Prevalence of suicidal ideation and attempt: associations with psychiatric  disorders and HIV/AIDS in post-conflict Northern Uganda.

James Mugisha, Herbert Muyinda, Ashraf Kagee, peter Wandiembe, Stephen Kiwuwa,Mpugu, Davy Vancampfort, Eugene Kinyanda
1. Kyambogo University, Kampala, Uganda
2. Makerere University, Child Health and Development Centre, School of Medicine, Mulago Hill, Kampala, Uganda
3. Stellenbosch University, Department of Psychology, South Africa
4. Department of Statistical Methods, Makerere University, COBAMS, Makerere Hill, Kampala Uganda
5. Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
6. University Psychiatric Centre University of Leuven, Kortenberg, Belgium
7. MRC/UVRI Uganda Research Unit on AIDS, Uganda/MRC-DFID African Leadership Award, 50-59 Nakiwogo
Street, Entebbe, Uganda
8. Department of Psychiatry, Makerere University College of Health Sciences, School of Health Sciences Makerere
Hill, Kampala, Uganda

Abstract:
Background: Research on the prevalence of suicidal ideation, attempt, and cormorbid psychiatric disorders in post-conflict areas is still limited.

Aim:We explored the prevalence of suicidal ideation, attempt, associated psychiatric disorders and HIV/AIDS in post-conflict  Northern Uganda, an area that experienced civil strife for over two decades.

Methods: A total of 2400 respondents (aged 18 and above) and randomly selected in three districts  (Gulu, Amuru and Nwoya), were interviewed. Multivariable logistic regression was used to assess for associations between suicidality (suicidal ideation and attempt) and psychiatric cormorbidities.

Results: The prevalence of suicidal ideation and attempt were 12.1 % and 6.2 % respectively. Suicidality was significantly (P<0.001) higher among respondents with major depressive disorder (adjusted Odds Ratio (OR) = 9.5; 95%CI= 7.4, 12.1) and post-traumatic stress disorder (adjusted OR =2.4; 95%CI= 1.6, 3.6). Men had lower odds of ideating or attempting suicide compared to women (adjusted OR = 0.55; 95%CI: 0.38, 0.82).

Conclusion: The prevalence rate of suicide ideation and attempt indicate a major public health problem in post-conflict Northern Uganda. Effective public mental health programs that that target both suicidality and psychiatric co-morbodities will be vital.  Special attention should be given to women in post conflict Northern Uganda.

Keywords: Suicide attempt, ideation, cormorbidity, post-conflict Northern Uganda