1
|
Sathian B, Menezes RG, Asim M, Mekkodathil A, Sreedharan J, Banerjee I, van Teijlingen ER, Roy B, Subramanya SH, Kharoshah MA, Rajesh E, Shetty U, Arun M, Ram P, Srivastava VK. Cigarette smoking dose-response and suicidal ideation among young people in Nepal: a cross-sectional study. Nepal J Epidemiol 2020; 10:821-829. [PMID: 32257512 PMCID: PMC7112959 DOI: 10.3126/nje.v10i1.28277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 01/10/2023] Open
Abstract
Background Worldwide, tobacco smoking is a major risk factor for morbidity and early mortality among adult population. The present study aimed to find out the association between current smoking and suicidal ideation among young people in Nepal. Materials and Methods A cross-sectional questionnaire-based survey was carried out among 452 youths from Pokhara, Nepal. The present study included both genders (age 18-24 years) who were smokers as well as non-smokers. Results Across the study period, 452 participants were identified after matching for age, and sex (226 in the smoking group and 226 in the non-smoking group). The mean age of participants was 21.6±1.2 years and 58.8% were males. The overall rate of suicidal ideation in our cohort was 8.9%. Smokers were slightly more likely to report suicidal ideation than non-smokers (aOR 1.12). The risk of developing suicidal ideation was 3.56 (95% CI 1.26-10.09) times more in individuals who smoked greater than 3.5 cigarettes per week (p=0.01). Conclusion The rate of suicidal ideation was slightly higher among smokers and a dose-response relationship was identified with the number of cigarettes smoked per week. Being aware of the link between smoking and suicidal ideation may help health care professionals working with young people to address more effectively the issues of mental well-being and thoughts about suicide.
Collapse
Affiliation(s)
- Brijesh Sathian
- Surgery Department, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ritesh G Menezes
- Forensic Medicine Division, Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Asim
- Surgery Department, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | | | | | | | - Edwin R van Teijlingen
- Centre for Midwifery, Maternal and Perinatal Health, Bournemouth University, Bournemouth, UK
| | - Bedanta Roy
- Department of Physiology, Quest International University Perak (QIUP), city Campus, Ipoh, Perak Darul Ridzuan, Malaysia
| | | | | | - Elayedath Rajesh
- School of Behavioural Sciences, Mahatma Gandhi University, India
| | - Ullasa Shetty
- Department of Forensic Medicine, A. J. Institute of Medical Sciences, Mangalore, India
| | - M Arun
- Department of Forensic Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - Pradhum Ram
- Division of Cardiovascular Medicine, Emory University Hospital, Atlanta, GA, USA
| | | |
Collapse
|
2
|
Mikula P, Timkova V, Linkova M, Vitkova M, Szilasiova J, Nagyova I. Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support. Front Psychol 2020; 11:504. [PMID: 32256439 PMCID: PMC7093596 DOI: 10.3389/fpsyg.2020.00504] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/02/2020] [Indexed: 01/03/2023] Open
Abstract
Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation (p < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.
Collapse
Affiliation(s)
- Pavol Mikula
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Marcela Linkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Marianna Vitkova
- Department of Neurology, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Jarmila Szilasiova
- Department of Neurology, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| |
Collapse
|
3
|
Timkova V, Nagyova I, Reijneveld SA, Tkacova R, Stewart RE, van Dijk JP, Bültmann U. Suicidal ideation in patients with obstructive sleep apnoea and its relationship with disease severity, sleep-related problems and social support. J Health Psychol 2018; 25:1450-1461. [PMID: 29493290 DOI: 10.1177/1359105318758859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We aimed to assess the prevalence of suicidal ideation and to examine the relationships between obstructive sleep apnoea severity, sleep-related problems, social support and suicidal ideation in obstructive sleep apnoea patients. We included 149 patients (68% male; mean age, 48.99 ± 9.57 years) with diagnosed obstructive sleep apnoea (Apnoea–Hypopnoea Index ⩾5) based on full-night polysomnography. The prevalence of suicidal ideation among obstructive sleep apnoea patients was 20.1 per cent. Structural equation modelling showed that suicidal ideation in obstructive sleep apnoea was strongly related to poor sleep quality and high fatigue levels. No relationship between social support and suicidal ideation in obstructive sleep apnoea patients was found.
