Level of Suicidal Tendency and Associated Factors among Patients with Mental Illness- A Cross Sectional Study

Abstract

Background: Suicide is a major public health concern worldwide and is closely related to mental illness. In Bangladesh, suicidal thoughts and attempts are common among people with psychiatric disorders. However, limited research evidence is available regarding the level of suicidal tendency and associated behavioral and situational factors among patients with mental illness. Identifying these factors is necessary to reduce suicidal risk and improve mental health services. Aim: To determine the level of suicidal tendency and identify the associated behavioral and situational factors among patients with mental illness. Methods: This was a quantitative cross-sectional study conducted among 130 patients with mental illness. Data were collected through face-to-face interviews using a socio demographic and the Suicide Intent Scale (SIS). Data were analyzed in SPSS (version 20) using descriptive statistics. The Chi-square test was used to examine associations between suicidal tendency and related factors, and Fisher’s exact test was used when the expected cell count was less than 5. Ordinal logistic regression was used to identify the independent factors associated with suicidal tendency. Results: The mean age of the participants was 24.24 ± 8.72 years. The majority were female (62.3%), unmarried (54.6%), and belonged to the middle-income group (96.9%). Schizophrenia was the most common diagnosis (36.2%), followed by bipolar I disorder (15.4%) and bipolar affective disorder (13.1%). The median Suicide Intent Scale (SIS) score was 13.5 (range: 4-25). Most participants were categorized as having medium suicidal risk (66.9%), followed by low risk (20.8%) and high risk (12.3%). Among behavioral factors, history of substance use was significantly associated with suicidal tendency (P = 0.013). In ordinal logistic regression analysis, history of substance use remained an independent predictor of higher suicidal risk (B = 1.954, P = 0.010; 95% CI: 0.473–3.435). Among situational factors, monthly family income was significantly associated with suicidal tendency in regression analysis (B = –2.258, P = 0.030; 95% CI: –4.298 to –0.219), indicating that participants from non-middle income groups were more likely to have higher suicidal risk. Other behavioral and situational variables were not statistically significant. Conclusion: This study shows that most patients with mental illness had a moderate level of suicidal tendency. History of substance use was an important associated factor. These findings show that regular suicide risk screening and checking substance use history can help to prevent suicide among patients with mental illness. Keywords: Suicide intent scale, Suicidal tendency, Mental illness, Substance use, Risk factors, Bangladesh.