Suicidal and Death Ideation in a Cohort of Psychiatric Outpatients: Prevalence and Risk Factors

In Africa, data on the prevalence and predictors of death and suicidal ideation is lacking. In this study, a cross-sectional design was used to investigate the prevalence and risk factors for death and suicidal ideation in a cohort of 239 psychiatric patients receiving outpatient treatment at nine sites in the Durban area (South Africa) in 2015. Prevalence rates for death and suicidal ideation were high, with 35 (16%) patients reporting death ideation and 95 (40%) reporting suicidal ideation. Both death and suicidal ideation were significantly associated with unemployment (ORs = 2.61 and 2.34, respectively) and a primary diagnosis of depressive disorder (ORs = 4.72 and 6.54, respectively). Factors that uniquely predicted death ideation were: not being in an intimate relationship (OR = 6.45), ethnicity (being Indian South African: OR = 3.28) and a primary diagnosis of bipolar disorder (OR = 4.61), with suicidal ideation being uniquely predicted by a lower level of educational attainment (OR 2.86), ethnicity (being Black South African: OR = 3.36) and a primary diagnosis of borderline personality disorder (OR = 7.14). Study findings are discussed in terms of their implications for practice and future research.