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Mottla ME, Bowler ME, Asgary R. Epidemiology, risk factors, and strategies to prevent and manage poisonings due to pharmaceuticals in children in low income and low-middle income countries: A systematic review. J Glob Health 2023; 13:04173. [PMID: 38154015 PMCID: PMC10754493 DOI: 10.7189/jogh.13.04173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Abstract
Background There are significant disparities in the burden of disease due to poisoning between children in low- and high-income countries (HICs). However, there is limited data on the impact of increasing pharmaceutical access in low income countries (LICs) and low-middle income countries (LMICs) on the epidemiology of and risk factors associated with poisoning in children in these settings. Furthermore, while strategies in HICs have effectively reduced the burden of disease due to poisonings in children, there is limited information regarding the efficacy of these interventions in LICs/LMICs. Methods We conducted a systematic review in eight databases for literature published between January 2000 to April 2022 to evaluate the epidemiology and risk factors associated with poisonings due to pharmaceuticals and effective strategies to prevent and manage them in children in LICs/LMICs. From 16 061 retrieved articles, 41 were included in the final analysis. Results Pharmaceuticals were a common cause of poisoning in children in LICs/LMICs, occurring in between 12.4% and 72.36% of cases. Major risk factors were unsafe medication storage and inadequate caregiver knowledge. Delayed access to care and younger age were associated with increased mortality. Prevention strategies that included education demonstrated improvements in knowledge; however, their impact on incidence and mortality was unclear. Management strategies detailed individual patient care interventions, most commonly gastric lavage and activated charcoal. Meanwhile, delayed presentation, limited provider knowledge, and inadequate laboratory resources to support therapeutic monitoring hindered optimal management. Conclusions The combination of educational interventions for prevention, along with regulatory processes to maximise medication storage and formulation safety, could be effective in reducing the burden of poisoning in LICs/LMICs. The development of national or regional protocols for the management of common medication poisonings, augmented by the development of poison control centers and expansion of laboratory access in facilities may help reduce the morbidity and mortality associated with pharmaceutical poisonings in children in LICs/LMICs. Further evidence regarding contextual factors, risk and benefit profiles, the pattern of poisoning, and the impact of preventive and treatment interventions specific to LICs/LMICs is needed to better refine recommendations in these settings. Registration PROSPERO: CRD42022315686.
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Affiliation(s)
- Mary Elizabeth Mottla
- Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Mary-Ellis Bowler
- Department of Global Health, George Washington Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Ramin Asgary
- Department of Global Health, George Washington Milken Institute School of Public Health, Washington, District of Columbia, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Kaya K, Akgunduz E, Erdem Z, Hilal A. Child deaths due to firearm-related İnjuries in Adana, Turkey. Niger J Clin Pract 2021; 24:1645-1648. [PMID: 34782503 DOI: 10.4103/njcp.njcp_549_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Death by firearm is unacceptable for children who need to be under the protection of the state and the family, wherever and however. Firearm-related fatality is common among all ages. One of the causes of this high rate is likely the easy access to firearms. Aim This study aims to discuss the characteristics of deaths attributable to childhood firearm injuries in Adana, Turkey and to compare them with similar studies. Patients and Methods In this study, the records of 448 (1.97%) cases under 18 years of age who died due to firearm-related injuries among a total of 22,668 cases whose autopsies were performed by the Morgue Department, Council of Forensic Medicine Adana Group Administration between January 1, 2004 and December 12, 2017 were retrospectively evaluated. Results Age ranged from 45 days to 18 years; 285 cases were male and 163 cases were female, and male/female ratio was 1.7. The majority of cases were between 13 and 18 years of age (n: 340, 76.0%). According to the manner of death, the leading cause was homicide (n: 212, 47.4%) and the most frequently used type of firearm were shotguns (n: 226). Single firearm wound was present in 82.8% of the cases. The location of entrance wounds revealed that 185 wounds were located in the head-neck. Although homicide was the leading manner of death among the overall cases, it was determined that suicide was the leading cause among the 13-18 age group (n: 149). Firearm-related injuries and deaths in children should bring child neglect to the agenda. Conclusion Presence of firearms at home and easy access are the causes of increased firearm injuries and death in children. Easily accessible weapons in homes are often involved in suicides and homicides, as well as accidents, which are more common in young children and adolescents. We believe that the use of firearms outside of the security forces should be prohibited and that strict laws should be enforced on the handling and use of firearms.
