Do patients volunteer their life weariness and suicidal ideations? A Sri Lankan study

Sri Lanka has a high suicide rate. The importance of suicidal ideations and their relationship to the common mental disorders (CMD) have not been adequately explored. This study examined whether patients harboring suicidal thoughts or life weariness would volunteer them. It also examined the relationship between life weariness, suicidal ideations, and the probability of underlying CMD.

A case control study was nested within a cross-sectional survey of attendees to the outpatients department in a general hospital. The index group consisted of patients presenting with multiple complaints and repeated visits, the control group was 100 patients randomly selected from a total of 5,767 between 16 and 65 years of age, not fulfilling criteria for the index group. Presence of underlying CMD was assessed by the General Health Questionnaire 30 (GHQ-30). The two groups were compared for symptoms volunteered, response to questions from GHQ-30 on suicidal ideations, and hopelessness.

Somatic symptoms were the most common in both groups. Eighty-one patients (81%) in the index group and 34 patients (34%) in the control group had probable CMD. No patient in either group volunteered suicidal ideation as a symptom. However, 59% of index patients and 26% of controls admitted life weariness, and 51/59 index patients and 15/26 controls who had life weariness also had underlying CMD as defined by GHQ scores.

Patients who have suicidal thoughts do not volunteer them unless directly asked. There is a strong relationship between suicidal ideation and the probability of underlying CMD.