significantly increased risk of suicide attempts after the inclusion of common risk factors and co-morbidities. Thus, psychotic experiences should be included in routine psychiatric assessments to identify the individuals most at risk for attempting suicide.

     

Psychotic experiences,sexual minority status,and suicidal behavior among young adult college students in the United States

Psychotic experiences significantly predict suicidal behaviors; however, it is unknown whether these associations are conditional on sexual minority status. We analyzed cross-sectional data from the Healthy Minds Study (N = 109,975), which was collected between September 2020 and June 2021 from young adult (aged 18–34) students from across 140 colleges across the United States. Having psychotic experiences and sexual minority status were associated with significantly greater odds of reporting suicidal ideation, suicide plan, and suicide attempt, adjusting for sociodemographic characteristics. We found significant interactions between psychotic experiences and sexual minority status, such that the relations between psychotic experiences and suicidal behaviors were stronger among heterosexual students than among sexual minority students. However, the interactions disappeared for suicidal ideation and plans after adjusting for socio-behavioral risk factors. Future research can explore whether psychotic experiences predict suicide attempts among sexual minority status behavior socio-behavioral risk factors.

     

Trajectories of suicidal ideation in depressed older adults undergoing antidepressant treatment

Suicide is a public health concern in older adults. Recent cross sectional studies suggest that impairments in executive functioning, memory and attention are associated with suicidal ideation in older adults. It is unknown whether these neuropsychological features predict persistent suicidal ideation. We analyzed data from 468 individuals ≥ age 60 with major depression who received venlafaxine XR monotherapy for up to 16 weeks. We used latent class growth modeling to classify groups of individuals based on trajectories of suicidal ideation. We also examined whether cognitive dysfunction predicted suicidal ideation while controlling for time-dependent variables including depression severity, and age and education. The optimal model using a zero inflated Poisson link classified individuals into four groups, each with a distinct temporal trajectory of suicidal ideation: those with ‘minimal suicidal ideation’ across time points; those with ‘low suicidal ideation’; those with ‘rapidly decreasing suicidal ideation’; and those with ‘high and persistent suicidal ideation’. Participants in the ‘high and persistent suicidal ideation’ group had worse scores relative to those in the “rapidly decreasing suicidal ideation” group on the Color-Word ‘inhibition/switching’ subtest from the Delis–Kaplan Executive Function Scale, worse attention index scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and worse total RBANS index scores. These findings suggest that individuals with poorer ability to switch between inhibitory and non-inhibitory responses as well as worse attention and worse overall cognitive status are more likely to have persistently higher levels of suicidal ideation.Clinicaltrial.gov numberNCT00892047.     

Variability in suicidal ideation during treatment for individuals at clinical high risk for psychosis: The importance of repeated assessment

Aim

Suicide risk is elevated among individuals at clinical high risk for psychosis (CHR-P). The current study examined variability in suicidal ideation during treatment for individuals at CHR-P.

Methods

A retrospective chart review was used to examine the course of suicidal ideation during 16 sessions of individual psychotherapy for 25 individuals at CHR-P.

Results

Suicidal ideation was reported by 24% of participants at session 1 and 16% at session 16, with minimal within-subject change in the presence of suicidal ideation across the two time points. However, a more fine-grained investigation at each session indicated that 60% of individuals at CHR-P experienced suicidal ideation at least once during treatment. Additionally, there was great variability in suicidal ideation both within and between participants over the course of the 16 sessions.

Conclusions

These findings highlight the importance of repeated assessment when examining suicidal ideation as a treatment outcome for individuals at CHR-P.     

Early childhood abuse and late-life suicidal ideation

Objectives: In younger populations childhood sexual and physical abuse have been found to be associated with suicidal ideation. Such associations have not been examined among older adults.

Setting: Data from the National Comorbidity Study-Replication (NCS-R).

Participants: Older adults (60+, N?=?1610) from the NCS-R sample.

Measurements: Suicidal ideation occurring after the age of 60 was assessed. Early-life factors were assessed including childhood physical and sexual abuse and parent's internalizing and externalizing symptoms. Participants’ internalizing and externalizing symptoms were also assessed.