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Affiliation(s)
- K Kaya
- Department of Forensic Medicine, Cukurova University, Adana, Turkey
| | - E Akgunduz
- Department of Forensic Medicine, Council of Forensic Medicine, Diyarbakır, Turkey
| | - Z Erdem
- Department of Forensic Medicine, Council of Forensic Medicine, Adana, Turkey
| | - A Hilal
- Department of Forensic Medicine, Cukurova University, Adana, Turkey
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Ben Khelil M, Zgarni A, Belghith M, Harzallah H, Zhioua M, Hamdoun M. Trends of juvenile and adolescent suicides in North Tunisia: a 12-year study. Public Health 2021; 194:223-231. [PMID: 33962100 DOI: 10.1016/j.puhe.2021.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 02/08/2021] [Accepted: 02/27/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of our study was to analyze the epidemiological characteristics for suicide methods and factors over a 12-year period among child suicides in Northern Tunisia and to compare juvenile and adolescent suicides. STUDY DESIGN This is a cross-sectional study. METHODS We included all child and adolescent suicide cases that took place in the North of Tunisia over a 12 year period (2005-2016). Data were collected from medical records and judicial inquiries and were classified into three sections: sociodemographic data, the circumstances of suicide, and the autopsy findings. Data were then compared between the 'juvenile suicide group' and 'the adolescent suicide group', according to the WHO definition. RESULTS Casualties were equally males and females, mostly adolescents (74.5%), aged 15 years old on average. Hanging was the most frequent suicidal method. A peak of frequency was observed in 2014. CONCLUSION Our results suggested to focus, among other preventive measures, on the role of media coverage of child suicides.
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Affiliation(s)
- M Ben Khelil
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | - A Zgarni
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - M Belghith
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - H Harzallah
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - M Zhioua
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - M Hamdoun
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
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4
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Al-Mendalawi MD. Alpha-lipoic acid intoxication in an adolescent girl. Turk Arch Pediatr 2021; 56:173. [PMID: 34286329 PMCID: PMC8269943 DOI: 10.5152/turkarchpediatr.2020.20201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/28/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Mahmood D Al-Mendalawi
- Paediatrics and Child Health, Consultant Paediatrician, Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
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5
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Suicide in children and adolescents: a Tunisian perspective from 2009 to 2015. Forensic Sci Med Pathol 2017; 13:417-425. [PMID: 28879455 DOI: 10.1007/s12024-017-9909-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Abstract
This study presents the characteristics of child and adolescent suicides which occurred in Kairouan, Tunisia. Data were collected from autopsy records of the Forensic Department of the University Hospital Ibn El Jazzar of Kairouan. General characteristics of suicides among children and adolescents (under the age of 18) between 2009 and 2015 were retrospectively reviewed. A total of 49 cases, with a female predominance (61.2%) and a mean age of 15.4 ± 2.1, were registered. Most of the victims were from rural areas (93.1%). In most cases, suicide occurred in the victim's home or the surrounding area (73.4%). The identified precipitating factors were family problems in 55.1%, and school issues in 12.2%. The most common suicide method was hanging (69.38%) for both genders, followed by self-immolation for males and poisoning for females, the majority using pesticides. This study offers useful information to understand the risk factors in Tunisian child and adolescent suicides and provides a basis for the development of urgently needed preventive strategies.
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Hajebi A, Abbasi-Ghahramanloo A, Hashemian SS, Khatibi SR, Ghasemzade M, Khodadost M. Risk-taking behaviors and subgrouping of suicide in Iran: A latent class analysis of national registries data. Psychiatry Res 2017; 255:355-359. [PMID: 28609673 DOI: 10.1016/j.psychres.2017.05.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 04/14/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
Suicide is one the most important public health problem which is rapidly growing concerns. The aim of this study was to subgroup suicide using LCA method. This cross-sectional study was conducted in Iran based on 66990 records registered in Ministry of Health in 2014. A case report questionnaire in the form of software was used for case registries. Latent class analysis was used to achieve the research objectives. Four latent classes were identified; (a) Non-lethal attempters without a history of psychiatric disorders, (b) Non-lethal attempters with a history of psychiatric disorders, (c) Lethal attempters without a history of psychiatric disorders, (d) Lethal attempters with a history of psychiatric disorders. The probability of completed/an achieved suicide is high in lethal attempter classes. Being male increases the risk of inclusion in lethal attempters' classes (OR = 4.93). Also, being single (OR = 1.16), having an age lower than 25 years (OR = 1.14) and being a rural citizen (OR = 2.36) associate with lethal attempters classes. The males tend to use more violent methods and have more completed suicide. Majority of the individuals are non-lethal attempters who need to be addressed by implementing preventive interventions and mental support provision.
