Suicidal ideation in German primary care

OBJECTIVE: To examine suicidal ideation in a sample of German primary care patients.

METHODS: We conducted a cross-sectional study and included 1455 primary care patients who visited 1 of 41 general practitioners (GPs) working at 19 different sites. Suicidal ideation and psychopathology were assessed with the Patient Health Questionnaire (PHQ) in an anonymous screening together with health care utilization.

RESULTS: One hundred seventy-one (11.8%) of 1455 patients endorsed the suicidal ideation item of the PHQ. These patients were significantly younger, more often female and unmarried, suffered more often from psychopathology and reported more health care utilization than patients without suicidal ideation. Patients with the highest frequency of suicidal ideation also talked more often routinely about psychosocial problems with their GP, used more often medication against their complaints and searched more often for a psychotherapist than other suicidal ideators. Yet, these patients were not more likely to be in psychotherapy at the time of the screening.

CONCLUSION: Our data suggest that suicidal ideation is a common phenomenon in primary care, which is independently associated with psychopathology in terms of depression, anxiety and somatoform complaints. Psychosocial support from GPs and medication seem to be easier available for primary care patients with suicidal ideation than psychotherapy, independent of the severity of the suicidal ideation.