Results: Logistic regression analysis showed that male gender, mother's internalizing symptoms and childhood physical and sexual abuse were associated with suicidal ideation. The association between child abuse and suicidal ideation was mediated by participants’ externalizing symptoms.

Conclusions: Health care workers should screen for suicidal ideation among older adults. In particular, older males with externalizing disorders and a history of child abuse may be at a heightened risk for suicidal ideation.     

Suicidality in the "prodromal" phase of schizophrenia

Objectives

Patients with schizophrenia are at high risk for suicide ideation, attempts, and completed suicide. However, suicidal behavior during the prodromal phase of schizophrenia and a possible association between prodromal suicidal behavior and suicidality after the onset of overt psychosis are not studied.

Methods

One hundred six consecutively admitted schizophrenia patients with recent onset were evaluated retrospectively for prodromal symptoms and suicidality during the prodromal phase and after the onset of frank psychosis. In addition, 106 matched control subjects from the general population were evaluated for suicidality during the same age period of the prodromal phase of the corresponding patient.

Results

Suicide ideation and attempt during the prodromal period were reported in 25.5% and 7.5% of the patients, which are 3.8- and 8-fold greater than in the controls, respectively. Patients with suicidal behavior experienced a greater number of prodromal symptoms than those without. Prodromal depressive mood, marked impairment in role functioning, and tobacco smoking exerted an independent effect on suicide ideation, whereas depressive mood was the symptom significantly more frequent in patients with suicide attempt. Suicide attempts were associated with an earlier onset of prodromal symptoms and frank psychosis. All patients with prodromal suicide attempts were cigarette smokers. Suicide ideation during the prodromal phase was strongly associated with lifetime suicidality after the onset of frank psychosis.

Conclusions

Suicidal behavior is quite common during the prodromal period. The association of smoking, depressive mood, impaired functioning, and a large number of prodromal symptoms, particularly in patients with an early onset of symptomatology, carries a substantially increased risk for suicide ideation. Particular care is needed in patients with prodromal suicide ideation after the onset of frank psychosis because the risk to attempt suicide is high.     

Depressive characteristics of adult psychiatric inpatients with a history of multiple versus one or no suicide attempts

Background: A growing body of research suggests that individuals with a history of multiple suicide attempts exhibit more severe psychopathology than individuals with only one or no previous suicide attempts. Given the strong link between diagnoses of major depression and suicide risk, our primary goal was to determine which specific depressive characteristics differentiate multiple attempters from patients with one or no previous attempts. Methods: Participants were 121 depressed adult psychiatric inpatients. Participants were administered diagnostic interviews to assess the course and characteristics of their depression history as well as measures of suicidal ideation, suicide attempts, depressive symptoms, hopelessness, and dysfunctional attitudes. Results: Patients with a history of multiple suicide attempts exhibited higher levels of suicidal ideation and depressive symptoms, but not hopelessness or dysfunctional attitudes, than the other two groups. In addition, multiple attempters reported an earlier age of major depression onset. Conclusions: The current results add to a growing body of research suggesting that multiple attempters may represent a distinct patient population. Depression and Anxiety, 2009. Published 2008 Wiley‐Liss, Inc.     

Understanding suicidal ideation in psychosis: findings from the Psychological Prevention of Relapse in Psychosis (PRP) trial

OBJECTIVE: To examine the clinically important phenomenon of suicidal ideation in psychosis in relation to affective processes and the multidimensional nature of hallucinations and delusions. METHOD: In a cross-sectional study of 290 individuals with psychosis, the associations between level of suicidal ideation, affective processes, positive symptoms, clinical and demographic variables were examined. RESULTS: Forty-one per cent of participants expressed current suicidal ideation. Suicidal ideation was associated with depressed mood, anxiety, low self-esteem, negative illness perceptions, negative evaluative beliefs about the self and others and daily alcohol consumption. Frequency of auditory hallucinations and preoccupation with delusions were not associated with suicidal ideation; however, positive symptom distress did relate to suicidal thoughts. CONCLUSION: Affective dysfunction, including distress in response to hallucinations and delusions, was a key factor associated with suicidal ideation in individuals with psychotic relapse. Suicidal ideation in psychosis appears to be an understandable, mood-driven process, rather than being of irrational or 'psychotic' origin.     

