Prevalence and psychiatric correlates of suicidal ideation in primary care patients: gender differences

Abstract

Evaluation of primary care (PC) patients for suicidal ideation is an important task for family practitioners, because it was reported that more than 80% of patients 6 months before their suicidal attempt were consulted by physician [1]. PC services have a key role in provision of services for medical as well as for psychiatric conditions [2]. The aim of this study was to establish prevalence of suicidal ideation and its correlates in PC patients according to gender. Methods: Study was performed in four PC settings in two major cities of Lithuania. In each setting during a four week period all consecutive patients attending family practitioner were invited to participate in this cross-sectional study. In total 1170 patients were approached. However, final study sample included 998 patients (68% women and 32% men; mean age 50±19 years, range from 18 to 89 years). Patients were assessed for current mental disorders (major depressive episode, MDE; generalized anxiety disorder, GAD; posttraumatic stress disorder, PTSD; panic disorder and social phobia), for suicidal ideation and for excessive alcohol use using the Mini International Neuropsychiatric Interview (MINI). Information regarding medication use was obtained from the medical records. Results: Suicidal ideation was identified in 61 (6.1%; 95% CI 4.6−7.6) PC patients, 6.7% (95% CI 4.8−8.5) of women and 5% (95% CI 2.6−7.4) of men. Of all (n = 61) patients with suicidal ideation 24.6% used anxiolytics, 8.2% used antidepressants and 1.6% used antipsychotics. Most prevalent current mental disorders were MDE found in 15.2%, anxiety disorders (GAD, panic disorder, social phobia or PTSD) found in 26.3%, and excessive alcohol use found in 34.8% of patients. In univariate analysis suicidal ideation was associated with antidepressant use (OR, 5.4; 95% CI: 1.9–15.2), presence of MDE (OR, 3.7; 95% CI; 2.2−6.6), anxiety disorder (OR, 3.0; 95% CI; 1.8−5.1), and with anxiolytics use (OR, 2.2; 95% CI; 1.2−4.