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Ogunwale A, Ojo TM. Decriminalising attempted suicide in Nigeria. Lancet Psychiatry 2024:S2215-0366(24)00372-9. [PMID: 39637876 DOI: 10.1016/s2215-0366(24)00372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Revised: 10/30/2024] [Accepted: 10/31/2024] [Indexed: 12/07/2024]
Affiliation(s)
- Adegboyega Ogunwale
- Forensic Unit, Department of Clinical Services, Neuropsychiatric Hospital, Abeokuta, Nigeria; Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK.
| | - Tunde Masseyferguson Ojo
- National Mental Health Programme, Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria; Department of Psychiatry, College of Health Sciences, University of Abuja, Abuja, Nigeria
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Iweama CN, Agbaje OS, Lerum NI, Igbokwe CC, Ozoemena LE. Suicidal ideation and attempts among Nigerian undergraduates: Exploring the relationships with depression, hopelessness, perceived burdensomeness, and thwarted belongingness. SAGE Open Med 2024; 12:20503121241236137. [PMID: 38533197 PMCID: PMC10964440 DOI: 10.1177/20503121241236137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/13/2024] [Indexed: 03/28/2024] Open
Abstract
Objective The study investigated the prevalence of suicidal behavior and its association with depression, hopelessness, perceived burdensomeness, and thwarted belongingness in a sample of undergraduates in Nigeria. Introduction Suicide is a leading cause of death among young adults globally. However, information about suicidal ideation, attempts, and relationships with psychiatric factors, perceived burdensomeness, and thwarted belongingness is sparse in Nigeria. The study investigated the prevalence of suicidal ideation and attempts and associated factors in a sample of undergraduates in Nigeria. Methods We collected data from a cross-sectional survey of 625 undergraduate students primarily recruited from universities, colleges of education, and polytechnics in Adamawa Central Senatorial Zone, Adamawa State, northeast Nigeria. The Suicidal Behaviors Questionnaire-Revised, the 15-item Interpersonal Needs Questionnaire, the 9-item Patient Health Questionnaire, and the 20-item version of the Beck Hopelessness Scale were administered to the participants. We used descriptive statistics and binary and multivariate logistic regressions for data analysis. Results A total of 616 students with a mean age of 21.41 ± 4.72 years completed the study. The prevalence of suicidal behavior was 34.9% (215/616). Having a female sex (adjusted odds ratio [AOR] = 8.37, 95% confidence interval (CI): 2.06, 34.03), depression (AOR = 45.15, 95% CI: 0.95, 5.11), hopelessness (AOR = 20.10, 95% CI: 5.56, 72.41), and perceived burdensomeness (AOR = 89.15, 95% CI: 29.63, 268.30) were associated with suicidal ideation. In addition, being a female (AOR = 1.69, 95% CI = 1.02, 2.83), being a 200-level student (AOR = 3.41, 95% CI = 1.46, 7.96), and being a 300-level student (AOR = 0.28, 95% CI = 0.11, 0.74) were associated with suicidal attempt. Conclusion The study's findings show that suicidal behaviors (ideations and attempts) are prevalent among undergraduate students in northeast Nigeria. The findings underline the need for the development of mental health services and early identification and intervention for at-risk young people in Nigeria.
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Affiliation(s)
- Cylia Nkechi Iweama
- Faculty of Education, Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Olaoluwa Samson Agbaje
- Faculty of Education, Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Namuga Isaiah Lerum
- Faculty of Education, Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Charles Chima Igbokwe
- Faculty of Education, Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Lawretta Eyuche Ozoemena
- Faculty of Education, Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Enugu, Nigeria
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Mahesar RA, Shaikh S, Latif M, Azeema N, Solangi A, Abro SY. Analysis of Newspaper Reporting of Non-fatal Suicide Attempts During the Covid-19 Lockdown in Pakistan. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231172342. [PMID: 37080193 DOI: 10.1177/00302228231172342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: This study was aimed to observe newspaper reports about non-fatal suicide attempts in Pakistan during the COVID-19 lockdown. Methods: We performed content analysis of news reports about incomplete suicides from four vernacular newspapers of Pakistan between March and August 2020. Results: A total of 87 news reports about suicide attempts were examined; the vast majority of the suicide attempters was Muslims (78%), males (64%), females (36%) with (33%) mentions of age, ranging from 19-30 years, and married were (76%). However, occupation was largely missing from (93%) of the news. Self-poisoning was the commonly reported method in (65%) of suicide attempts, whereas familial discord was the leading risk factor for (72%) of suicide attempts. Conclusions: Although psychological intervention is crucial to reduce familial discords as risk factors, monitoring the mental health conditions of people vulnerable to suicide and the figures on attempted suicides should be maintained and collected nationally and regionally.