Collapse
Affiliation(s)
- Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, PJ Safarik University in Kosice, Kosice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia
| | - Sijmen A Reijneveld
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ruzena Tkacova
- Department of Pneumology and Phtiseology, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia
| | - Roy E Stewart
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, PJ Safarik University in Kosice, Kosice, Slovakia
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
4
|
Bethune A, da Costa L, van Niftrik CHB, Feinstein A. Suicidal Ideation After Mild Traumatic Brain Injury: A Consecutive Canadian Sample. Arch Suicide Res 2017; 21:392-402. [PMID: 27310250 DOI: 10.1080/13811118.2016.1199990] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aims to elucidate psychosocial and injury features contributing to SI following concussion or mild traumatic brain injury (mTBI) and the time course for its development. Between 1998 and 2012, a sample of 871 patients referred to a follow-up clinic after concussion treatment in an urban tertiary care ED were consecutively offered enrollment at 3 months post injury. Data from psychiatric and social-demographic assessments were consecutively collected at 2 visits (3 and 6 months after injury) respectively. Chi-square and t-tests were performed to identify associations between variables related with SI. Logistic regression analysis was performed to identify factors independently associated. During the enrolment period, 2,296 patients with mTBI presented to the ED. 871 adults completed psychiatric and social demographic clinic assessments at 3 months, and 500 returned at 6 months. Suicidal ideation was expressed by 6.3% at 3 months and 8.2% at 6 months. Regression models showed SI independently associated with: speaking English as a second language (ESL) and injury mechanism (MVC passenger) at 3 and 6 months; and history of depression and marital status at 3 months only. SI is common 3 months after mTBI, and appears more at 6 month follow up. These findings suggest earlier screening for predisposing factors and closer monitoring of those at risk for suicidality.
Collapse
|
5
|
Gomez R, McLaren S. The center for epidemiologic studies depression scale: support for a bifactor model with a dominant general factor and a specific factor for positive affect. Assessment 2014; 22:351-60. [PMID: 25085880 DOI: 10.1177/1073191114545357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES For the Center for Epidemiologic Studies Depression Scale (CES-D) ratings, the study examined support for a bifactor model, and also the internal consistency reliability and external validity of the factors in this model. METHOD Participants (N = 1,178) were older adults from the general community who completed the CES-D. RESULTS Confirmatory factor analysis of their ratings indicated support for the bifactor model. For this model, the general factor explained most of the covariance in the scores of the CES-D items for Depressed Affect, Somatic Symptoms and Retarded Activity, and Interpersonal Difficulties items. Most of the covariance in the scores of the Positive Affect (PA) scale was explained by its own specific factor. Additional analyses showed support for internal consistencies and external validities of general factors based on all the CES-D items, and when PA items were excluded, and also the PA-specific factor. DISCUSSION The findings support the use of a total CES-D score without the PA items and also the concurrent use of the PA scale score.
Collapse
Affiliation(s)
- Rapson Gomez
- Federation University Australia, Ballarat, Victoria, Australia
| | - Suzanne McLaren
- Federation University Australia, Ballarat, Victoria, Australia
| |
Collapse
|
6
|
Morefield K, Walker C, Smith D, Harvey P, Dunn K, Battersby M. An Inpatient Treatment Program for People with Gambling Problems: Synopsis and Early Outcomes. Int J Ment Health Addict 2013. [DOI: 10.1007/s11469-013-9462-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
7
|
Menezes RG, Subba SH, Sathian B, Kharoshah MA, Senthilkumaran S, Pant S, Arun M, Kundapur R, Jain A, Lobo SW, Ravi Shankar P. Suicidal ideation among students of a medical college in Western Nepal: a cross-sectional study. Leg Med (Tokyo) 2012; 14:183-7. [PMID: 22522041 DOI: 10.1016/j.legalmed.2012.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 02/15/2012] [Accepted: 02/15/2012] [Indexed: 11/27/2022]
Abstract
Many studies have been conducted in the developed countries to know the magnitude and factors influencing suicidal ideation among medical students, but such data are sparse in developing countries. This cross-sectional study was therefore conducted to find out the prevalence of suicidal ideation and factors influencing such ideation among students of a medical college in Western Nepal. A total of 206 students were selected using random sampling and questioned about their socio-demographic factors, other risk factors and suicidal ideation using a preformed validated questionnaire. The data were analyzed using SPSS for Windows Version 16.0 and the EPI Info 3.5.1 Windows Version. Descriptive statistics and testing of hypothesis were applied for the statistical methodology. The univariate and multivariate logistic regression methods were used to examine the association between different variables. Suicidal ideation in the last one year was present in nearly one tenth of the study population and in almost one fifth of them life-time suicidal ideation was present. Factors that were associated with suicidal ideation were primarily dissatisfaction with academic performance, being in the clinical semesters, having history of drug abuse and feeling neglected by parents. Most common reason reported for suicidal ideation was family related followed by self-related. Recognition of suicidal ideation among students and their associated factors can help in detecting it on time, making the right interventions and controlling the problem. Understanding the magnitude of the problem and their epidemiology via scientific study like this would be the first step in this process.
