scholarly journals Risk factors for suicide in Bangladesh: case–control psychological autopsy study

BJPsych Open ◽  
2020 ◽  
Vol 7 (1) ◽  
Author(s):  
S. M. Yasir Arafat ◽  
M. A. Mohit ◽  
Mohammad S. I. Mullick ◽  
Russell Kabir ◽  
Murad M. Khan

Background Suicide is an important, understudied public health problem in Bangladesh, where risk factors for suicide have not been investigated by case–control psychological autopsy study. Aims To identify the major risk factors for suicide in Dhaka, Bangladesh. Methods We designed a matched case–control psychological autopsy study. We conducted a semi-structured interview with the next-of-kin of 100 individuals who died by suicide and 100 living controls, matched for age, gender and area of residence. The study was conducted from July 2019 to July 2020. Results The odds ratios for the risk factors were 15.33 (95% CI, 4.76–49.30) for the presence of a psychiatric disorder, 17.75 (95% CI, 6.48–48.59) for life events, 65.28 (95% CI, 0.75–5644.48) for previous attempts and 12 (95% CI, 1.56–92.29) for sexual abuse. Conclusions The presence of a psychiatric disorder, immediate life events, previous suicidal attempts and sexual abuse were found as significant risk factors for suicide in Dhaka, Bangladesh.

The Lancet ◽  
2002 ◽  
Vol 360 (9347) ◽  
pp. 1728-1736 ◽  
Author(s):  
Michael R Phillips ◽  
Gonghuan Yang ◽  
Yanping Zhang ◽  
Lijun Wang ◽  
Huiyu Ji ◽  
...  

2017 ◽  
Vol 63 (2) ◽  
pp. 151-160 ◽  
Author(s):  
Victoria Ross ◽  
Kairi Kõlves ◽  
Diego De Leo

Background: As young Australian males are at a high risk of suicide, the identification of risk factors other than psychopathology is vital for the development of comprehensive suicide prevention measures. Aims: The study investigated whether there were differences in risk factors and pathways to suicide in young adult males from Queensland, Australia, with and without a diagnosable psychiatric disorder. Methods: A case–control, psychological autopsy method was applied using a control group of young males who had died suddenly from causes other than suicide. Results: Suicide cases without a psychiatric diagnosis more frequently displayed behaviours indicative of their suicidality (such as previous attempts, disposing of possessions and making statements of hopelessness) than controls without a diagnosis. Suicides without a diagnosis also displayed more ‘difficult’ personality traits, such as higher levels of neuroticism and aggression. They also experienced poorer quality of life and were significantly more likely than their controls to have experienced a recent separation from a spouse or partner. Conclusion: The results of this study confirmed the existence of several distinct characteristics of young males who die by suicide in the absence of any diagnosable psychiatric disorder.


2018 ◽  
Vol 49 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Liang Zhou ◽  
Guojun Wang ◽  
Cunxian Jia ◽  
Zhenyu Ma

AbstractBackgroundSuicide rate among rural elderly is the highest among all age groups in China, yet little is known about the suicide risks in this rapidly growing vulnerable population.MethodsThis matched case–control psychological autopsy study was conducted during June 2014 to September 2015. Consecutive samples of suicides aged 60 or above were identified in three provinces (Shandong, Hunan, and Guangxi) in China. Living comparisons were 1:1 matched with the suicides in age (±3 years old), gender, and living location. Risk factors included demographic characteristics, being left-behind, mental disorder, depressive symptoms, stressful life events, and social support.ResultsA total of 242 suicides and 242 comparisons were enrolled: 135 (55.8%) were male, mean (s.d.) age was 74 (8) years. The most frequently used suicide means were pesticides (125, 51.7%) and hanging (95, 39.3%). Independent risks of suicide included unstable marital status [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.61–10.92], unemployed (compared with employed, OR 4.43, 95% CI 1.09–17.95), depressive symptoms (OR 1.34, 95% CI 1.21–1.48), and mental disorder (OR 6.28, 95% CI 1.75–22.54). Structural equation model indicated that the association between being left-behind and suicide was mediated by mental disorder, depressive symptoms, stressful life events, and social support.ConclusionsUnstable marital status, unemployed, depressive symptoms, and mental disorder are independent risk factors for suicide in rural elderly. Being left-behind can elevate the suicide risk through increasing life stresses, depressive symptoms, mental disorder, and decreasing social support. Elderly suicide may be prevented by restricting pesticides, training rural physicians, treating mental disorders, mitigating life stress, and enhancing social connection.


