Factors associated with history of suicide attempt among patients with major depressive disorder at a community mental health center in the Peruvian Andes: a case-control study.

Background: A history of suicide attempt among patients with major depressive disorder has been associated with clinical, psychosocial, and familial vulnerabilities, yet evidence from community mental health services in underserved Andean settings remains limited. Methods: A retrospective, record-based case-control study was conducted at the Kuska Wiñarisun Community Mental Health Center in Ayacucho, Peru, during 2022. The study included 122 adults with major depressive disorder: 61 cases with a documented history of suicide attempt and 61 controls without such history. Sociodemographic, clinical, psychosocial, and familial variables were extracted from clinical records using a structured data-collection form. Bivariate comparisons and logistic regression models were used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results: Among cases, 100 documented suicide attempts were recorded, with a mean of 1.64 ± 0.67 attempts per patient. In minimally adjusted exposure-specific models, history of suicide attempt was associated with alcohol dependence (adjusted OR = 3.21; 95% CI: 1.01-10.25), borderline personality disorder (adjusted OR = 2.64; 95% CI: 1.25-5.58), history of traumatic exposure or abuse (adjusted OR = 7.38; 95% CI: 1.54-35.31), and family history of suicide attempt (adjusted OR = 3.71; 95% CI: 1.52-9.05). Conclusion: These findings may inform trauma-informed, family-sensitive, and culturally responsive suicide-risk assessment for patients with major depressive disorder in underserved Andean community mental health settings.