TY - JOUR

T1 - Suicidal ideation among Nepali widows

T2 - an exploratory study of risk factors and comorbid psychosocial problems

AU - Garrison-Desany, H. M.

AU - Lasater, M. E.

AU - Luitel, N. P.

AU - Rimal, D.

AU - Pun, D.

AU - Shrestha, S.

AU - Tol, W.

AU - Surkan, P. J.

PY - 2020

Y1 - 2020

N2 - Purpose: Suicide is a leading cause of death among Nepali women of reproductive age. Suicidal ideation has known associations with stressful life events, which Nepali widows disproportionately experience. We aimed to identify risk and protective factors that could lead to effective interventions for this population. Methods: To study suicidal ideation in Nepali widows, we collected data from 204 women in urban, semi-urban, and rural areas whose husbands died at least one year prior. The questionnaire included sociodemographic information, the Hopkins Symptom Checklist-25, PTSD Checklist—Civilian Version, Somatic Symptom Scale–8, and the Multidimensional Scale of Perceived Social Support. Overall severity of prolonged grief was assessed by a counselor after completing a structured clinical interview. Using multivariate regression models, we assessed associations of sociodemographic and psychosocial indicators with past-year suicidal ideation. Latent profile analysis was also performed to estimate profiles of comorbidities. Results: Past-year suicidality was high, with 16.2% (N = 33). Each year increase since husband's death was protective and reduced odds of ideation 8% (95% CI 0.85–0.98) and being educated and of older age also reduced the odds of ideation by 0.21 (95% CI 0.06–0.70), and 0.09 (95% CI 0.01–0.64), respectively. Depression (OR = 6.37, 95% CI 2.78–14.59), PTSD (OR = 3.84, 95% CI 2.15–6.86), prolonged grief (OR = 6.04, 95% CI 3.04–12.00) and anxiety (OR = 6.52, 95% CI 2.96–14.38) were highly associated with suicidality, and mapped onto the three profiles of increasing mental distress severity. Conclusion: Suicide remains a major issue among Nepali widows, showing high comorbidity with other mental disorders. Screening for depression, anxiety, and prolonged grief, may aid in identifying widows at increased risk of suicidal ideation.

AB - Purpose: Suicide is a leading cause of death among Nepali women of reproductive age. Suicidal ideation has known associations with stressful life events, which Nepali widows disproportionately experience. We aimed to identify risk and protective factors that could lead to effective interventions for this population. Methods: To study suicidal ideation in Nepali widows, we collected data from 204 women in urban, semi-urban, and rural areas whose husbands died at least one year prior. The questionnaire included sociodemographic information, the Hopkins Symptom Checklist-25, PTSD Checklist—Civilian Version, Somatic Symptom Scale–8, and the Multidimensional Scale of Perceived Social Support. Overall severity of prolonged grief was assessed by a counselor after completing a structured clinical interview. Using multivariate regression models, we assessed associations of sociodemographic and psychosocial indicators with past-year suicidal ideation. Latent profile analysis was also performed to estimate profiles of comorbidities. Results: Past-year suicidality was high, with 16.2% (N = 33). Each year increase since husband's death was protective and reduced odds of ideation 8% (95% CI 0.85–0.98) and being educated and of older age also reduced the odds of ideation by 0.21 (95% CI 0.06–0.70), and 0.09 (95% CI 0.01–0.64), respectively. Depression (OR = 6.37, 95% CI 2.78–14.59), PTSD (OR = 3.84, 95% CI 2.15–6.86), prolonged grief (OR = 6.04, 95% CI 3.04–12.00) and anxiety (OR = 6.52, 95% CI 2.96–14.38) were highly associated with suicidality, and mapped onto the three profiles of increasing mental distress severity. Conclusion: Suicide remains a major issue among Nepali widows, showing high comorbidity with other mental disorders. Screening for depression, anxiety, and prolonged grief, may aid in identifying widows at increased risk of suicidal ideation.

KW - Depression

KW - Suicide

KW - Transcultural psychiatry

KW - Women’s health

U2 - 10.1007/s00127-020-01932-7

DO - 10.1007/s00127-020-01932-7

M3 - Journal article

C2 - 32794027

AN - SCOPUS:85089388512

VL - 55

SP - 1535

EP - 1545

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

SN - 0933-7954

ER -