Non-fatal suicidal behaviour in rural Ethiopia: a cross-sectional facility- and population-based study

BMC Psychiatry

Research Article

Girmay Medhin¹  Sujit D Rathod²  Crick Lund³  Erica Breuer³  Solomon Teferra⁴  Medhin Selamu⁴  Maji Hailemariam⁴  Atalay Alem⁴  Tsion Shiferaw⁴  Abebaw Fekadu⁵  Charlotte Hanlon⁶  Mark Jordans⁷  Martin Prince⁸  Tedla W. Giorgis⁹ 

[1] Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia;Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK;Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa;Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, UK;Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, UK;Department of Research and Development, HealthNet Transcultural Psychosocial Organisation, Amsterdam, The Netherlands;Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, UK;Republic of Ethiopia Federal Ministry of Health, Addis Ababa, Ethiopia;

关键词: Suicide attempt;    Suicidal ideation;    Suicidal plan;    Suicidal behaviour;    Low and middle income country;    Ethiopia;   

DOI  :  10.1186/s12888-016-0784-y

 received in 2015-10-13, accepted in 2016-03-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundInjury related to self-harm is one of the leading causes of global disease burden. As a formative work for a programme to implement comprehensive mental healthcare in a rural district in Ethiopia, we determined the 12-month prevalence of non-fatal suicidal behaviour as well as factors associated with this behaviour to understand the potential burden of the behaviour in the district.MethodPopulation-based (n = 1485) and facility-based (n = 1014) cross-sectional surveys of adults, using standardised, interview-based measures for suicidality (items on suicide from the Composite International Diagnostic Interview), depressive symptoms (the Patient Health Questionnaire) and alcohol use disorders (Alcohol Use Disorder Investigation Test; AUDIT).ResultsThe overall 12-month prevalence of non-fatal suicidal behaviour, consisting of suicidal ideation, plan and attempt, was 7.9 % (95 % Confidence Interval (CI) = 6.8 % to 8.9 %). The prevalence was significantly higher in the facility sample (10.3 %) compared with the community sample (6.3 %). The 12-month prevalence of suicide attempt was 4.4 % (95 % CI = 3.6 % to 5.3 %), non-significantly higher among the facility sample (5.4 %) compared with the community sample (3.8 %). Over half of those with suicidal ideation (56.4 %) transitioned from suicidal ideation to suicide attempt. Younger age, harmful use of alcohol and higher depression scores were associated significantly with increased non-fatal suicidal behaviours. The only factor associated with transition from suicidal ideation to suicide attempt was high depression score. Only 10.5 % of the sample with suicidal ideation had received any treatment for their suicidal behaviour: 10.8 % of the community sample and 10.2 % of the facility sample. Although help seeking increased with progression from ideation to attempt, there was no statistically significant difference between the groups.ConclusionNon-fatal suicidal behaviour is an important public health problem in this rural district. A more in-depth understanding of the context of the occurrence of the behaviour, improving access to care and targeting depression and alcohol use disorder are important next steps. The role of other psychosocial factors should also be explored to assist the provision of holistic care.

【 授权许可】

CC BY   
© Fekadu et al. 2016