Magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals in northwest Ethiopia: a multicentre cross-sectional study

Abstract

ObjectiveThis study aimed to assess magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals, northwest Ethiopia using suicide module of World Mental Health Survey initiative version of the WHO, composite international diagnostic interview.DesignMulticentre-based cross-sectional study was used.SettingData were collected using face to face interview from patients with epilepsy who attended outpatient treatment at primary public hospitals at northwest Ethiopia.ParticipantsAdult patients with epilepsy (n=563) who came to attend outpatient treatment during the study period were included in the study using systematic random sampling technique.Outcome measuresSuicidal ideation, suicidal attempt and factors associated with suicidal ideation and attempt.ResultsThe overall magnitude of suicidal ideation and attempt was 26.5% and 12.6%, respectively. Being woman adjusted OR ((AOR)=1.68, 95% CI 1.09 to 3.23), living alone (AOR=2.4, 95% CI 1.47 to 3.92), divorced/widowed/(AOR=2.2, 95% CI 1.09 to 7.8), family history of suicidal attempt (AOR=2.53, 95% CI 1.34 to 4.79), depression (AOR=3.18, 95% CI 1.85 to 5.45), anxiety (AOR=2.92, 95% CI 1.68 to 5.09), comorbid medical illness (AOR=2.60, 95% CI 1.17 to 5.82) and poor social support (AOR=2.35, 95% CI 1.26 to 4.40) were statistically associated with suicidal ideation. Depression (AOR=4.87, 95% CI 2.56 to 9.28) living alone (AOR=2.66, 95% CI 1.62 to 5.41), family history of committed suicide (AOR=2.80, 95% CI 1.24 to 6.39), taking medication for mental illness (AOR=2.17, 95% CI 1.06 to 4.46), hazardous alcohol use (AOR=2.10, 95% CI 1.05 to 4.23) were statistically associated with suicidal attempts at a p value <0.05.ConclusionThis study showed that the magnitude of suicidal ideation and attempt was high among people with epilepsy. Being woman, living alone, having depression and anxiety, single, divorced/widowed in marital status, family history of suicidal attempt and poor social support were statistically associated with suicidal ideation. Having depression, living alone, family history of suicide attempt, hazardous alcohol use and drug taking for mental illness were statistically associated with suicidal attempt. Based on the findings of this study early screening, detection and management of suicide were recommended in people with epilepsy.

The Association between Depression and Suicidal Ideation A Systematic Review and MetaAnalysis

“…This study is similar with previous studies in USA (20) ,Colombia, (21), Brazil (22), China ( 10) Nepal (11), Washington (23), Canada, (24), Bosnia and Herzegovina, (25), Poland, (26), Brazil (27), Malaysia(28) ,, South Africa (29), Nigeria (30), Eriteria (8 ), in India (31), Ethiopia (32)(33)(34)(35), Addis Ababa Ethiopia (36) This may be due to high depressive symptoms that are related to suicidal risk and thoughts.…”

The Association between Depression and Suicidal Ideation A Systematic Review and Meta-Analysis

“…This study is similar with previous studies in USA (20) ,Colombia, (21), Brazil (22), China (10) Nepal (11), Washington (23), Canada, (24), Bosnia and Herzegovina (25), Poland (26), Brazil (27), Malaysia (28), South Africa (29), Nigeria (30), Eriteria [8], in India (31), Ethiopia (32)(33)(34)(35), Addis Ababa Ethiopia [36]. This may be due to high depressive symptoms that are related to suicidal risk and thoughts.…”

Antiepileptic drugs and the risk of suicide in patients with epilepsy

“…Suicide risk factors in epileptic patients include age, gender, socioeconomic factors, a history of psychiatric disorders and factors related to epilepsy itself (Giambarberi and Munger Clary, 2022). Suicide risk tends to decrease with age and is highest among adolescents with epilepsy (Christensen et al, 2007;Nigussie et al, 2021). In the population analysed in the present study, suicidal ideations were more common in women, even independently of depression (Kim et al, 2020;Nigussie et al, 2021), while more suicide attempts and suicides were observed among men (Abraham et al, 2019).…”