A cross-sectional study to assess the cause of present suicide attempt and socio-demographic profile among the suicide attemptees in a tertiary care centre, Bengaluru

Context: A high suicide rate is an index of social disorganization. In India, it is the second leading cause of death among 15-29 years age group. Young age, female sex, poor education, unemployment and socio economic deprivation are some of the potential risk factors. Aim: To assess the cause of present suicide intent and socio-demographic profile in patients with attempted suicide in a tertiary care centre. Settings and design: Study setting in tertiary care centre, Bengaluru and a Cross-sectional study design. Methods and material: A Cross Sectional Study was conducted among 476 suicide attempted patients by Convenient sampling from January 2016 to May 2017. Data was collected by using a pretested, semi-structured questionnaire. Statistical analysis: Descriptive statistics and inferential statistics if required. Results: Mean age of study participants was 30.65+0.75 years. Most of the suicide victims (82.97%) were from nuclear families.24.57%of study participants had family history of suicide.49.66% of them had a suicidal intent during the past 12 months and only 26.89% of them sought professional help. Conclusion: Suicides and attempted suicides are slowly but steadily assuming the levels of a public health problem caused by multiple factors. Hence there is a need to address the risk factors for suicide attempts and preventing them by taking proper measures at individual, family and societal level.

A STUDY ON PSYCHOSOCIODEMOGRAPHIC PROFILE OF PATIENTS PRESENTING WITH ATTEMPTED SUICIDE: AN OBSERVATIONAL STUDY FROM CENTRAL INDIA

Introduction: The presence of psychiatric illness is an important risk factor for suicide. Attempted suicide is one of the major psychiatric emergencies. Suicide attempts are considered to be the best predictors of an eventual completed suicide. Objective:The aim of the study was to explore the Socio-demographic prole and psychiatric diagnosis of the patients with suicidal attempt. Methods: The study population included those patients who were admitted and being managedfor attempted suicide and brought for psychiatric evaluation during the period of 12 months (1st Feb 2019- 31 Jan 2020) at L.N.M.C Bhopal. Each patient underwent a detailed psychiatric st evaluation by a consultant psychiatrist once they were medicallystable. Result: Among the total patients (N=100), 83% were in the age group 20-39 years. Majority of the cases were female (n=76). 68% cases were married and majority was of Hindu religion. Most common method of attempted suicide was by poisoning, by intake of Organophosphates. Depressive Disorder (50%) and Alcohol use disorder (25%) were the most common psychiatric diagnosis.` Conclusion: Attempted suicide is widely prevalent in younger age group. It is usually by poisoning and the use of Organophosphates is the most common in our setting and is commonly associated with Depressive disorder. Hence, psychiatric care is essential for this patient.

Psychiatric Co-Morbidities of Suicide Attempters: A Cross Sectional Observation in a Tertiary Care Hospital of North India

Background: Psychiatric disorders are at increased risk for suicide. Attempted suicide is a common clinical problem in a general hospital. It has a serious clinical and socio-economical impact too. Aims: This study was carried out to assess the prevalence of psychiatric co-morbidities of suicide attempters attending the emergency. Material and methods: This study was a cross sectional, observational study which was conducted at the Community General Hospital Unit, Institute of Mental Health and Neurosciences-Kashmir an associated hospital of Government Medical College Srinagar among the suicide patients attending the outpatient service and inpatient services of the hospital fulfilling inclusion and exclusion criteria over a period of one and a half year, from November 2017 to May 2019. Written informed consent was obtained in a simple and easily understandable unambiguous language. For the diagnosis of psychiatric comorbidity, we used MINI International Neuropsychiatric Interview Schedule Plus (MINI PLUS). A p-value of <0.05 was taken as statistically significant. Results: A total of 221 cases who had been admitted following unsuccessful suicide attempts to the emergency and psychiatry department were taken up for the study. They were evaluated in detail with regards to past attempt of suicide, family history of psychiatric illness or suicide and the presence of psychiatric co-morbidity and the results have been presented below in tabulated and graphical forms. 77.4% of the attempters had no history of psychiatric illness in their family while 22.6% of patients did have family history of a psychiatric illness. 98.2% of attempters had no family history of suicide while 1.8% of the patients gave a family history of suicide. 21.26% males and 54.75% females had associated psychiatric co-morbidities and 23.9% had no associated psychiatric co-morbidities. Conclusion: The most common psychiatric morbidity associated with suicide was found to be major depressive disorder. Most importantly, the suicide attempters should be looked with sympathy rather than with a grimace on face. Such people should not be stigmatized and we should not let their shoulders drop. Keywords: Depression, Bipolar Disorder, Morbidity, Suicide.

