Necho Mogesie, Tsehay Mekonnen, Zenebe Yosef
Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Int J Ment Health Syst. 2021 Jan 23;15(1):13. doi: 10.1186/s13033-021-00437-3.
Suicidal ideation and suicidal attempt are warning signs for and determine the prognosis of completed suicide. These suicidal behaviors are much more pronounced in people living with HIV/AIDS. Despite this, there is a scarcity of aggregate evidence in Africa. This study was therefore aimed to fill this gap.
we extensively searched Psych-info, PubMed, Scopus, and EMBASE to obtain eligible studies. Further screening for a reference list of articles was also done. Meta XL package was used to extract data and the Stata-11 was also employed. Cochran's Q- and the Higgs I test were engaged to check heterogeneity. Sensitivity and subgroup analysis were implemented. Egger's test and funnel plots were used in detecting publication bias.
The pooled prevalence of suicidal ideation was 21.7% (95% CI 16.80, 26.63). The pooled prevalence of suicidal ideation in Ethiopia, Nigeria, Uganda, and South Africa was 22.7%, 25.3%, 9.8%, and 18.05% respectively. The pooled prevalence of suicidal ideation was larger; 27.7% in studies that used Composite International Diagnostic Interview (CIDI) than Mini-international Neuropsychiatric Interview (MINI); 16.96%. Moreover, the prevalence of suicidal ideation in studies with a sample size of < 400 was 23.42% whereas it was 18.3% in studies with a sample size ≥ of 400 participants. The pooled prevalence of suicidal attempts in this study was 11.06% (95% CI 6.21, 15.92). A suicidal attempt was higher in Ethiopia (16.97%) and Nigeria (16.20%) than Uganda (3.51%). This pooled prevalence of suicidal attempt was higher among studies that used a smaller sample (< 400 participants) (15.5%) than studies that used a larger sample size (≥ 400 participants) (8.4%). The pooled prevalence of suicidal attempt was 3.75%, and 16.97% in studies that used MINI and CIDI respectively. Our narrative synthesis revealed that advanced stages of AIDS, co-morbid depression, perceived HIV stigma, and poor social support was among the factors strongly associated with suicidal ideation and attempt.
The pooled magnitude of suicidal ideation and attempt was high and factors like advanced stages of AIDS, co-morbid depression, perceived stigma, and poor social support were related to it. Clinicians should be geared towards this mental health problem of HIV patients during management.
自杀意念和自杀未遂是自杀死亡的警示信号，并决定其预后。这些自杀行为在艾滋病毒/艾滋病感染者中更为明显。尽管如此，非洲缺乏综合证据。因此，本研究旨在填补这一空白。
我们广泛检索了Psych-info、PubMed、Scopus和EMBASE以获取符合条件的研究。还对文章的参考文献列表进行了进一步筛选。使用Meta XL软件包提取数据，并使用Stata-11软件。采用Cochran's Q检验和Higgs I检验来检查异质性。进行了敏感性和亚组分析。使用Egger检验和漏斗图检测发表偏倚。
自杀意念的合并患病率为21.7%（95%可信区间16.80，26.63）。埃塞俄比亚、尼日利亚、乌干达和南非自杀意念的合并患病率分别为22.7%、25.3%、9.8%和18.05%。使用综合国际诊断访谈（CIDI）的研究中自杀意念的合并患病率更高，为27.7%，而使用迷你国际神经精神病学访谈（MINI）的研究中为16.96%。此外，样本量<400的研究中自杀意念的患病率为23.42%，而样本量≥400名参与者的研究中为18.3%。本研究中自杀未遂的合并患病率为11.06%（95%可信区间6.21，15.92）。埃塞俄比亚（16.97%）和尼日利亚（16.20%）的自杀未遂率高于乌干达（3.51%）。使用较小样本（<400名参与者）的研究中自杀未遂的合并患病率（15.5%）高于使用较大样本量（≥400名参与者）的研究（8.4%）。使用MINI和CIDI的研究中自杀未遂的合并患病率分别为3.75%和16.97%。我们的叙述性综述表明，艾滋病晚期、合并抑郁症、感知到的艾滋病毒污名以及社会支持不足是与自杀意念和自杀未遂密切相关的因素。
自杀意念和自杀未遂的合并程度较高，艾滋病晚期、合并抑郁症、感知到的污名以及社会支持不足等因素与之相关。临床医生在管理过程中应关注艾滋病毒患者的这一心理健康问题。
