Pillaveetil Sathyadas Indu1, Thekkethayyil Viswanathan Anilkumar2, Ramdas Pisharody3, Paul Swamidhas Sudhakar Russell4, Damodaran Raju5, P Sankara Sarma6, Saradamma Remadevi7, K R Leela Itty Amma8, A Sheelamoni3, Chittaranjan Andrade9. 1. Department of Community Medicine, Government Medical College, Trivandrum, Kerala, India; Clinical Epidemiology Resource & Training Centre, Government Medical College, Trivandrum, Kerala, India. Electronic address: indupsaniltv@gmail.com. 2. Department of Psychiatry, Government Medical College, Trivandrum, Kerala, India; Clinical Epidemiology Resource & Training Centre, Government Medical College, Trivandrum, Kerala, India. 3. Clinical Epidemiology Resource & Training Centre, Government Medical College, Trivandrum, Kerala, India. 4. Department of Child Psychiatry, Christian Medical College, Vellore, India. 5. Department of Psychiatry, Government Medical College, Trivandrum, Kerala, India. 6. Department of Biostatistics, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. 7. Department of Community Medicine, Government Medical College, Trivandrum, Kerala, India; Clinical Epidemiology Resource & Training Centre, Government Medical College, Trivandrum, Kerala, India. 8. Department of Community Medicine, Government Medical College, Trivandrum, Kerala, India. 9. Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Abstract
BACKGROUND: It is known that persons who die by suicide commonly visit a primary care physician (PCP) shortly before the fatal act.There is little information on history of suicide attempt in depressed patients who consult PCPs for non-mental health indications.This information is important because past history of suicide attempt is a known predictor of future suicide risk. OBJECTIVE: To estimate the prevalence of depression among outpatients in primary care and to determine the prevalence and determinants of past suicide attempt among them. METHOD: This cross-sectional study was conducted in six primary care settings, both public and private, in Kerala, India. A psychiatrist evaluated adult outpatients (n=827), diagnosed depression using ICD-10 Diagnostic Criteria for Research, and elicited history of suicide attempt. RESULTS: Overall depression prevalence was 27.2% and was higher in women. Past suicide attempt was identified in 6.9% (95% CI, 5.17-8.63%) of all outpatients; higher in women (9.2%) than men (3.6%). Among the depressed, 21.3% had previously attempted suicide; while this figure was 1.5% in the non-depressed. The prevalence of current depression was 81% (severe depression, 61%) in patients reporting past suicide attempts. In univariate analyses, female gender, perceived financial stress, and being depressed were significantly associated with past suicide attempts. In multivariate analysis, current depression was the largest predictor of past suicide attempt (adjusted odds ratio, 14.3; 95% CI, 6.60-31.07). CONCLUSION: Depression and suicide attempt are both common in primary care. Depression is the single most important predictor of suicide attempt.
BACKGROUND: It is known that persons who die by suicide commonly visit a primary care physician (PCP) shortly before the fatal act.There is little information on history of suicide attempt in depressed patients who consult PCPs for non-mental health indications.This information is important because past history of suicide attempt is a known predictor of future suicide risk. OBJECTIVE: To estimate the prevalence of depression among outpatients in primary care and to determine the prevalence and determinants of past suicide attempt among them. METHOD: This cross-sectional study was conducted in six primary care settings, both public and private, in Kerala, India. A psychiatrist evaluated adult outpatients (n=827), diagnosed depression using ICD-10 Diagnostic Criteria for Research, and elicited history of suicide attempt. RESULTS: Overall depression prevalence was 27.2% and was higher in women. Past suicide attempt was identified in 6.9% (95% CI, 5.17-8.63%) of all outpatients; higher in women (9.2%) than men (3.6%). Among the depressed, 21.3% had previously attempted suicide; while this figure was 1.5% in the non-depressed. The prevalence of current depression was 81% (severe depression, 61%) in patients reporting past suicide attempts. In univariate analyses, female gender, perceived financial stress, and being depressed were significantly associated with past suicide attempts. In multivariate analysis, current depression was the largest predictor of past suicide attempt (adjusted odds ratio, 14.3; 95% CI, 6.60-31.07). CONCLUSION:Depression and suicide attempt are both common in primary care. Depression is the single most important predictor of suicide attempt.
Authors: Atif Adam; Ameena Jain; Alexandra Pletnikova; Rishi Bagga; Allison Vita; Lisa N Richey; Neda Gould; Supriya Munshaw; Kavi Misrilall; Matthew E Peters Journal: JMIR Form Res Date: 2020-07-03
Authors: Alma Delia Genis-Mendoza; Diana María Dionisio-García; Thelma Beatriz Gonzalez-Castro; Carlos Alfonso Tovilla-Zaráte; Isela Esther Juárez-Rojop; María Lilia López-Narváez; Rosa Giannina Castillo-Avila; Humberto Nicolini Journal: Front Psychiatry Date: 2022-06-10 Impact factor: 5.435