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Affiliation(s)
- Ahmad Hajebi
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran; Department of Epidemiology, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Reza Khatibi
- Department of Epidemiology, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran; Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Masomeh Ghasemzade
- Mental & Social Health and Addiction Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Mahmoud Khodadost
- Department of Epidemiology, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran; Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Duramaz BB, Yıldırım HM, Kıhtır HS, Yeşilbaş O, Şevketoğlu E. Evaluation of forensic cases admitted to pediatric intensive care unit. Turk Arch Pediatr 2015; 50:145-50. [PMID: 26568689 DOI: 10.5152/turkpediatriars.2015.2399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/04/2015] [Indexed: 11/22/2022]
Abstract
AIM This study aimed to determine the epidemiological and clinical characteristics of pediatric forensic cases to contribute to the literature and to preventive health care services. MATERIAL AND METHODS Pediatric forensic cases hospitalized in our pediatric intensive care unit below the age of 17 years were reviewed retrospectively (January 2009-June 2014) . The patients were evaluated in two groups as physical traumas (Group A) and poisonings (Group B). The patients' age, gender, complaints at presentation, time of presentation and referral (season, time) and, mortality rates were determined. Cases of physical trauma (Group A) were classified as traffic accidents, falling down from height, falling of device, drowning, electric shock, burns and child abuse. Poisonings (Group B) were classified as pharmaceuticals, pesticides, other chemicals and unknown drug poisonings. RESULTS Two hundred twenthy cases were included. The mean age was 5.1+3.1 years. One hundred fifteen (%52.5) of the cases were male and 105 (%47.5) were female. Group A consisted of 62 patients and Group B consisted of 158 patients. The patients presented most frequently in summer months. The most common reason for presentation was falling down from height (12.7%) in Group A and accidental drug poisoning (most frequently antidepressants) in Group B. The mortality rate was 5%. CONCLUSION Forensic cases in the pediatric population (physical trauma and poisoning) are preventable health problems. Especially, preventive approach to improve the environment for falling down from height must be a priority. Increasing the awareness of families and the community on this issue, in summer months during which forensic cases are observed most frequently can contribute to a reduction in the number of cases.
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Affiliation(s)
- Burcu Bursal Duramaz
- Clinic of Pediatrics, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Hamdi Murat Yıldırım
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Hasan Serdar Kıhtır
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Osman Yeşilbaş
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
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Oner S, Yenilmez C, Ozdamar K. Sex-related differences in methods of and reasons for suicide in Turkey between 1990 and 2010. J Int Med Res 2015; 43:483-93. [PMID: 25995209 DOI: 10.1177/0300060514562056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/07/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To analyse suicides occurring in Turkey between 1990 and 2010 according to sex, age, reason and method. METHODS Data concerning suicides occurring in Turkey between 1990 and 2010 were obtained from annual records published by the Turkish Statistical Institute. Data were analysed according to sex, age, reason for suicide and suicide method. RESULTS The crude suicide rate was 2.42 per 100 000 population in 1990 and 4.02 per 100 000 population in 2010. The highest number of suicides was seen in those aged 15-24 years. In this age group, the number of suicides in females was significantly higher than in males. The most common suicide method in Turkey was hanging. Men used firearms more frequently than women. All the reasons for suicide occurred in a higher number of males than females; however, the difference between males and females was more significant for economic problems, relationship problems and educational failure. The leading reason for suicide in females was relationship problems. CONCLUSION Detecting population subgroups with a high suicide risk and obtaining regional demographic data are of great importance for future studies on suicide prevention.