A comparison of correlates of suicidal ideation prior to initial hospitalization for first-episode psychosis with prior research on correlates of suicide attempts prior to initial treatment seeking

Aim: Individuals with first‐episode psychosis, like those with chronic psychotic disorders, are at elevated risk for suicidal ideation and suicide attempts. However, relatively little is known about suicidality among first‐episode patients prior to their initial presentation for treatment. This analysis was designed as a US‐based examination of recent findings on prior suicide attempts from Dublin, Ireland, here focusing on prevalence and correlates of suicidal ideation during the weeks prior to initial treatment‐seeking. Methods: Participants included 109 first‐episode inpatients with primary psychotic disorders in public‐sector settings that serve an urban, low‐income, socially disadvantaged, predominantly African American population. Eligible patients had received <3 months of prior antipsychotic treatment and had not been hospitalized for psychosis >3 months prior to the index admission, though most were completely treatment naïve. Assessments included the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, Birchwood Insight Scale, and a rigorous method for determining age at onset of first psychotic symptoms and duration of untreated psychosis. Results: Disconcertingly, nearly one quarter of patients (23%) endorsed a history of suicidal ideation in the 2 weeks prior to first admission. In the model designed to replicate the prior study in Ireland, Calgary Depression score (calculated omitting hopelessness and suicidal ideation as these were separate variables in the analysis) was a predictor of suicidal ideation (P < 0.01). In separate bivariate analyses analogous to the original study, two domains of insight were associated with suicidal ideation. Conclusions: Findings suggest that depression, insight, and suicidality should be carefully monitored among first‐episode patients initiating treatment and during the early course of illness. As insight improves, coping strategies should be enhanced with a goal of minimizing depression and preventing suicidality.     

Psychotic Experiences and Schizotypy in Early Adolescence Predict Subsequent Suicidal Ideation Trajectories and Suicide Attempt Outcomes From Age 18 to 38 Years

Subclinical risk markers for schizophrenia predict suicidality, but little is known about the nature of the relationship. Suicidal ideation is often considered homogenous, but distinguishing passive from active ideation (ie, thoughts of death vs thoughts of killing oneself) and different temporal patterns may further the understanding of risk factors. We tested whether schizotypy and psychotic experiences (PEs) in early adolescence predict subsequent growth trajectories of suicidal ideation and suicide attempt outcomes. Participants were 1037 members of the population-representative Dunedin Study cohort. PE was measured at 11 years and schizotypy at 13 and 15 years. Outcomes were passive and active suicidal ideation, and suicide attempt, measured at 18, 21, 26, 32, and 38 years. Passive ideation was best represented by 2 trajectories, including persistent and transient ideation classes. Schizotypy predicted membership in the smaller persistent class (odds ratio [OR] = 1.21, P = .041), whereas PE was not associated with class membership. The probability of suicide attempts was 13.8% in the persistent ideation class, compared with 1.8% in the transient class. Active ideation was best represented by a 1-class model, the intercept of which was predicted by schizotypy (OR = 1.23, P = .015). Suicide attempts were predicted by schizotypy (OR = 1.53, P = .040) and PE (OR = 3.42, P = .046), and this was partially mediated by indirect effects via the active ideation trajectory. Findings indicate that adolescent schizotypy and PE are related to subsequent suicidal ideation and attempts. Suicidal ideation is heterogeneous, and schizotypy is specifically related to a persistent passive ideation subgroup.     

