Prevalence of suicidality among people with substance use disorders at Mathari national teaching and referral hospital in Nairobi county, Kenya.

Abstract

Introduction: The World Health Organization estimates that within the next five years 15 to 30 million people around the world will attempt suicide every year, with 10% of these being successful in their attempts. Documented evidence shows that substance use disorders are a major risk factor for suicidality. Different studies have found conflicting results on the prevalence of suicidal behaviors among people with substance use disorders. There is paucity of literature in Kenya showing estimate prevalence of suicidality among people with substances use disorders. Purpose: This study sought to determine the prevalence of suicidality among patients with substance use disorders attending outpatient clinics at Mathari National Teaching and Referral Hospital. Materials and Methods: This was a cross-sectional study. Two hundred and eleven patients with history of substance use disorders attending outpatient clinics at Mathari hospital were invited to participate in the study upon giving informed consent. A socio-demographic questionnaire was used to collect socio-demographic characteristics. The World Health Organization’s Alcohol, Smoking and Substance Involvement Screening and Test (ASSIST) tool was used to measure the type and duration of substance use while the Becks Scale for Suicidal Ideation (BSSI) was used for detecting and measuring the current intensity of the patients’ specific attitudes, behaviors, and plans to commit suicide. Collected data was double-entered into MSAccess software and checked for errors prior to commencement of data analysis using STATA software. Results: A Total of 211 participants participated in the study. The mean age of the respondents was 30.8 years. Of the 211 respondents, males (197) at 93.4 % were considerably more than the females at 6.6 % (14). Christians were considerably more than the Muslims and the other religions. Majority of the respondents attained secondary education as their highest level of education with university having the least number. Majority of the respondents were casual laborers. Majority of them were never married while a handful were divorced, separated or widowed. The mean income of the respondents was ksh16715.6 with majority earning less than Ksh. 5000.viii The prevalence of lifetime suicidal attempts was 25.1% . with the proportion of participants with active suicidal ideation was 6.6% which is higher than the prevalence of suicide ideation and attempts in the general population.. Alcohol was the most commonly used substance followed by cannabis, tobacco, amphetamines and cocaine. Opiods, sedatives and hallucinogens had the lowest prevalence. Participants who were using cocaine at risky levels were about 9 times more likely to have suicidal ideation (A.O.R.=9.38, 95% C.I. 1.88-46.73) as compared to those who do not use cocaine/ use at low risk levels. Respondents who had previously attempted suicide were about 8 times more likely to have suicidal ideation (A.O.R.=7.73, 95% C.I. 2.19-27.20) as compared to those who had never attempted suicide.21 % of participants had comorbidities with depression ( 10% ),bipolar mood disorders ( 8.1%) and schizophrenia ( 3.8% ).no significant association was established between comorbidities and suicidality. Conclusion: Risk of suicide is higher among people with substance use disorders compared with the general population. There is need for clinicians to routinely and continuously screen patients with substance use disorders for suicidal thoughts and behaviors through.