Prevalence and factors associated with suicidality among the elderly attending non-psychiatric wards at Mulago National Referral Hospital and Uganda Cancer Institute

Abstract

Background: The elderly are especially vulnerable to suicide. Older adults are at a substantially higher risk of dying by suicide compared to the younger age categories for a number of reasons including the fact that they tend to use more lethal methods and are less likely to recover. The actual rates of suicidality in this population are limited in Uganda. Thus, we aimed to study the prevalence and factors associated with suicidality among elderly attending non-psychiatric wards at Mulago national referral hospital and Uganda cancer institute. Methods: This was a cross- sectional study. We studied 275 elderly patients attending non- psychiatric wards at Mulago national referral hospital and Uganda cancer institute. Suicidality was measured using the suicidality module of the Mini International neuropsychiatric interview. Data was entered into Microsoft excel sheet, cleaned and then exported to SPSS version 25 for analyses. To assess the associated factors for suicidality, first chi-square test was used at a bivariate level to assess differences in suicidality between various independent variable groups. All variables with p<0.2 were then entered into a stepwise multivariable logistic regression model to identify those that are independently associated with suicidality. All analyses were two sided (p<0.05). Results: Suicidality was identified in 54.9% of old persons. The prevalence for low, moderate and high risk for suicidality were 47.6%, 4.4%, and 2.9% respectively. The prevalence of suicidal ideation was 25.1% and that of suicidal attempts was 6.5%. Organophosphate ingestion and a combination of other methods were the most common methods of suicidal attempt. The factors associated with increased risk for suicidality was severe depression (moderately severe depression: adjusted OR=5.49 (2.03 – 14.8), p=0.001 and severe depression: adjusted OR=12.07 (3.43 – 42.45) p<0.001). Participant attending Uganda Cancer Institute had 55% significant lower risk for suicidality with adjusted OR= 0.45 (0.21 – 0.94), p=0.033). Conclusion: These findings suggest a high rate of suicidality among older persons admitted in non-psychiatric wards. Severe depression is a risk factor for suicidality. Keywords: Suicidality, high risk, elderly, non- psychiatric wards