People with mental health problems attending primary care settings report less suicidal ideation following physical activity counselling: Findings from a low income country

Background: With over 75 % of all suicides occurring in low- and middle-income countries (LMICs), the burden on health care systems and societies is highest in this part of the world. Since psychotropic medication is seldomly available in primary care settings in LMICs, non-pharmacological interventions to reduce suicidal ideation are essential. Physical activity has the potential to reduce suicidal ideation, but the current evidence is inconsistent and mainly derived from studies in high-income countries. In this secondary analysis of 3 pre-test/post-test studies without a control group studies, we aim to explore whether being physically active is associated with reductions in suicidal ideation in people with mental health problems in rural areas in Uganda.Methods: From 682 primary care patients, 151 were eligible and included in 8-weeks once weekly physical activity counselling of which 61 (50 female; age = 44.1 +/- 13.7 years; body mass index = 21.6 +/- 3.6) reported suicidal ideation at baseline and were included in this secondary analysis. Suicidal ideation was assessed with item 9 of the Patient Health Questionnaire-9 (PHQ-9), physical activity levels with the Simple Physical Activity Questionnaire (SIMPAQ). Wilcoxon signed-rank tests were used.Results: Suicidal ideation (PHQ-9 item 9 >= 1) prevalence dropped from 100 % to 9.8 % post-intervention (P < 0.001). Following the intervention, significantly higher physical activity levels were observed (SIMPAQ total scored = 54.9 +/- 41.4 min/day versus 287.3 +/- 149.7 min/day, P < 0.001).Conclusions: Our data demonstrate that physical activity might be a promising intervention in reducing suicidal ideation in primary care patients in low-resourced settings. Randomized controlled trials are warranted to confirm these beneficial findings.

Automated summary

Physical activity may be a promising intervention to reduce suicidal ideation in primary care patients in low-resourced settings, according to a study conducted in rural areas of Uganda. Further randomized controlled trials are needed to confirm these findings.