Suicidal behaviour and clinical correlates in young adults in Rwanda: a population-based, cross-sectional study

Abstract

# Background A significant proportion of persons who were contemplating suicide or completed suicide had met with a health care provider in the preceding months, however suicidal behaviour was not detected. To improve identification of persons with suicidal behaviour in need of care and support, this study aimed to investigate clinical symptoms that may identify young men and women (aged 20-35 years) with suicidal behaviour (ideation, plan and attempts) in Rwanda. # Methods This was a secondary analysis of data collected from a population based, cross-sectional study conducted in the Southern province of Rwanda in 2011/2012. After a response rate of 99.8%, the final sample was 917 people (477 women and 440 men). A validated Mini-International Neuropsychiatric Interview tool was used to measure suicidal behaviour. Bivariable and multivariable logistic regressions were performed to test the association between suicidal behaviour and clinical symptoms such as major depressive episode, physical pain symptoms and perceived overall health. # Results Approximately, 4.7% of the number of women (n=477) and 1.4% of the number of men (n=440) had attempted suicide in the preceding one month. For women, major depressive episode (Adjusted Odds Ratio, AOR=6.11; 95% confidence interval CI=4.03-10.84), physical pain symptoms experienced almost daily (AOR=1.80; 1.15-2.84) and poorly perceived overall health (AOR=3.08; 1.89-5.00) were statistically significant correlates of suicidal behaviour. For men, only major depressive episode was a statistically significant correlate of suicidal behaviour (AOR=4.75; 1.72-13.12). # Conclusion At health centre level, trained professionals should be made aware that young adults suffering from depression may also suffer from suicidal behaviour. It is therefore important to sensitively inquire about suicidal behaviour followed by appropriate support. For women in particular, suffering from persistent physical pain symptoms or poorly perceived overall health are warning signs that may indicate suicidal behaviour. At community level, community health workers can use the self-rated health form to identify people in poor health and escort them to the health centre for assessment.