Author(s):  
Jane Pirkis ◽  
Angela Nicholas ◽  
David Gunnell

Abstract Much of our knowledge about the risk factors for suicide comes from case–control studies that either use a psychological autopsy approach or are nested within large register-based cohort studies. We would argue that case–control studies are appropriate in the context of a rare outcome like suicide, but there are issues with using this design. Some of these issues are common in psychological autopsy studies and relate to the selection of controls (e.g. selection bias caused by the use of controls who have died by other causes, rather than live controls) and the reliance on interviewing informants (e.g. recall bias caused by the loved ones of cases having thought about the events leading up to the suicide in considerable detail). Register-based studies can overcome some of these problems because they draw upon contain information that is routinely collected for administrative purposes and gathered in the same way for cases and controls. However, they face issues that mean that psychological autopsy studies will still sometimes be the study design of choice for investigating risk factors for suicide. Some countries, particularly low and middle income countries, don't have sophisticated population-based registers. Even where they do exist, there will be variable of interest that are not captured by them (e.g. acute stressful life events that may immediately precede a suicide death), or not captured in a comprehensive way (e.g. suicide attempts and mental illness that do not result in hospital admissions). Future studies of risk factors should be designed to progress knowledge in the field and overcome the problems with the existing studies, particularly those using a case–control design. The priority should be pinning down the risk factors that are amenable to modification or mitigation through interventions that can successfully be rolled out at scale.


2017 ◽  
Vol 27 ◽  
pp. 123-126 ◽  
Author(s):  
Manami Kodaka ◽  
Toshihiko Matsumoto ◽  
Michiko Takai ◽  
Takashi Yamauchi ◽  
Shizuka Kawamoto ◽  
...  

2006 ◽  
Vol 36 (9) ◽  
pp. 1265-1274 ◽  
Author(s):  
DANIEL MICHAEL JAMES HARWOOD ◽  
KEITH HAWTON ◽  
TONY HOPE ◽  
LOUISE HARRISS ◽  
ROBIN JACOBY

Background. The role of physical illness and life problems in contributing to suicide in older people is potentially important with regard to suicide prevention.Method. The aim of the study was to determine the life problems other than psychiatric illness contributing to suicide in older people. Semi-structured psychological autopsy interviews, covering life problems and physical illness prior to death, were conducted with informants for 100 people aged 60 years old and over who died through suicide in five English counties. Interviews were completed with informants for 54 age- and sex-matched control subjects who died through natural causes.Results. The three most frequent life problems associated with suicide were physical illness, interpersonal problems, and bereavement. Physical health problems were present in 82% and felt to be contributory to death in 62%. Pain, breathlessness and functional limitation were the most frequent symptoms. Interpersonal problems were present in 55% of the sample and contributory in 31%. The corresponding figures for bereavement-related problems were 47% and 25%. In the case-control analysis, the problems found to be risk factors for suicide were problems related to a bereavement over 1 year before death (OR 3·5, 95% CI 1·2–10·6), and problems with accommodation (OR 5·0, 95% CI 1·1–22·8), finances (p=0·01), and retirement (p=0·02).Conclusion. Physical illness, interpersonal problems and bereavement are commonly associated with suicide in older people, but financial, accommodation, retirement and long- term bereavement-related problems may be more specific risk factors.


2020 ◽  
Author(s):  
Isabel Maranga ◽  
Patrick Onyango ◽  
Dickens Omondi

Abstract Child sexual abuse is a public health problem with negative physical, mental, behavioral and learning outcomes to survivors. Recent Kenya Demographic Health Survey showed that 22% of women and 13% of men in western Kenya have experienced sexual abuse compared to 14% women and 6% men nationally. Its burden, predisposing factors and, sources of or reasons for differential exposure for boys are yet unclear. Whereas schools have a major influence on a child’s development and behavior, they have been identified as important settings where child sexual abuse might occur. However, how sexual abuse is patterned by type and location of school remains an open question. The present study investigated risk factors of sexual abuse among school-going children in primary schools in Kisumu County. Using a cross-sectional study design and guided by the ecological model, the study determined association between type of school and sexual abuse; association between location of school and sexual abuse, and spaces that predispose school-going children to sexual abuse in primary schools. A sample of 398 pupils aged between 10 – 16 years randomly identified participants from 37 pre-selected primary schools in Kisumu Central and Kisumu West sub-Counties was used. The schools had been stratified by location (rural and urban) and type (public or private, boarding or day). Parental permission was sought for respective pupils to participate in the study. Data from pupils was collected using self-administered questionnaires and focus group discussions, and key informant interviews from guidance and counseling teachers. The mean age of participants was 13 years. More pupils attended day schools than boarding schools (88% versus 12%; p= 0.017). Forced sex (29%) was the most common type of sexual abuse. More girls than boys had ever experienced any type of sexual abuse 29% versus 20%; p=0.038. Whereas there was no statistical difference in pupils’ experience of sexual abuse by type and location of school x2= 2.044; p>0.05 and x2= 0.823 p>0.05, pupils thought that attending public day schools is associated with higher risk for sexual abuse mainly while walking to and from home. Pupils cited bushes inside school (52%), latrines/toilets (51%) and bushes outside school (50%) as spaces where one is more likely to experience sexual abuse. Being a female pupil was the most significant risk factor for sexual abuse in the primary schools surveyed. This indicates that gendered predisposition plays an important role in occurrence of sexual abuse in primary schools. Though not statistically significant in this study, it is plausible that risky spaces and type of schools might modify female gender predisposition in subtler ways as suggested from the pupils’ perspectives. There is need for a gendered focus in a complex primary schooling environment


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