Abstract:
Background: Suicide is a global health problem that has prompted the World Health
Organization (WHO) to announce the Mental Health Action to reduce suicide rates. It
is estimated that annually, 1 million people die by suicide globally. In Kenya, the
suicide mortality rate was reported to be 6.1 per 100,000 population in 2019. Suicide
attempt is a crucial risk factor for subsequent suicide, making it a psychiatric
emergency. As such, transient factors that reflect an imminent risk of suicide must be
treated as a crisis that needs to be thoroughly investigated and thereafter be accorded
immediate intervention.
Objectives: This study aimed to determine the patterns of psychiatric morbidity,
methods of suicide employed as well as their socio-demographic and clinical factors
that may predispose patients admitted at Moi Teaching and Referral Hospital
(MTRH) to attempted suicide.
Methods: This was a cross-sectional study conducted between August 2019 and July
2021 among 154 adult patients admitted at MTRH with current history of attempted
suicide. All potential participants who met the eligibility criteria and consented to
participate were enrolled. Their socio-demographic and clinical characteristics data
were collected using a structured questionnaire while the validated Mini International
Neuropsychiatric Interview Version 7.0 was employed in screening for mental
disorders. Potential participants' ability to give an informed consent was assessed
using the University of California Brief Assessment of Capacity to Consent (UBACC)
questionnaire. Categorical data were reported descriptively as frequencies with
corresponding proportions. Inferential data analysis techniques using Pearson chisquare
and Fisher‘s exact tests were performed using STATA version 14 and the
results presented in the form of charts and tables.
Results: Majority 109 (70.8%) of the participants were less than 35 years old with
more than two thirds 107 (69.5%) being male. About half 76 (49.4%) of the
participants were not married, professed the Christian faith 112 (72.7%), had attained
a secondary level of education 65 (42.2%), unemployed 57 (37.0%) and earned a
monthly income below Ksh10,000) 133 (86.4%). Ingestion of organophosphate 110
(71.4%) was the most frequent method adopted for attempting suicide followed by
prescription drug overdose 14 (9.1%). Major depressive disorder (MDD) 60 (39.0%),
alcohol use disorder (AUD) 50 (32.5%), psychotic disorder 27 (17.5%) and bipolar 26
(16.9%) were the most prevalent mental disorders. Male participants had a four-fold
significantly increased likelihood (AOR = 3.99; 95% CI: 1.59, 11.30; p=0.005) of
alcohol use disorder associated with attempted suicide.
Conclusion: The leading psychiatric morbidities were major depressive disorder
(MDD) and alcohol use disorder (AUD). Organophosphate poison ingestion and
prescription drug overdose were the most employed patterns of attempted suicide.
Young male adults (below 35 years) with AUD and female with MDD were
vulnerable to attempting suicide.
Recommendation: There is need to inculcate routine mental health screening across
various demographics for hospitalized patients outside the psychiatric unit to aid in
early detection and prevention of attempted suicide. Organophosphate purchase and
use should be regulated by government agencies, and sensitization on consequences
of prescription drug overdose should be enhanced. Organophosphates purchase and
use should be regulated by government agencies. Furthermore, programs targeting at
risk groups should be established and implemented.