Clinical characteristics and associated factors with suicidal ideation and suicide attempts among patients with depression: a priliminary study in Hue, Vietnam

Abstract

Background: Depression significantly increases the risk of suicide, particularly in low- and middle-income countries such as Vietnam, where individuals with major depression face an estimated 20-fold higher suicide risk than the general population. Data on clinical characteristics and factors associated with suicidal ideation and attempts among hospitalized depressed patients in Vietnam remain limited, especially in central Vietnam, where Hue Central Hospital serves as a major tertiary referral center for severe psychiatric cases. Objectives: To describe characteristics of suicidal ideation and attempts among depressed inpatients and identify factors associated with suicide attempts. Methods: A cross-sectional study was conducted among 38 patients diagnosed with depression (ICD-10 criteria) presenting with suicidal ideation or attempts, admitted to the Mental Health Department of Hue Central Hospital, using convenience sampling. Clinical characteristics were assessed via a self-designed questionnaire. Chi-square and Fisher's exact tests (for expected cell frequencies <5) compared proportions, while bivariate regression identified factors associated with suicide attempts, calculating odds ratios (OR) and 95% confidence intervals (CI). Results: Suicide attempt prevalence was 36.8% (n = 14). Suicidal ideation occurred between 6 AM and 6 PM in 52.6% of cases. A clear suicide plan was reported by 57.9% of patients, yet only 28.9% disclosed their ideation to others. Attempt methods included medication overdose (64.3%), hanging (14.3%), and cutting (21.4%). Two or more depressive episodes (OR = 5.405; 95% CI: 1.290 - 22.727; p = 0.037) and a history of previous attempts (Fisher's exact test, p < 0.001) were significant risk factors. A trend toward increased risk appeared among patients with psychotic symptoms (OR = 6.111; 95% CI: 0.999 - 37.490; p = 0.077), though not statistically significant. Conclusion: This preliminary study offers locally relevant data on suicidal behavior among depressed inpatients in Hue, Vietnam. Few patients disclosed their suicidal ideation, and those with multiple depressive episodes or prior attempts warrant close monitoring. Since suicidal ideation most commonly occurred during daytime hours, clinicians should maintain vigilant assessment throughout the day, particularly between 6 AM and 6 PM. These findings should be interpreted cautiously given the small sample size and cross-sectional design; larger prospective studies are needed to confirm these associations.