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Affiliation(s)
- Rameez Ali Mahesar
- Department of Media and Communication Studies, Shah Abdul Latif University, Khairpur, Pakistan
| | - Sadia Shaikh
- Benazir School of Business, Benazir Bhutto Shaheed University, Karachi, Pakistan
| | - Muhammad Latif
- Department of Education, GC Women University, Sialkoat, Pakistan
| | - Nusrat Azeema
- Department of Mass Communication, Allama Iqbal Open University, Islamabad, Pakistan
| | - Aneela Solangi
- Department of English, Shaheed Benazir Bhutto University, Shaheed Benazirabad, Pakistan
| | - Shaila Yaseen Abro
- Department of English, Shaheed Benazir Bhutto University, Shaheed Benazirabad, Pakistan
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Olibamoyo O, Ola B, Coker O, Adewuya A, Onabola A. Trends and patterns of suicidal behaviour in Nigeria: Mixed-methods analysis of media reports from 2016 to 2019. S Afr J Psychiatr 2021; 27:1572. [PMID: 33824754 PMCID: PMC8008030 DOI: 10.4102/sajpsychiatry.v27i0.1572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Media coverage of suicides in Nigeria appears to be explicitly descriptive and deviates from the recommended best practice. Despite these shortcomings, verifiable information provided by these media outlets could arguably, at the minimum, mirror the reality of the trends and patterns of suicidal behaviour in Nigeria. AIM This study aimed to analyse the trends and patterns of suicidal behaviour in Nigeria using media reports from 2016 to 2019. We examined the effect of gender and age groups on these trends and patterns of suicidal behaviour. SETTING The study was carried out in Nigeria. METHODS Qualitative content analysis was used to assess the content of each verifiable suicide event. In total, 336 verified suicide-related events were selected from 4365 media reports. Quantitative data were collected on age, gender, type of suicidal behaviour, method, place and motivation for suicidal behaviour. Data were analysed using the Statistical Package for the Social Sciences software. Fisher's exact test was used to examine the association between gender, age groups and other variables. p-value was set at ≤ 0.05. RESULTS Completed suicide was the most common reported suicidal behaviour. Hanging was the dominant reported method, followed by poisoning. Significant gender differences were observed between age groups (p < 0.001) and methods of suicidal behaviour (p < 0.001). Also, significant age differences were observed between the methods of suicidal behaviour (p < 0.001), places (p < 0.001) and motivations for suicidal behaviour (p < 0.001). CONCLUSION The study confirms that there are gender and age differences in the trends and patterns of suicidal behaviour in Nigeria.
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Affiliation(s)
- Olushola Olibamoyo
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
| | - Bolanle Ola
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
| | - Olurotimi Coker
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
| | - Abiodun Adewuya
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
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Oyetunji TP, Arafat SMY, Famori SO, Akinboyewa TB, Afolami M, Ajayi MF, Kar SK. Suicide in Nigeria: observations from the content analysis of newspapers. Gen Psychiatr 2021; 34:e100347. [PMID: 33521558 PMCID: PMC7812081 DOI: 10.1136/gpsych-2020-100347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/23/2020] [Accepted: 12/01/2020] [Indexed: 01/31/2023] Open
Abstract
Background Suicide is a global public health problem and Nigeria is one of the epicentres of suicide in the world. However, there is a dearth of research exploring the epidemiological aspects of suicide in Nigeria. Aim To examine the demographic information and precipitating events for suicides in Nigeria by analysing the contents of newspaper reports of suicide. Methods We searched, collected, and analysed published news reports about suicide from 10 English newspapers in Nigeria. A total of 350 suicide reports were assessed between January 2010 and December 2019 after screening and sorting. Results The mean (SD) age of the reported cases was 36.33 (15.48) years. Majority of the reported cases were male (80.6%), married (51.8%), students (33.6%), living in a semi-urban area (40.3%) and among the age group of 25–34 (25.3%). Hanging (48.6%) and poisoning (32.2%) were the most commonly reported methods of suicide. Financial constraints and marital conflicts were most commonly assumed precipitating factors. Conclusion This study suggests that being male, married, or living in semi-urban areas are associated with suicide in Nigeria. Further community-based studies are warranted to generalise the findings and adopt appropriate preventive strategies.