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Affiliation(s)
- Setenay Oner
- Department of Biostatistics, Osmangazi University, Eskisehir, Turkey
| | - Cinar Yenilmez
- Department of Psychiatry, Osmangazi University, Eskisehir, Turkey
| | - Kazim Ozdamar
- Department of Biostatistics, Osmangazi University, Eskisehir, Turkey
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Mendes R, Santos S, Taveira F, Dinis-Oliveira RJ, Santos A, Magalhães T. Child Suicide in the North of Portugal. J Forensic Sci 2014; 60:471-5. [DOI: 10.1111/1556-4029.12685] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 03/31/2014] [Accepted: 04/15/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Ricardo Mendes
- National Institute of Legal Medicine and Forensic Sciences; North Branch; Jardim Carrilho Videira Porto Portugal
- College of Health Technology of Porto; Rua Valente Perfeito 322 Vila Nova de Gaia Portugal
| | - Sara Santos
- Biomedical Sciences Institute “Abel Salazar”; University of Porto; Rua Jorge Viterbo Ferreira 228 Porto Portugal
| | - Francisco Taveira
- National Institute of Legal Medicine and Forensic Sciences; North Branch; Jardim Carrilho Videira Porto Portugal
- Biomedical Sciences Institute “Abel Salazar”; University of Porto; Rua Jorge Viterbo Ferreira 228 Porto Portugal
- Forensic Sciences Center - CENCIFOR; largo da Sé Nova; Coimbra Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Forensic Sciences Center - CENCIFOR; largo da Sé Nova; Coimbra Portugal
- Department of Legal Medicine and Forensic Sciences; Faculty of Medicine; University of Porto; Alameda Professor Hernâni Monteiro Porto Portugal
- Department of Sciences; Advanced Institute of Health Sciences - North (ISCS-N); CESPU; CRL; Rua Central da Gandra 1317 Gandra Portugal
- REQUIMTE; Laboratory of Toxicology; Department of Biological Sciences; Faculty of Pharmacy; University of Porto; Rua Jorge Viterbo Ferreira 228 Porto Portugal
| | - Agostinho Santos
- National Institute of Legal Medicine and Forensic Sciences; North Branch; Jardim Carrilho Videira Porto Portugal
- Forensic Sciences Center - CENCIFOR; largo da Sé Nova; Coimbra Portugal
- Department of Legal Medicine and Forensic Sciences; Faculty of Medicine; University of Porto; Alameda Professor Hernâni Monteiro Porto Portugal
- Health Sciences School; University of Minho; Campus Gualtar Braga Portugal
| | - Teresa Magalhães
- National Institute of Legal Medicine and Forensic Sciences; North Branch; Jardim Carrilho Videira Porto Portugal
- Biomedical Sciences Institute “Abel Salazar”; University of Porto; Rua Jorge Viterbo Ferreira 228 Porto Portugal
- Forensic Sciences Center - CENCIFOR; largo da Sé Nova; Coimbra Portugal
- Department of Legal Medicine and Forensic Sciences; Faculty of Medicine; University of Porto; Alameda Professor Hernâni Monteiro Porto Portugal
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Suicides in adolescence: A twelve-year study from Eastern Turkey. J Forensic Leg Med 2014; 27:6-8. [PMID: 25287791 DOI: 10.1016/j.jflm.2014.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/17/2014] [Accepted: 07/17/2014] [Indexed: 11/21/2022]
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Karbeyaz K, Akkaya H, Balci Y, Urazel B. Analysis of Suicide Notes: An experience in Eskişehir City. Noro Psikiyatr Ars 2014; 51:275-279. [PMID: 28360638 DOI: 10.4274/npa.y7000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 01/12/2013] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION It is estimated that a million people around the world die by suicide each year. It has been reported that a note was left in 5%-43% of the suicides. In this study, it we aimed to evaluate and discuss suicide notes in our city which is situated in Western Anatolia and where several universities are located. METHOD All forensic deaths in Eskişehir in 10-year period between 2001 and 2011 were evaluated. Forensic investigation files were assessed. After investigation, Out of 399 cases, 168 (42.1%) cases, who were determined to have left a suicide letter, telephone message (sms) or message via social network sites, were included in the scope of the study. RESULTS It was found that 95 (56.5%) of all cases had left a suicide letter, 69 (41.1%) cases had sent a telephone message to a person or more than one person, 4 (2.4%) cases had written notes about suicide and death in social networking sites. CONCLUSION A suicide note is an important finding in suicide cases to clarify the case. However, the note should be confirmed by investigation to be accepted as evidence.
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Affiliation(s)
- Kenan Karbeyaz
- Forensic Medicine Institution, Eskişehir Branch Office, Eskişehir, Turkey
| | - Harun Akkaya
- Forensic Medicine Institution Presidency, İstanbul, Turkey
| | - Yasemin Balci
- Department of Forensic Medicine, Muğla Sıtkı Koçman University, Faculty of Medicine, Muğla, Turkey
| | - Beyza Urazel
- Department of Forensic Medicine, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey
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12
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Suicidal childhood deaths with firearms in Antalya, Turkey. J Forensic Leg Med 2013; 20:644-6. [PMID: 23910852 DOI: 10.1016/j.jflm.2013.03.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 03/24/2013] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to determine the characteristics of suicidal childhood deaths with the use of firearms that occurred from 2000 to 2009 in Antalya. The autopsy reports of the Antalya branch of the Turkish Forensic Medicine Council and judicial records were reviewed retrospectively. There were 60 suicidal deaths between 0 and 18 years of age. Firearms were used in 20 cases (11 males, 9 females). The shotgun (n = 15) was the most frequently used weapon. The site of bullet entries were the chest (n = 6), abdomen (n = 5), right temple (n = 5), mouth (n = 2) and neck (n = 2). Most suicides (n = 16) were in the home. In contrast to many other studies, the most frequently used weapon for suicides was the shotgun in this study.
