Patterns and Predictors of Suicide Attempts Among Inpatients at the Federal Neuro-Psychiatric Hospital, Enugu, Nigeria: A Retrospective Cohort Study

Abstract

Background: Suicide is a significant public health concern, particularly among psychiatric patients. Understanding the patterns and predictors of suicide attempts within hospital settings is crucial for developing effective prevention strategies. Aim: This study aimed to identify the demographic, clinical, and psychosocial factors associated with suicide attempts among inpatients at the Federal Neuro-Psychiatric Hospital, Enugu, Nigeria, using a retrospective cohort design. Methods: Medical records of inpatients with documented suicide attempts during hospitalisation at the Federal Neuro-Psychiatric Hospital, Enugu, Nigeria, were reviewed in a retrospective study. The review covered admissions between January 2015 and December 2023. Data were collected on demographic characteristics (age, gender, marital status, and education level), clinical diagnoses (primary psychiatric disorder, comorbid conditions), treatment history (duration of hospitalisation, medication, and therapy), and psychosocial factors (family history of mental illness, substance use, and socioeconomic status). Descriptive statistics were used to identify patterns, while logistic regression analysis was performed to determine the predictors of suicide attempts. Results: A total of 2,150 inpatients were reviewed, with 320 (14.9%) having documented suicide attempts during their hospitalisation. The majority of those who attempted suicide were female (62.5%), aged between 18-35 years (54.1%), and unmarried (67.8%). Schizophrenia (34.4%), major depressive disorder (30.2%), and bipolar disorder (18.9%) were the most common primary diagnoses among these patients. Substance use disorders were present in 41.3% of those who attempted suicide. Logistic regression analysis revealed that being female (OR=1.45; 95% CI: 1.16-1.81), having a diagnosis of major depressive disorder (OR=2.78; 95% CI: 2.13-3.64), and having a history of substance use (OR=1.92; 95% CI: 1.47-2.50) were significant predictors of suicide attempts. Conclusion: Suicide attempts among psychiatric inpatients at the Federal Neuro-Psychiatric Hospital, Enugu, Nigeria, are associated with specific demographic and clinical factors, particularly among young females, those with major depressive disorder, and individuals with substance use disorders. These findings underscore the need for targeted interventions and tailored suicide prevention strategies, particularly for high-risk groups identified in this study. Further research should explore the impact of psychosocial interventions on reducing suicide attempts in this population.