Stigmatization (Health Coverage)

Media descriptions of mental illness and the mentally ill are often characterized by stigmatization. For example, in media coverage mental illnesses are often associated with crimes and violence (Ma, 2017). In consequence, patients are presented not only as peculiar and different, but also as dangerous. Thus, the media maintain misconceptions and stigma (Klin & Lemish, 2008; Srivastava et al., 2018). Field of application/theoretical foundation: Health communication, anti-stigma communication, anti-stigma research, stigmatization Example studies: Carpiniello et al. (2007); McGinty et al. (2014) Information on Carpiniello et al. 2007 Authors: Bernardo Carpiniello, Roberta Girau, Maria Germana Orrù Research questions: The study explores the portrayal of mental illness in Italy’s leading national and regional newspapers, asking whether a different pattern emerged in describing criminal offences committed by the mentally ill in reports relating to homicides, suicide, and other acts of violence. Object of analysis: The total sample included N = 2279 all articles relating to homocides, suicides or attempted suicides as well as acts of violence in two leading Italian newspapers (Corriere della Sera, n = 387 and La Repubblica, n = 375) and the two leading regional newspapers (L'Unione Sarda, n = 783 and La Nuova Sardegna, n = 733) Time frame of analysis: October 2002 to March 2003 Info about variables Variables: For each article it was coded whether or not the criminal offence had been attributed to a mentally ill person (actions were deemed to have been attributed to the mentally ill only when clearly stated or strongly alluded to by the author of the article) as well as use of stigmatizing language (Penrose-Wall et al., 1999) Reliability: No information Level of analysis: News article Topics Homicide Suicide Attempted suicide Homicide + suicide Sex-related violence Other violent acts Attribution to a mentally ill person yes no Stigmatizing language Fool/ foolishness Monster/ monstrosity Maniac/ maniacality Mad/ madness Insane/ insanity Lunatic References Carpiniello, B., Girau, R., & Orrù, M. G. (2007). Mass-media, violence and mental illness. Evidence from some Italian newspapers. Epidemiologia E Psichiatria Sociale, 16(3), 251–255. https://doi.org/10.1017/s1121189x00002359 Klin, A., & Lemish, D. (2008). Mental disorders stigma in the media: Review of studies on production, content, and influences. Journal of Health Communication, 13(5), 434–449. https://doi.org/10.1080/10810730802198813 Ma, Z. (2017). How the media cover mental illnesses: a review. Health Education, 117(1), 90–109. https://doi.org/10.1108/HE-01-2016-0004 McGinty, E. E., Webster, D. W., Jarlenski, M., & Barry, C. L. (2014). News media framing of serious mental illness and gun violence in the United States, 1997-2012. American Journal of Public Health, 104(3), 406–413. https://doi.org/10.2105/AJPH.2013.301557 Penrose-Wall, J., Baume, P., & Martin, G. (1999). Achieving the balance: A resource kit for Australian media professionals for the reporting and portrayal of suicide and mental illnesses. Publications Production Unit (Public Affairs, Parliamentary and Access Branch), Commonwealth Dept. of Health and Aged Care. Srivastava, K., Chaudhury, S., Bhat, P. S., & Mujawar, S. (2018). Media and mental health. Industrial Psychiatry Journal, 27(1), 1–5. https://doi.org/10.4103/ipj.ipj_73_18

SOCIODEMOGRAPHIC FACTORS AND CLINICAL FACTORS OF SUICIDAL ATTEMPTS IN TERTIARY CARE CENTER

Background: The objective was to study the sociodemographic data, psychiatric disorder and mode of attempt in suicide attempted patients referred to department of psychiatry,tertiary care center,Ranchi. Materials and Methods: During the 3-month period 140 referrals were screened for the presence of suicide attempters in the department of psychiatry. Results: Adult age, male, urban background, employed were more represented in this study. More than 66.4% of all attempters had psychiatric disorder. The most common method of attempt was by use of insecticide. Conclusions: Majority of suicide attempter patients had mental illness. Early identication and treatment of these disorders would have prevented morbidity and mortality associated with this.

Analysis of news media reports of suicides and attempted suicides during the COVID-19 lockdown in India

Background Based on previous experience there is justifiable concern about suicidal behaviour and news media reporting of it during COVID-19 pandemic. Methods This study used a systematic search of online news media reports (versions of newspapers, magazine and other digital publications) of suicidal behaviour during India’s COVID-19 lockdown and compared it to corresponding dates in 2019. Data was gathered using a uniform search strategy from 56 online news media publications 24 March to 3 May for the years 2019 and 2020 using keywords, suicide, attempted suicide, hangs self and kills self. Demographic variables and methods used for suicide were compared for suicide and attempts between the 2 years using chi-squared tests (χ2). Results There were online news media reports of 369 cases of suicides and attempted suicides during COVID lockdown vs 220 reports in 2019, a 67.7% increase in online news media reports of suicidal behaviour. Compared to 2019, suicides reported during lockdown were significantly older (30 vs 50 years, p < 0.05), men (71.2% vs 58.7%; p < 0.01), married (77.7% vs 49%; p < 0.01) and employed (82.9% vs 59.5%; p < 0.01). During the lockdown, significantly more suicides were by hanging (64.4% vs 42%), while poisoning (8.5% vs 21.5%) and jumping in front of a train (2% vs 9.4%) (p < 0.05) were significantly reduced. Comparison of COVID and non-COVID groups showed that online news media reports of COVID cases of suicide and attempted suicide were significantly more likely to be men (84.7% vs 60.4%; p < 0.01), older (31–50 years 52.9% vs 25.8%; p < 0.01) employed (91.5% vs 64.3%; p < 0.01), had poor mental (40.1% vs 20.8%; p < 0.01) and poor physical health (24.8% vs 7.9%;11.8, p < 0.01). Conclusion Increase in online news media reports of suicides and attempts during COVID-19 lockdown may indicate an increase in journalists’ awareness about suicide or more sensational media reporting or may be a proxy indicator of a real community increase in suicidal behaviour. It is difficult to attribute changes in demographic profile and methods used only to changes in journalists’ reporting behaviour and should be further explored. We therefore call upon the Government of India to urgently release national suicide data to help devise a comprehensive suicide prevention strategy to address COVID-19 suicidal behaviour.