Conflict-related anterior cingulate functional connectivity is associated with past suicidal ideation and behavior in recent-onset schizophrenia

Suicide is highly prevalent in schizophrenia (SZ), yet it remains unclear how suicide risk factors such as past suicidal ideation or behavior relate to brain function. Circuits modulated by the prefrontal cortex (PFC) are altered in SZ, including in dorsal anterior cingulate cortex (dACC) during conflict-monitoring (an important component of cognitive control), and dACC changes are observed in post-mortem studies of heterogeneous suicide victims. We tested whether conflict-related dACC functional connectivity is associated with past suicidal ideation and behavior in SZ. 32 patients with recent-onset of DSM-IV-TR-defined SZ were evaluated with the Columbia Suicide Severity Rating Scale and functional MRI during cognitive control (AX-CPT) task performance. Group-level regression models relating past history of suicidal ideation or behavior to dACC-seeded functional connectivity during conflict-monitoring controlled for severity of depression, psychosis and impulsivity. Past suicidal ideation was associated with relatively higher functional connectivity of the dACC with the precuneus during conflict-monitoring. Intensity of worst-point past suicidal ideation was associated with relatively higher dACC functional connectivity in medial parietal lobe and striato-thalamic nuclei. In contrast, among those with past suicidal ideation (n = 17), past suicidal behavior was associated with lower conflict-related dACC connectivity with multiple lateral and medial PFC regions, parietal and temporal cortical regions. This study provides unique evidence that recent-onset schizophrenia patients with past suicidal ideation or behavior show altered dACC-based circuit function during conflict-monitoring. Suicidal ideation and suicidal behavior have divergent patterns of associated dACC functional connectivity, suggesting a differing pattern of conflict-related brain dysfunction with these two distinct features of suicide phenomenology.     

Thought suppression and suicidal ideation: preliminary evidence in support of a robust association

Background: The suppression of unwanted thoughts appears to contribute to the development and maintenance of emotional disorders. This report tested the thought suppression paradigm in relation to suicidal ideation. Based on the ironic process theory, we hypothesized that the suppression of unwanted thoughts, especially suicidal thoughts, would associate with a higher frequency and a greater intensity of suicidal ideation. Methods: Study 1 examined cross‐sectional associations between self‐reported thought suppression and the frequency of suicidal ideation in a nonclinical sample of 166 undergraduate students. Study 2 extended cross‐sectional findings in an inpatient sample of 71 suicidal adolescents. Study 3 examined prospective associations between suicidal thought suppression and increases in self‐reported suicidal ideation over a 4‐week period in a separate nonclinical sample of 118 undergraduate students. Results: Findings across studies support a robust association between thought suppression and suicidal ideation, even controlling for general depressive symptoms. Participants in Studies 1 and 2 who endorsed greater tendencies toward suppression of thoughts, especially suicidal thoughts (Study 2), displayed higher concurrent levels of suicidal ideation. Participants in Study 3 who endorsed greater baseline tendencies toward suppression of suicidal thoughts displayed an increase in the severity of suicidal ideation over time. Conclusions: Suppression of suicidal thoughts may represent 1 mechanism contributing to the persistence of suicidal ideation. Clinicians may wish to explore patients' reactions to suicidal ideation and consider acceptance‐oriented strategies among patients who attempt to control unwanted suicidal thoughts. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Affective processes in the onset and persistence of psychosis

AbstractObjectives Cognitive models suggest that beliefs and appraisal processes are crucially important in the onset and persistence of psychosis. This study investigated whether (i) neuroticism increases the risk for development of psychotic symptoms, and (ii) a delusional interpretation and/or a depressed response to hallucinatory experiences predicts the onset of psychotic disorder.Method A general population sample with no lifetime evidence of any psychotic disorder was interviewed with the Composite International Diagnostic Interview Schedule (CIDI) at baseline and 1 and 3 years later. At year 3, individuals with CIDI evidence of psychotic symptoms were interviewed by clinicians to identify onset of psychotic disorder.Results Baseline level of neuroticism increases the risk for incident psychotic symptoms. Given the presence of hallucinatory experiences at baseline, the increase in risk of having the psychosis outcome was much higher in the group with delusional ideation or depressed mood at year 1 than in those without delusional ideation or depressed mood.Conclusion A cognitive style characterised by a tendency to worry increases the risk for newly developed psychotic symptoms. Individuals who report hallucinatory experiences and react to these with a delusional interpretation and/or negative emotional states have an increased risk for developing clinical psychosis.     