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Affiliation(s)
- Tosin Philip Oyetunji
- Department of Human Nutrition, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Savar, Bangladesh
| | | | | | - Michael Afolami
- Department of International Relations, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | - Moyo Faith Ajayi
- Department of Psychology, Adekunle Ajasin University, Akungba-Akoko, Ondo, Nigeria
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India
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Anic A, Robertson LJ. Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa. S Afr J Psychiatr 2020; 26:1526. [PMID: 33101728 PMCID: PMC7565019 DOI: 10.4102/sajpsychiatry.v26i0.1526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/04/2020] [Indexed: 11/27/2022] Open
Abstract
Background Mental disorders and substance use disorders (SUD) commonly occur together, impacting healthcare outcomes. The diagnosis of substance use is often inadequate when comorbidity is present. It is vital to understand the prevalence of substance use amongst psychiatric patients to inform both clinical practice and service development in South Africa. Aim To ascertain the prevalence and clinical correlates of SUD amongst acute psychiatric inpatients. Setting The setting for this study was Helen Joseph Hospital acute psychiatric ward. Methods A cross-sectional study was conducted whereby consecutively admitted patients were invited to participate in a structured clinical interview utilising the alcohol use disorders identification test (AUDIT) and drug use disorders identification test (DUDIT) questionnaires. Statistical comparisons were made between those with and without SUD. Results Of 150 participants, 100 (67%) were identified with a SUD. Those with SUD were younger (p = 0.0010), more often male (p = 0.012), less likely to have a disability grant (p = 0.015) and more likely to be brought to hospital by police, ambulance or self than by a family member (p = 0.025). Almost half of people with bipolar disorder (47.3%) and schizophrenia (41.4%) had comorbid SUD. Twenty-three (15%) participants identified with SUD on questionnaire had been missed clinically. Only two participants were referred for inpatient substance rehabilitation on discharge. Conclusion Substance use disorders are highly prevalent amongst psychiatric inpatients. The AUDIT and DUDIT are potentially useful screening tools in routine clinical practice. Greater collaboration between psychiatric and substance rehabilitation services is recommended.
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Affiliation(s)
- Ani Anic
- Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.,Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Lesley J Robertson
- Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.,Sedibeng District Health Services, Vanderbijlpark, South Africa
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Ding K, Slate M, Yang J. History of co-occurring disorders and current mental health status among homeless veterans. BMC Public Health 2018; 18:751. [PMID: 29914470 PMCID: PMC6006730 DOI: 10.1186/s12889-018-5700-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background Homeless veterans are at high risk for co-occurring disorders (COD), defined as mental illnesses that include at least one alcohol or other drug use disorder and at least one non-drug related mental disorder. However, epidemiological studies examining the prevalence of COD and associated mental health status in this population are limited. The objectives of the study were: (1) to describe a history of diagnosed mental disorders among homeless veterans admitted to a transitional housing program, and (2) to examine the associations of the prior diagnosed COD and other mental disorders with current mental health status. Methods Study participants were male homeless veterans admitted to a transitional housing program from July 2015 to September 2017 in a large municipal area in Northeast Ohio, the United States. Cross-sectional, self-reported data from the admission assessment were included and analyzed. History of mental disorder diagnoses were aggregated into five categories for the purpose of this study: no mental disorders, only alcohol or other drug use disorder(s), one non-drug related mental disorder, two or more non-drug related mental disorders, and COD. Current mental status were measured as empowerment, mental component summary score (MCS) and physical component summary score (PCS) of health related quality of life (VR-12), and perceived overall well-being. Sample distribution of the five categories and their associations with current mental status were examined using Generalized Linear Model test. Results Of all participants, 76.7% had at least one prior diagnosed mental disorder, including 47.4% with any drug-related disorders. Over one-third (37.2%) reported having COD. Compared to those with no mental disorder history, those with COD scored significantly lower on MCS and empowerment scores; those with any prior diagnosed non-drug related mental disorders also scored significantly lower on MCS. No significant differences, however, were found in current mental health status between those with COD and those with mental disorders but not COD. Conclusions COD prevalence among homeless veterans was within the parameter of other literature reports. Veterans with COD compared to veterans with no history of mental disorders tended to have lower MCS and empowerment scores. Veterans with COD had the same mental health status as those with other mental disorders.
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Affiliation(s)
- Kele Ding
- Kent State University, Kent, OH, USA.
