Suicidal behavior reported by 10.3% of chronic-care patients in Malawi

Researchers assessed suicidal behavior among 2,240 adults receiving care for chronic health conditions in Neno District, Malawi. The analysis was conducted as part of a randomized trial of treatment for major depressive disorder. Patients reporting low mood and/or anhedonia were screened with the Patient Health Questionnaire (PHQ-9); those indicating suicidal ideation received a further suicidality assessment. The researchers used univariate analysis and multivariable logistic regression to examine prevalence and demographic correlates.

Overall, 10.3% of screened patients reported suicidal behavior. The article reports that, among this group, 34% had suicidal ideation in the previous week, 7% had attempted suicide in the past, 26% had an existing self-harm plan and 10% were currently experiencing suicidal ideation. Elevated depressive symptoms were associated with suicidal behavior (p < 0.000, as reported). Younger age (p = 0.001) and female sex (p = 0.02) were also associated with greater odds of reporting it.

The findings identify suicidal behavior in a population with chronic conditions and depressive symptoms, but do not test an intervention or establish causation. The sample was drawn from one district and selected for low mood and/or anhedonia, so the prevalence estimate should not be generalized to all adults with chronic conditions in Malawi. Further details on the assessment and category denominators are not provided in the supplied text.