Abstract
There are a million suicide deaths in the world annually, and 75% of these occur in low- and middle-income countries (LMICs). However, there are limited resources to prevent suicidal deaths in those regions. The aim was to assess the prevalence of suicidal behavior and associated factors among patients visiting for medical care at a health center and residents in the community. A comparative study was employed by interviewing 2,625 residents in the community and 1,363 patients at the health center about suicidal behavior in northwest Ethiopia, from March 2017 to February 2018. Logistic analysis was employed with adjusted odds ratios and 95% confidence interval (CI) and with p-value < 0.05. The total prevalence of suicidal behavior (ideation, plan, and attempt) was found to be 5.6% (with 95% CI range 5–6%). It was found to be 4.4% with 95% CI range 4–5% in residents and 7.9% with 95% CI range 6–9% in patients. Female sex, depressive symptoms, physical/verbal abuse, and feeling stigmatized were identified as a risk factors for suicidal behavior, whereas a healthy lifestyle, such as eating regular meals of fruits and vegetables, doing physical exercise regularly, and having public health insurance were identified as protective risk factors for suicidal behavior even after adjusting for being a patient or not. The proportion of suicidal behavior was double in patients compared with residents. Suicidal behavior should be assessed in patients who visit for medical help and integration of mental health service within the primary health care system is recommended, especially in low-income countries.
Highlights
Every year, there are a million suicide deaths in the world, and of this, two-thirds occur in lowand middle-income countries (LMICs), including Ethiopia [1], where resources to prevent suicidal deaths are limited [2]
The prevalence of suicidal behavior was high in the study area with almost a double prevalence among participants who sought medical care compared with residents in the community
Mental health services should be recommended within primary health care centers to prevent later suicide death in people who visited for medical care in resourcelimited settings
Summary
There are a million suicide deaths in the world, and of this, two-thirds occur in lowand middle-income countries (LMICs), including Ethiopia [1], where resources to prevent suicidal deaths are limited [2]. Even though the World Health Organization has a plan of indicators to measure suicide death incidence [2], it still produces few reports on the magnitude of suicide in rural residents and patients in resource-limited countries with high a magnitude of morbidities. The 1-month prevalence of suicidality at an outpatient clinic in China was 2.3% [13]; 2–3% in an African review showing that socioeconomic characteristics of patients correlates with suicidal behavior, and lifetime suicide attempts were reported by 3.2% (n = 332) of the study population [3]. The overall 12-month prevalence of non-fatal suicidal behavior, consisting of suicidal ideation, plan, and attempt, was 7.9% [95% confidence interval (CI) = 6.8–8.9%] in Ethiopia [16]
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