Suicidality in Tuberculosis Patients and their Non- Tuberculosis Family Contacts in Nigeria

Abstract

Objective: This study aimed at determining the prevalence and correlates of suicidal behavior in patients with tuberculosis as compared with their non-tuberculosis control, and to determine its association with disease pattern. Method: One hundred and fifteen patients with tuberculosis and 115 caregivers/family members visiting the Multi-drug Treatment Resistant (MDR) Treatment Centre at University College Hospital, Ibadan Centre were screened for suicidal behavior, depression, psychosis, alcohol or drug use, using the Mini International Neuropsychiatric Interview (MINI) and patient’s records. Physician’s report was used to determine the presence of a co-morbid general medical condition. Data were analyzed using SPSS version 20.0. Results: A significantly higher proportion of the TB cases compared to controls had suicidal ideation (44.3% versus 3.5%, p <0.001), suicidal plan (21.7% versus 1.7%) and attempt (14.8% versus 0.9%). Five patients (4.3%) of the TB cases completed suicide in the course of the study. A significantly higher proportion of the TB cases had Suicidality Scores in the moderate to high range (44.3%) compared to the controls (3.5%). Predictors of suicidality in TB were extra-pulmonary spread, p < 0.01, any substance use disorder, p < 0.01, lung abscess, p < 0.01, HIV/AIDS, p < 0.01and depression, p = 0.01. Conclusion: The high prevalence of suicidal behavior and its association with several disease severity indicators in this study reinforces the existing evidence for increased risk of suicidal behaviors in chronic physical illnesses, necessitating more robust consultation-liaison services for MDR-TB patients.