Abstract
BackgroundEast Asian countries have high suicide rates. However, little is known about clinical and sociodemographic factors associated with suicidality in Asian populations. The aim of this study was to evaluate the factors associated with suicidality in patients with major depressive disorder (MDD) from six Asian countries.MethodsThe study cohort consisted of 547 outpatients with MDD. Patients presented to study sites in China (n = 114), South Korea (n = 101), Malaysia (n = 90), Singapore (n = 40), Thailand (n = 103), and Taiwan (n = 99). All patients completed the Mini-International Neuropsychiatric Interview (MINI), the Montgomery–Asberg Depression Rating Scale (MADRS), the Global Severity Index(SCL-90R), the Fatigue Severity Scale, the 36-item short-form health survey, the Sheehan Disability Scale, and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients were classified as showing high suicidality if they scored ≥6 on the MINI suicidality module. Multivariate logistic regression analysis was used to examine sociodemographic and clinical factors related to high suicidality.ResultsOne hundred and twenty-five patients were classed as high suicidality. Unemployed status (adjusted odds ratio [OR] 2.43, p < 0.01), MADRS score (adjusted OR 1.08), p < 0.001, and GSI (SCL-90R) score (adjusted OR 1.06, p < 0.01) were positively related to high suicidality. Hindu (adjusted OR 0.09, p < 0.05) or Muslim (adjusted OR 0.21, p < 0.001) religion and MSPSS score (adjusted OR 0.82, p < 0.05) were protective against high suicidality.ConclusionsA variety of sociodemographic and clinical factors were associated with high suicidality in Asian patients with MDD. These factors may facilitate the identification of MDD patients at risk of suicide.
Highlights
East Asian countries have high suicide rates
The mean (SD) time taken for completion of the self-administered questionnaires was 35.8 (14.1) min, and for face-to-face interview was 38.1 (13.8) min
In Malaysia and Thailand, about 10% of major depressive disorder (MDD) patients were classed as high suicidality, whereas in South Korea over 40% of MDD patients were classed as high suicidality
Summary
East Asian countries have high suicide rates. little is known about clinical and sociodemographic factors associated with suicidality in Asian populations. The aim of this study was to evaluate the factors associated with suicidality in patients with major depressive disorder (MDD) from six Asian countries. The suicide rate in East Asian countries, including South Korea, Japan, and China, is especially high. According to a 2011 report from the World Health Organization’s worldwide initiative for the prevention of suicide, Korea ranked third, Japan ranked ninth, and China ranked twenty-fourth out of 105 countries for suicide rate [3]. Despite such compelling figures, suicide is relatively under-researched, and preventive. The profiles of risk and protective factors of suicide in Asian countries differ from those of Western countries [10]
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