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      Elevated Risk of Suicidal Ideation in HIV-Positive Persons

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      Author(s): 1 , * , 2
      Publication date (Electronic):
      Journal: Depression Research and Treatment
      Publisher: Hindawi Publishing Corporation

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          Abstract

          Globally, suicide and HIV/AIDS remain two of the greatest healthcare issues, particularly in low- and middle-income countries. Several studies have observed a relationship between suicidal behaviour and HIV/AIDS. Materials and Methods. The main objective of this research was to determine the prevalence of elevated risk of suicidal ideation in HIV-positive persons immediately following voluntary HIV counselling and testing (VCT). The study sample consisted of adult volunteers attending the VCT clinic at a university-affiliated, general state hospital. Participants completed a sociodemographic questionnaire, Beck's Hopeless Scale, and Beck's Depression Inventory. Results. A significantly elevated risk of suicidal ideation was found in 83.1% of the patients who tested seropositive. Despite a wide age range in the cohort studied, the majority of patients with suicidal ideation were males in the younger age group (age < 30 years), consistent with the age-related spread of the disease and an increase in suicidal behaviour in younger people. Relevant associated variables are discussed. Conclusion. The results serve as important markers that could alert healthcare professionals to underlying suicide risks in HIV-positive patients. It is recommended that screening for elevated risk of suicidal ideation and prevention of suicidal behaviour should form a routine aspect of comprehensive patient care at VCT clinics.

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          The measurement of pessimism: the hopelessness scale.

          A. Beck, A. Weissman, D. Lester … (1974)
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            Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey.

            D Leo, Huong Thi Tran, Lakshmi Vijayakumar … (2005)
            The objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community. The community survey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys. Suicide attempts (0.4-4.2%), plans (1.1-15.6%), and ideation (2.6-25.4%) varied by a factor of 10-14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22% and 88% of the attempts. The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed.
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              Suicidal behaviour across the African continent: a review of the literature

              Becky Mars, Stephanie Burrows, Heidi Hjelmeland … (2014)
              Background Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world’s second most populous continent, are limited. Methods We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Results Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa’s population; suicide attempt data were available for <20% of countries (7/53). Crude estimates suggest there are over 34,000 (inter-quartile range 13,141 to 63,757) suicides per year in Africa, with an overall incidence rate of 3.2 per 100,000 population. The recent Global Burden of Disease (GBD) estimate of 49,558 deaths is somewhat higher, but falls within the inter-quartile range of our estimate. Suicide rates in men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. Conclusions Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Depress Res Treat
                Journal ID (iso-abbrev): Depress Res Treat
                Journal ID (publisher-id): DRT
                Title: Depression Research and Treatment
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-1321
                ISSN (Electronic): 2090-133X
                Publication date (Print): 2015
                Publication date (Electronic): 29 September 2015
                Volume: 2015
                Electronic Location Identifier: 609172
                Affiliations
                1Department of Behavioural Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
                2Department of Family Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
                Author notes

                Academic Editor: Verinder Sharma

                Article
                DOI: 10.1155/2015/609172
                PMC ID: 4603315
                PubMed ID: 26491561
                SO-VID: 2c69b2a8-c3cf-41dd-9038-e000d5ab7614
                Copyright © Copyright © 2015 L. Schlebusch and R. D. Govender.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 29 June 2015
                Date accepted : 10 September 2015
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Neurology
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                ScienceOpen disciplines: Neurology

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