Is unemployment less important than expected for suicide attempted in developing regions? Occupational profile of suicide attempts in Jujuy, north westernmost Argentina

Background: Mental health practices consider unemployment as a suicide main risk factor, based on models built for populations of developed countries. Aim: This study assesses the association between the occupational risk factor and suicidal behaviors, by considering sex, age and temporal distribution, in a Latin American Andean population from north westernmost Argentina. Methods: Data include 481 suicide attempt cases assisted by emergency service psychologists at a head hospital in the Jujuy Province, northern Argentina, during two biennials. General categories and specific types of occupational situation, sex, age and temporal distribution were analyzed. Results: 83.58% of cases corresponded to the with occupation category, but without occupation characterized male cases ( p-value = .01). The type no referred occupation (19.15%) mainly contributed to this association ( p-value = .02). Unemployed only represented 1.6%. These features revealed independent from the biennial period of assistance ( p-value = .96 (general), p-value = .86 (specific)). Associations by age ranges did not seem to be specific of suicidal attempts. Conclusion: The present contribution provides an occupational characterization of suicide attempts in an Andean population from north westernmost Argentina. Unemployment is not associated with suicidal behavior in this population, suggesting that dissimilar patterns underlie suicidal behavior of populations from developed and developing regions.

Comportamentos suicidas em pessoas com transtornos relacionados a substâncias

Objetivo: identificar os aspectos associados aos comportamentos suicidas em pessoas com transtornos relacionados a substâncias. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa, de publicações entre 2006 e 2016, nas Bases de dados LILACS, CINAHL e MEDLINE. Analisaram-se os dados de forma descritiva a partir de figuras. Resultados: identificaram-se 78 aspectos associados aos comportamentos suicidas, dentre 54 artigos da amostra, os quais foram classificados em aspectos sociodemográficos e econômicos; clínicos e biológicos; relacionados à cognição, comportamento, emoção e pensamento; aos eventos de vida estressante; a manifestação de sintomas e transtornos mentais; ao uso de substâncias; e aos próprios comportamentos suicidas. Conclusão: enfatiza-se a complexidade dos comportamentos suicidas em pessoas com transtornos relacionados a substâncias frente a heterogeneidade dos aspectos identificados. Descritores: Saúde Mental; Transtornos Relacionados ao Uso de Substâncias; Ideação Suicida; Tentativa de Suicídio; Suicídio; Fatores de Risco. AbstractObjective: to identify the aspects associated with suicidal behaviors in people with substance-related disorders. Method: this is a bibliographic, descriptive study, of the integrative-review type, of publications between 2006 and 2016, LILACS, CINAHL and MEDLINE. The data were analyzed descriptively from figures. Results: the search identified 78 aspects associated with suicidal behavior among 54 articles in the sample, which were classified into sociodemographic and economic; clinical and biological aspects; related to cognition, behavior, emotion and thought; to stressful life events; the manifestation of symptoms and disorders; the use of substances; and to their own suicidal behaviors. Conclusion: one emphasizes the complexity of suicidal behaviors in people with substance-related disorders regarding the heterogeneity of the identified aspects. Descriptors: Mental Health; Substance-Related Disorders; Suicidal Ideation; Suicide, Attempted; Suicide; Risk Factors.ResumenObjetivo: identificar los aspectos asociados con las conductas suicidas en personas con trastornos relacionados con sustancias. Método: este es un estudio bibliográfico, descriptivo, del tipo revisión integradora de publicaciones entre 2006 y 2016, LILACS, MEDLINE y CINAHL. Los datos fueron analizados descriptivamente a partir de cifras. Resultados: se identificaron 78 aspectos relacionados con la conducta suicida entre 54 artículos en la muestra, que se clasificaron en aspectos económicos y sociodemográficos, clínicos y biológicos; relacionados con el comportamiento, la cognición, la emoción y el pensamiento; a eventos estresantes de la vida; la manifestación de síntomas y trastornos; el uso de sustancias; y sus propios comportamientos suicidas. Conclusión: pone de relieve la complejidad de las conductas suicidas en personas con trastornos relacionados con sustancias con relación a la heterogeneidad de los aspectos identificados. Descriptores: Salud Mental; Transtornos Relacionados com Substancias; Ideación Suicida; Intento de Suicidio; Suicidio; Factores de Riesgo.