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Duko B, Ayano G. Suicidal ideation and attempts among people with severe mental disorder, Addis Ababa, Ethiopia, comparative cross-sectional study. Ann Gen Psychiatry 2018; 17:23. [PMID: 29881440 PMCID: PMC5984440 DOI: 10.1186/s12991-018-0193-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/25/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND People with severe mental disorders are associated with increased risk of suicide and suicide attempts compared to the general population. In low and middle-income countries, research concerning suicide attempts and completed suicide among people living with severe mental disorder is limited. The objective of this study was to assess suicide and attempts in people with severe mental disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. METHODS Institution-based cross-sectional study was conducted in August-September 2016. Patients with schizophrenia and bipolar disorder were selected using systematic random-sampling technique. The composite international diagnostic interview was used to assess suicide that was administered by psychiatry professionals. Substance use disorder was assessed through face-to-face interviews using structured clinical interview of DSM-IV. RESULTS A total of 542 (272 schizophrenia + 270 bipolar disorder) patients were included in the study. One hundred nineteen (43.75%) of schizophrenic participants and 128 (47.1%) of bipolar participants have suicidal ideation. Fifty-six (20.7%) of schizophrenic participants and 58 (21.3%) of bipolar participants have suicidal attempt. Among the schizophrenic and bipolar patients who had suicidal ideation, 31.8 and 32.60% had co-morbid substance use disorder, respectively. CONCLUSION In this study, which was performed in Ethiopia, suicidal ideation and attempt were shown to be common problems in people with schizophrenia and bipolar disorder. Co-morbid substance use disorder was a more frequent phenomenon among patients with suicidal ideation and attempt. Attention should be given to screen and assess suicidal ideation and attempt in persons with schizophrenia and bipolar disorder.
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Affiliation(s)
- Bereket Duko
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560 Hawassa, Ethiopia
| | - Getinet Ayano
- Research and Training Directorate, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
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Breet E, Goldstone D, Bantjes J. Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review. BMC Public Health 2018; 18:549. [PMID: 29699529 PMCID: PMC5921303 DOI: 10.1186/s12889-018-5425-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 04/10/2018] [Indexed: 12/15/2022] Open
Abstract
Background Understanding relationships between substance use and suicidal ideation and behaviour (SIB) has important public health implications for suicide prevention in low- and middle-income countries (LMICs), where 75% of suicides occur. This systematic review explored the associations between substance use and SIB in LMICs. Methods We searched five databases using a combination of keywords for substance use, SIB and LMICs to identify English-written quantitative studies published between January 2006 and February 2016. Data were extracted to provide an overview of what is known about the topic, highlight gaps in the literature, and explore the implications of current knowledge for suicide prevention. Studies included in the review were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network checklist. Results Analysis of included studies (N = 108) demonstrated a consistent positive association between substance use and SIB across all substances (i.e. alcohol, tobacco, cannabis, illicit drugs, non-medical use of prescription drugs), all substance use dimensions (i.e. intoxication, use, and pathological use) and all SIB dimensions (i.e. suicidal ideation, non-fatal suicidal behaviour, and suicide). Most of the available research evidence comes from upper-middle-income countries, only 22% comes from lower-middle-income and low-income countries. Most studies focused on alcohol and tobacco, while neglecting substances such as cannabis, opioids, sedatives, stimulants, misuse of prescription medication, inhalants, and hallucinogens. Most of the studies employed a cross-sectional design, were conducted within a risk-factor paradigm, and provided little information about the potential interaction between variables. Conclusions Public health suicide prevention policy and research in LMICs should take account of the fact that: substance use is a potentially modifiable risk factor; assessment and management of substance use is integral to the care of at-risk patients; reducing consumption and hazardous use of substances in LMICs is important for suicide prevention; and research needs to be expanded to include more theory driven research that focuses on all substance use dimensions and SIB dimensions, while employing more sophisticated statistical methods. Electronic supplementary material The online version of this article (10.1186/s12889-018-5425-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elsie Breet
- Department of Psychology, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch, 7602, South Africa.
