Factors associated with suicidal behaviour among depressed patients in Penang, Malaysia

INTRODUCTION This study aims to highlight the factors associated with suicidal behavior among patients with depressive disorders. MATERIAL AND METHODS A retrospective (Jan 2002 - Dec 2007) evaluation of medical records was done at the psychiatric clinic at the Penang (Malaysia) Public Hospital. Data was analyzed using Statistical Package for Social Science SPSS version 13(®). Chi-square (χ(2)) test was used to assess the association among variables. Odds ratios were calculated. Multiple logistic regression was applied to identify the predictors for suicidal behavior. RESULTS Of 298 patients, 99 patients reported having thoughts of suicide. Overall, female respondents, particularly Chinese, constituted the majority reporting suicidal thoughts (p = 0.01). Cigarette (p < 0.01) and alcohol use (p < 0.01) were found to be associated with suicidal ideation. Among patients with medical comorbidities, diabetics were at a high risk for suicidal thoughts (odds ratio - OR = 1.05, 95% confidence interval - CI 0.45-2.46). In terms of social problems, marital and relationship difficulties were the main risk factors (OR = 2.03, 95% CI: 1.16-3.58). The significant predictors for suicidal behavior were found to be smoking and alcohol use (adjusted R(2) = 0.39, F change = 75.55, p < 0.01). CONCLUSIONS Chinese females were found at higher risk of suicidal ideation, as were smokers and alcohol users. The elderly aged 50 and over were also at a higher risk, followed by adolescents and youths aged 15-24 years. Comorbid medical complications and social problems were other factors that may contribute to suicidal ideation among the patients with depressive disorders.