Collapse
Affiliation(s)
- Ritesh G Menezes
- Department of Forensic Medicine, Srinivas Institute of Medical Sciences & Research Centre, Mangalore, India.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Shi Z, Taylor AW, Goldney R, Winefield H, Gill TK, Tuckerman J, Wittert G. The use of a surveillance system to measure changes in mental health in Australian adults during the global financial crisis. Int J Public Health 2010; 56:367-72. [DOI: 10.1007/s00038-010-0200-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 06/27/2010] [Accepted: 10/03/2010] [Indexed: 12/01/2022] Open
|
9
|
Sisask M, Kõlves K, Värnik A. Severity of Attempted Suicide as Measured by the Pierce Suicidal Intent Scale. CRISIS 2009; 30:136-43. [DOI: 10.1027/0227-5910.30.3.136] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Suicidal intent is an essential feature of suicidal behavior. Previous research has been controversial and the need for further evidence has been pointed out. Aims: The aim of the present study was to characterize the severity of attempted suicide by extracting components of suicidal intent and analyzing levels of suicidal intent by gender, age, and variables indicating the severity of attempted suicide. Methods: Data on suicide attempters (N = 469) were collected in Estonia using WHO SUPRE-MISS methodology. To measure suicidal intent, a revised version of the Pierce Suicidal Intent Scale (PSIS) was used. Results: The level of suicidal intent was not gender-dependent, but rose with age. Males and females were also similar in terms of discrete components. Classified in age groups, their unequivocally expressed “wish to die” was similar, but equivocal communication (components termed “arrangements” and “circumstances”) increased with age. Middle-aged groups scored higher for the “alcohol/drugs” component. Psychiatric diagnosis, method of attempting suicide, and duration of hospitalization were linked to suicidal intent, but danger to life as assessed by interviewers was not. Conclusions: In suicide-risk assessment, results from a Suicidal Intent Scale contribute to clinical observation and add valuable information about a suicidal person’s real intention.
Collapse
Affiliation(s)
- Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
- Tallinn University, Tallinn, Estonia
| | - Kairi Kõlves
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
- Australian Institute for Suicide Research and Prevention (AISRAP), Brisbane, Australia
| | - Airi Värnik
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
- Tallinn University, Tallinn, Estonia
- University of Tartu, Tartu, Estonia
- National Prevention of Suicide and Mental Ill-Health (NASP) at Karolinska Institute and Stockholm County Council’s Centre for Suicide Research and Prevention, WHO Lead Collaborating Centre of Mental Health Problems and Suicide Across Europe, Stockholm, Sweden
| |
Collapse
|
10
|
Goldney RD, Dal Grande E, Taylor A. Population-attributable risk of childhood sexual abuse for symptoms of depression and suicidal ideation in adulthood. Int J Psychiatry Clin Pract 2009; 13:285-91. [PMID: 24916938 DOI: 10.3109/13651500902947336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective. The aim of the study was to assess the population-attributable risks (PAR) of childhood sexual abuse (CSA) for depressive symptoms and suicidal ideation in adulthood. Method. A total of 2501 adult participants were randomly recruited and interviewed using a computer-assisted telephone interviewing system. They responded to items designed to assess depressive symptoms (SF-12), suicidal ideation (GHQ-28), and other distressing events, including CSA, as part of a broader, mental health survey of the South Australian population. Results. Logistic regression analyses indicated that CSA was associated with both depressive symptoms and suicidal ideation. However, PAR estimates indicated that only 0.8% of depressive symptoms could be attributed to CSA. Similarly, only 2.2% of suicidal ideation in the population could be attributed to CSA. Conclusions. Notwithstanding the individual distress associated with CSA, a population perspective indicated that the impact of CSA in adulthood was not as great as one might interpret from media reports.
Collapse
Affiliation(s)
- Robert D Goldney
- Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
| | | | | |
Collapse
|
11
|
Chamberlain P, Goldney R, Delfabbro P, Gill T, Dal Grande L. Suicidal Ideation. CRISIS 2009; 30:39-42. [DOI: 10.1027/0227-5910.30.1.39] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background. Suicidal ideation is an important risk factor for suicide attempts and completions, and early identification of the likely presence of self-harm cognitions would benefit clients and clinicians alike. This study examined the clinical utility of the Kessler K10 psychological distress score as an indicator of suicidal ideation. Methods. Suicidal ideation was assessed on the basis of four relevant questions contained in the General Health Questionnaire (GHQ-28), and these were subsequently analyzed against the K10 scores. The data were collected using a monthly risk-factor surveillance system where each month a representative random sample of South Australians over the age of 16 years is interviewed. The cumulative data covered the period 2002 to 2007 (n = 12,884). Results. Psychological distress and suicidal ideation were reported by 9.9% and 5.1% of the participants, respectively. Univariate analysis demonstrated a positive linear relationship between the K10 score and suicidal ideation. Participants scoring in the very high range of the K10 were more likely to report suicidal ideation and this was experienced with greater frequency than by those who were less distressed. A logistic regression analysis revealed that even those in the moderate category were four times more likely to experience suicidal ideation than those in the low category, and those in the high and very high categories were 21 and 77 times more likely, respectively. Separate models based on sex and using odds-ratios based on very high vs. low K10 scores showed that males were 104 times more likely to report suicidal ideation compared to a 63 times higher rate for females. Both sexes had a 52% probability of experiencing suicidal ideation if they fell into the very high distress group. Conclusions. The K10 score is a clinically useful indicator of the presence of suicidal ideation.