| | - Daniel Goldstone
- Department of Psychology, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch, 7602, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch, 7602, South Africa
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Shibre T, Hanlon C, Medhin G, Alem A, Kebede D, Teferra S, Kullgren G, Jacobsson L, Fekadu A. Suicide and suicide attempts in people with severe mental disorders in Butajira, Ethiopia: 10 year follow-up of a population-based cohort. BMC Psychiatry 2014; 14:150. [PMID: 24886518 PMCID: PMC4052808 DOI: 10.1186/1471-244x-14-150] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 05/15/2014] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND People with severe mental disorders (SMD) are at higher risk of suicide. However, research into suicide attempts and completed suicide in people with SMD in low- and middle-income countries is mostly limited to patients attending psychiatric facilities where selection bias is likely to be high. METHODS A population-based cohort of 919 people with SMD from rural Ethiopia (who received standardized clinician diagnoses of schizophrenia (n = 358) major depressive disorder (n = 216) and bipolar I disorder (n = 345)) were followed up annually for an average of 10 years. The Longitudinal Interval Follow-up Evaluation chart was administered by psychiatrists and used to evaluate systematically suicidal behavior and risk factors, which may be amenable to intervention. RESULTS Over the follow-up period, the cumulative risk of suicide attempt was 26.3% for major depression, 23.8% for bipolar I disorder and 13.1% for schizophrenia, (p < 0.001). The overall incidence of completed suicide was 200.2/100,000 person-years (CI = 120.6, 312.5). Hanging was the most frequent method used (71.5%) for both attempters and completers. Most people who completed suicide were successful on the first attempt (84.2%), but the case-fatality rate for suicide attempt was 9.7%. In the adjusted logistic regression model, being currently married (Adjusted OR) =2.17, 95% CI = 1.21, 3.91), and having a diagnosis of bipolar I disorder (Adjusted OR = 2.59, 95% CI = 1.57, 4.26) or major depression (Adjusted OR = 2.71, 95% CI = 1.60, 4.58) were associated significantly with increased risk of suicide attempts. CONCLUSION In this sample of people with SMD from a rural setting, the rate of suicide was high. Initiatives to integrate mental health service into primary care need to focus on limiting access to suicide methods in people with SMD in addition to expanding access to mental health care.
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Affiliation(s)
- Teshome Shibre
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
- Ontario Shores Centre for Mental Health Sciences, University of Toronto, Toronto, Canada
| | - Charlotte Hanlon
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
- Health Services and Population Research Department, King’s College London, Institute of Psychiatry, Centre for Global Mental Health, London, UK
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atalay Alem
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Derege Kebede
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Solomon Teferra
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Gunnar Kullgren
- Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umea, Sweden
| | - Lars Jacobsson
- Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umea, Sweden
| | - Abebaw Fekadu
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
- King’s College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders and Affective Disorders Research Group, London, UK
- College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
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Diagnosing comorbidity in psychiatric hospital: challenging the validity of administrative registers. BMC Psychiatry 2013; 13:13. [PMID: 23297686 PMCID: PMC3544620 DOI: 10.1186/1471-244x-13-13] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 01/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study will explore the validity of psychiatric diagnoses in administrative registers with special emphasis on comorbid anxiety and substance use disorders. METHODS All new patients admitted to psychiatric hospital in northern Norway during one year were asked to participate. Of 477 patients found eligible, 272 gave their informed consent. 250 patients (52%) with hospital diagnoses comprised the study sample. Expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) together with retrospective checking of the records. The hospital diagnoses were blind to the expert. The agreement between the expert's and the clinicians' diagnoses was estimated using Cohen's kappa statistics. RESULTS The expert gave a mean of 3.4 diagnoses per patient, the clinicians gave 1.4. The agreement ranged from poor to good (schizophrenia). For anxiety disorders (F40-41) the agreement is poor (kappa = 0.12). While the expert gave an anxiety disorder diagnosis to 122 patients, the clinicians only gave it to 17. The agreement is fair concerning substance use disorders (F10-19) (kappa = 0.27). Only two out of 76 patients with concurrent anxiety and substance use disorders were identified by the clinicians. CONCLUSIONS The validity of administrative registers in psychiatry seems dubious for research purposes and even for administrative and clinical purposes. The diagnostic process in the clinic should be more structured and treatment guidelines should include comorbidity.
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Abstract
PURPOSE OF REVIEW The purpose of our review was to select, summarize and express opinions on a range of research studies published in 2011 on the clinical assessment, screening and monitoring of patients with substance use and psychiatric comorbidity, together with epidemiological and other relevant studies. RECENT FINDINGS There was a wide range of publications on many aspects of comorbidity. The research was carried out on different populations in different treatment settings, including an alcohol and drug treatment centre, an emergency medical department, a community mental health centre, a methadone maintenance programme and inpatient unit, and in the community. Several structured or semi-structured interviews and self-administered instruments were used for the assessments of psychiatric disorders, substance use disorders and related problems. Each study has its strengths and weaknesses, with some studies reporting interesting new methodology or results, and others confirming what was already known about the subject. SUMMARY The results of most studies support a high prevalence of substance misuse among individuals with psychiatric disorders and vice versa. Various aspects of the relationship between the two conditions are discussed.
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