Antidepressant treatment is associated with a reduction in suicidal ideation and suicide attempts

Objective: To measure changes in suicidal behaviours during 6 months of treatment with antidepressants. Method: A group of depressed patients (n = 195) were assessed for suicidal behaviours in the 6 months prior to treatment. They were prospectively assessed for suicidal behaviours during 6 months of treatment with antidepressants. Results: Patients who made suicide attempts fell from 39 in the 6 months prior to treatment to 20 during treatment. Significant suicidal ideation reduced from 47% at baseline to 14% at 3 weeks remaining below this during the rest of the treatment. Twenty patients had emergent suicidal ideation; five of them had not experienced some level of suicidal behaviour in the 6 months prior to treatment. Conclusion: Suicide behaviours are common in depressed out‐patients. Antidepressant treatment is associated with a rapid and significant reduction in suicidal behaviours. The rate of emergent suicidal behaviour was low and the risk benefit ratio for antidepressants appears to favour their use.     

Cigarette smoking is associated with suicidality in bipolar disorder

Objectives:  Cigarette smoking in individuals with bipolar disorder has been associated with suicidal behavior, although the precise relationship between the two remains unclear.
Methods:  In this prospective observational study of 116 individuals with bipolar disorder, we examined the association between smoking and suicidality as measured by Linehan's Suicide Behaviors Questionnaire (SBQ) and prospective suicide attempts over a nine-month period. Impulsivity was measured by the Barratt Impulsiveness Scale.
Results:  Smoking was associated with higher baseline SBQ scores in univariate and adjusted analyses, but was not significant after statistical adjustment for impulsivity in a regression model. A higher proportion of smokers at baseline made a suicide attempt during the follow-up period (5/31, 16.1%) compared to nonsmokers (3/85, 3.5%); p = 0.031, odds ratio = 5.25 (95% confidence interval: 1.2–23.5). Smoking at baseline also significantly predicted higher SBQ score at nine months.
Conclusions:  In this study, current cigarette smoking was a predictor of current and nine-month suicidal ideation and behavior in bipolar disorder, and it is likely that impulsivity accounts for some of this relationship.     

Life-Satisfaction,Engagement, Mindfulness,Flourishing, and Social Support: Do they Predict Depression,Suicide Ideation,and History of Suicide Attempt in Late Life?

ObjectiveSuicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults.MethodsParticipants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt.ResultsRelative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48–0.96).ConclusionResiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.     

Rumination and Pessimistic Certainty as Mediators of the Relation Between Lifetime Suicide Attempt History and Future Suicidal Ideation

This study examined whether rumination and certainty about pessimistic future-event predictions (P-Certainty) would mediate the relation between lifetime suicide attempt history and future suicidal ideation. Young adults, ages 18–25 (N = 143), with a suicide attempt history (n = 32) or no previous suicide attempt history (n = 111) at baseline, were followed up 2–3 years later and completed measures of rumination, depressive symptoms, hopelessness, suicidal ideation, and pessimistic future-event certainty. Lifetime suicide attempts at baseline were associated with higher suicidal ideation at follow up, and this relation was mediated by rumination and P-Certainty. Suicide attempters may be vulnerable to later ideation due to higher levels of rumination and also certainty in their pessimistic future expectations.     

Prevalence of Suicide Ideation in Two Districts of Uganda

ABSTRACT

Suicide ideation is common in all communities but research on suicidal behavior in Sub-Saharan Africa is scarce. The aim of this study was to determine the prevalence of self-reported suicidal ideation in two contrasting districts of Uganda. The method employed was a systematic sample of 939 respondents residing in Adjumani and Bugiri districts, using the Beck Scale for Suicide Ideation (BSS). Results indicated a higher rate of suicidal ideation in females, the unemployed and in Adjumani district. Consistent with other international studies, high rates of suicidal ideation were found in the Ugandan population. The higher prevalence of suicide ideation in the Adjumani District appears to be a symptom of psychosocial distress related to many years of social and political turmoil and the poor socio-economic conditions. In-depth observational studies are needed to fully understand the process of suicide ideation in Uganda.