ABSTRACT
Background: Suicidal behaviour is an established psychiatric complication of congestive cardiac failure (CCF), contributing significantly to morbidity and death by suicide. The magnitude and risk factors for suicidal behaviour among patients with CCF are yet to be unpacked, especially in developing nations such as Nigeria. Aim: To determine the prevalence of suicidal behaviour and the risk factors associated with suicidal behaviour, among patients with CCF in Nigeria. Setting: Cardiology outpatient clinic of Lagos State University Teaching Hospital, Lagos, Nigeria. Methods: A cross-sectional study was conducted among 98 randomly selected patients with a diagnosis of CCF. Participants were assessed with a socio-demographic and clinical factors questionnaire and Beck Scale of Suicidal Ideation. Chi-square test, t-test and logistic regression were used to analyse data. Results: The prevalence of suicidal ideation and suicidal attempt among patients with CCF was 52% and 1%, respectively. No socio-demographic factor was significantly associated with suicidal ideation. Clinical factors associated with suicidal ideation were age at diagnosis (p = 0.042), aetiology of CCF (p = 0.001) and severity of CCF (p = 0.032). Only the severity of CCF (odds ratio [OR] = 20.557, p = 0.014) predicted suicidal ideation among patients with CCF. Conclusion: Suicidal behaviour constitutes a huge burden among the outpatient CCF population. The identification of clinical risk factors for suicidal ideation (age at diagnosis, aetiology and severity of CCF) further illuminates a pathway to mortality among patients with CCF. Contribution: The findings lend a voice to the need for screening for suicidal behaviour, suicide prevention programmes, surveillance systems and government policies that support mental health for patients with CCF.
ABSTRACT
OBJECTIVE: To evaluate the clinico-pathological determinants of suicidal thoughts and behavior in patients with post-stroke depression (PSD) in a teaching hospital in south-west Nigeria. METHOD: A cross-sectional study was carried out in Lagos State University Teaching Hospital and it involved 89 consecutively selected outpatients with post-stroke depression (diagnosed using the depression module of Mini International Neuropsychiatric Inventory). Socio-demographic and clinical factors questionnaire, Mini-Mental State Examination, National Institute of Health Stroke Scale, and Beck Scale of Suicidal Ideation (BSSI) were administered to the participants. BSSI total score was used as a measure of suicidal thoughts. Ethical approval was obtained from the ethics and research committee of Lagos State University Teaching Hospital. RESULT: Time since stroke (the time since onset of the most recent stroke) had a significant negative correlation with suicidal thoughts (r = -0.263, p = 0.013). In the same vein, the probability of attempting suicide significantly reduces with time since stroke, Odds Ratio = 0.925, p = 0.047. CONCLUSION: Suicidal thoughts and behavior occur early in patients with post-stroke depression. The identification of shorter time since stroke as a correlate of suicidal thoughts and behavior among this patient population underscores the need for performing early assessment and prompt intervention for the at-risk individuals.
