Lifetime suicidal ideation and attempt are common among HIV+ individuals

Abstract

Background Estimates of the prevalence of lifetime suicidal ideation and attempt, and risks for new-onset suicidality, among HIV-infected (HIV+) individuals are not widely available in the era of modern combined antiretroviral treatment (cART). Method Participants (n=1560) were evaluated with a comprehensive battery of tests that included the depression and substance use modules of the Composite International Diagnostic Interview (CIDI) and the Beck Depression Inventory-II (BDI-II) as part of a large prospective cohort study at six U.S. academic medical centers. Participants with possible lifetime depression (n=981) were classified into five categories: 1) no thoughts of death or suicide (n=352); 2) thoughts of death (n=224); 3) thoughts of suicide (n=99); 4) made a suicide plan (n=102); and 5) attempted suicide (n=204). Results Twenty-six percent (405/1560) of participants reported lifetime suicidal ideation and 13% (204/1560) reported lifetime suicide attempt. Participants who reported suicidal thoughts or plans, or attempted suicide, reported higher scores on the BDI-II (p<0.0001), and higher rates of current major depressive disorder (p=0.01), than those who did not. Attempters reported higher rates of lifetime substance abuse (p=0.02) and current use of psychotropic medications (p=0.01) than non-attempters. Limitations Study assessments focused on lifetime, rather than current, suicide. Data was not collected on the timing of ideation or attempt, frequency, or nature of suicide attempt. Conclusions High rates of lifetime suicidal ideation and attempt, and the relationship of past report with current depressed mood, suggests that mood disruption is still prevalent in HIV. Findings emphasize the importance of properly diagnosing and treating psychiatric comorbidities among HIV persons in the cART era.

Suicide mortality among people accessing highly active antiretroviral therapy for HIV/AIDS in British Columbia: a retrospective analysis

“…Third, the lack of accepted methodology within this field of research, suicidality in HIV-positive populations, limits the comparability and generalizability of results across studies. 1,9,11,41,42 Fourth, suicides may be underestimated as those that occur as a result of selfadministered withdrawal of care or similar indirect ways often cannot be distinguished as such; however, given the definition of suicide used in this study includes accidental poisoning it may also be possible that the number of suicides was overestimated and that some instances of overdose death are, in fact, not suicides. Fifth, our sample size, information on certain variables such as injection drug use and sex distribution is limited; in addition, we had no access to clinical information regarding previous psychiatric history, particularly depression, or any mental health-related treatments.…”

Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease

“…Patients with suicidal ideation presented higher rates of depressive disorder, and those with a history of suicide attempts presented higher rates of alcohol abuse. 33 Mood disorder was considered the more prevalent psychiatric condition in HIV-positive patients and a challenge for liaison psychiatry consultation. 34 Suicide risk has also described in patients with chronic and oncologic diseases 13 and approximately 90% of individuals who commit suicide present a mental disorder.…”

Suicide ideation, depression and HIV among pregnant women in rural South Africa

“…In high-income settings research shows that suicide ideation, plans and attempts are elevated among persons living with HIV [34][35][36]. In the United States, for example, at least a third of women living with HIV report attempting suicide, mostly in the first week or month after learning their diagnosis, and having children is a significant predictor of suicide attempts [37].…”