Suicidal thoughts and behaviours in Cape Town: a cross-sectional study of prevalence, social, contextual, and clinical correlates
Year: 2025
Type: preprint
Study design: Observational Study
Abstract: Background: Suicidal thoughts and behaviours (STBs) are traditionally attributed to mental disorders; however, increasing evidence indicates that social determinants contribute to suicide risk. We examined STBs and their socioeconomic, psychosocial and clinical correlates in two communities in Cape Town. Methods: We conducted psychiatric diagnostic interviews (MINI) at three public-sector facilities (2023-2024). Adults aged ≥18 years, with and without HIV, were recruited in a 2:1 ratio. We examined associations between suicidal ideation and sociodemographic factors, violence exposure, perceived stress, mental disorders, and HIV, reporting average marginal effects (AME) as percentage-point differences in predicted probability. Results: We enrolled 613 participants (63.9% female; 65.4% living with HIV; median age 39). The prevalence of past 30-day suicidal ideation was 14.0%, while 22.2% reported a lifetime suicide attempt. Suicidal ideation was more likely among females (8.52 percentage points, 95% CI 3.08 -13.96), those reporting violence in the community (7.52, 0.87-14.17) or in the family (14.09, 4.56 -23.62), those with moderate (7.76, 2.76 -12.77) or high perceived stress (33.58, 20.67- 46.50), and those with depression (27.13, 14.67- 39.58), post-traumatic stress disorder (27.98, 12.12 - 43.84), or alcohol use disorder (8.34, 1.53 -15.15). Associations with high perceived stress and community violence persisted after adjustment for mental disorders. HIV status and other sociodemographic factors showed no evidence of association. Conclusion: STB prevalence was high in peri-urban communities in Cape Town and strongly associated with mental disorders, violence exposure, and perceived stress. These findings underscore the role of structural and psychosocial stressors in shaping suicide risk in low-income communities.
Source: medRxiv
Institutions: University of Cape Town, Stellenbosch University, South African Medical Research Council, Institute of Infectious Disease and Molecular Medicine, Tygerberg Hospital, University of Bern, LMU Klinikum, Institut für Psychiatrische Phänomik und Genomik, Ludwig-Maximilians-Universität München, Institute of Social and Preventive Medicine
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funders: National Science Foundation, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Fogarty International Center, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Cancer Epidemiology and Genetics, National Cancer Institute
OpenAlex ID: W7117645557
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