Belete Habte, Misgan Eyaya, Belete Tilahun
Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Front Psychiatry. 2021 Sep 27;12:560886. doi: 10.3389/fpsyt.2021.560886. eCollection 2021.
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 -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.
全球每年有100万例自杀死亡事件,其中75%发生在低收入和中等收入国家(LMICs)。然而,这些地区用于预防自杀死亡的资源有限。目的是评估在健康中心就诊的患者以及社区居民中自杀行为的患病率及其相关因素。2017年3月至2018年2月,在埃塞俄比亚西北部采用比较研究方法,对2625名社区居民和1363名健康中心患者进行了关于自杀行为的访谈。采用逻辑分析方法,计算调整后的优势比和95%置信区间(CI),P值<0.05。结果发现,自杀行为(意念、计划和企图)的总患病率为5.6%(95%CI范围为5%-6%)。居民中的患病率为4.4%(95%CI范围为4%-5%),患者中的患病率为7.9%(95%CI范围为6%-9%)。女性、抑郁症状、身体/言语虐待以及感到受辱被确定为自杀行为的危险因素,而健康的生活方式,如经常食用水果和蔬菜、定期进行体育锻炼以及拥有公共医疗保险,即使在调整是否为患者因素后,也被确定为自杀行为的保护性危险因素。患者中自杀行为的比例是居民的两倍。对于寻求医疗帮助的患者,应评估其自杀行为,建议在初级卫生保健系统中整合心理健康服务,尤其是在低收入国家。