Collapse
Affiliation(s)
| | - Robert Goldney
- Faculty of Health Sciences, University of Adelaide, Australia
| | - Paul Delfabbro
- School of Psychology, Faculty of Health Sciences, University of Adelaide, Australia
| | - Tiffany Gill
- Population Research and Outcomes Section, South Australian Department of Health, Adelaide, Australia
| | - Lora Dal Grande
- Population Research and Outcomes Section, South Australian Department of Health, Adelaide, Australia
| |
Collapse
|
12
|
Sisask M, Värnik A, Kõlves K, Konstabel K, Wasserman D. Subjective psychological well-being (WHO-5) in assessment of the severity of suicide attempt. Nord J Psychiatry 2008; 62:431-5. [PMID: 18846444 DOI: 10.1080/08039480801959273] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An objective way to measure the severity of suicide attempt is to use different psychometric scales. Aspects of suicide risk like suicidal intent, depression, hopelessness and well-being can be assessed and different practical scales are in use to facilitate the risk assessment procedure. The aims of current study were: 1) to analyse the association between the severity of suicide attempt measured by suicidal intent scale and characteristics of emotional status of suicide attempters measured by depression, hopelessness and well-being scales in different gender and age groups; 2) to test the applicability of well-being measured by the World Health Organisation well-being index (WHO-5) in suicide risk assessment. The data on suicide attempters (n=469) was obtained in Estonia (Tallinn) by the WHO Suicide Prevention-Multisite Intervention Study on Suicidal Behaviours (SUPRE-MISS) methodology. Different psychometric scales were used to measure suicidal intent (Pierce Suicidal Intent Scale) and emotional status (Beck Depression Inventory for depression, Beck Hopelessness Scale for hopelessness, WHO-5 for well-being). All psychometric scales correlated well with each other (P<0.05). Low level of well-being associated with high level of suicidal intent, depression and hopelessness. Suicidal intent correlated the most strongly with well-being. Analysis by gender and age groups revealed also significant correlations with two exceptions only: correlation between suicidal intent and hopelessness did not reach the significant level in males and in older adults (40+). The WHO-5 well-being scale, which is a short and emotionally positively loaded instrument measuring protective factors, can be used in settings without psychological/psychiatric expertise in preliminary suicide risk assessment.
Collapse
Affiliation(s)
- Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia.
| | | | | | | | | |
Collapse
|
13
|
Sumathipala A, Siribaddana S, Samaraweera SD. Do Patients Volunteer Their Life Weariness and Suicidal Ideations? A Sri Lankan Study. CRISIS 2004; 25:103-7. [PMID: 15387236 DOI: 10.1027/0227-5910.25.3.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Summary: Objectives: Sri Lanka has a high suicide rate. The importance of suicidal ideations and their relationship to the common mental disorders (CMD) have not been adequately explored. This study examined whether patients harboring suicidal thoughts or life weariness would volunteer them. It also examined the relationship between life weariness, suicidal ideations, and the probability of underlying CMD. Method: A case control study was nested within a cross-sectional survey of attendees to the outpatients department in a general hospital. The index group consisted of patients presenting with multiple complaints and repeated visits, the control group was 100 patients randomly selected from a total of 5,767 between 16 and 65 years of age, not fulfilling criteria for the index group. Presence of underlying CMD was assessed by the General Health Questionnaire 30 (GHQ-30). The two groups were compared for symptoms volunteered, response to questions from GHQ-30 on suicidal ideations, and hopelessness. Results: Somatic symptoms were the most common in both groups. Eighty-one patients (81%) in the index group and 34 patients (34%) in the control group had probable CMD. No patient in either group volunteered suicidal ideation as a symptom. However, 59% of index patients and 26% of controls admitted life weariness, and 51/59 index patients and 15/26 controls who had life weariness also had underlying CMD as defined by GHQ scores. Conclusion: Patients who have suicidal thoughts do not volunteer them unless directly asked. There is a strong relationship between suicidal ideation and the probability of underlying CMD.
Collapse
|