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Coskun M, Zoroglu S, Ghaziuddin N. Suicide rates among Turkish and American youth: a cross-cultural comparison. Arch Suicide Res 2012; 16:59-72. [PMID: 22289028 DOI: 10.1080/13811118.2012.640612] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This study compares youth (<24 years) suicide rates in Turkey and the United States; a demographic and cross-cultural comparison and exploration of possible causative factors. Publicly available data were compared for children, adolescents, and young adults for years 1992-2004. The mean general population suicide rate in Turkey (per 100,000) was, male = 3.53 and female = 2.31 (for the US, males = 18.37, females = 4.31); for ages below 15 years the rate was, males = 0.28 and females = 0.39 (for the US, males = 1.09 and females = 0.38); while for aged 15-24 years the rate was, males = 4.58 and females = 5.22 (for the US, males = 18.84 and females = 3.36). The patterns for Turkey are: (a) Female youth had a higher suicide rate than male youth; this was the reverse of the U.S. pattern, (b) Youth suicide increased during the time period in Turkey, whereas it was relatively stable in the US, (c) However, suicide rates in Turkey were generally lower than the US, (d) Fifty percent of all female suicide victims in Turkey were under the age of 24 years (versus 11% in the US). Possible psychosocial causative factors may include (a) negative social status of females (forced marriage, young marriage age, low literacy, honor killings); (b) substantial rural to urban migration which disrupts ties and exposes migrants to a less traditional cultural system; (c) shortage of mental health services; (d) and possibly, reduced religious education enrollment may be an additional factor.
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Affiliation(s)
- Murat Coskun
- Child and Adolescent Psychiatrist, Numune Training and Research Hospital, Child and Adolescent Psychiatry Clinic, Trabzon, Turkey.
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Akcan R, Arslan MM, Çekin N, Karanfil R. Unexpected suicide and irrational thinking in adolescence: a case report. J Forensic Leg Med 2011; 18:288-90. [PMID: 21771561 DOI: 10.1016/j.jflm.2011.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 04/21/2011] [Accepted: 05/04/2011] [Indexed: 11/25/2022]
Abstract
This report aims to draw attention to the fragility of adolescents' mind and irrational thinking in adolescence that might lead to suicide due to unusual experiences, by presenting a case of completed suicide with its unusual etiology. The victim, a 13 years old boy, had a quarrel with his mother as she sacrificed his pet, a cock, to prepare for dinner. Because of this, the victim had denied to join the family for dinner and wanted to be alone. While the family having dinner, a passing by neighbor realized that the victim was suspended with a ligature around his neck, in the backyard of the house. Meaningfully, there were feathers of cock in pants pockets of the deceased, in the corpse examination. Adolescents are experiencing dramatic physical and emotional changes, and being oversensitive and fragile in that period of life. Thus, a life experience that is tolerable to adults might badly affect adolescents and lead to suicide which is incomprehensible to them.
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Affiliation(s)
- Ramazan Akcan
- Hacettepe University School of Medicine Department of Forensic Medicine, Ankara, Turkey.
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Pakis I, Yayci N, Karapirli M, Yildiz N, Gunce E, Yilmaz R, Polat O. Childhood deaths due to suicide. AUST J FORENSIC SCI 2010. [DOI: 10.1080/00450611003685988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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Children, adolescents and young adults suicide data from Epirus, northwestern Greece. Forensic Sci Med Pathol 2009; 5:269-73. [DOI: 10.1007/s12024-009-9105-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
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17
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Uzun I, Karayel FA, Akyıldız EU, Turan AA, Toprak S, Arpak BB. Suicide Among Children and Adolescents in a Province of Turkey. J Forensic Sci 2009; 54:1097-100. [DOI: 10.1111/j.1556-4029.2009.01115.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Suicide in children and young adolescents up to 14 years of age has increased in many countries, warranting research and clinical awareness. International reported suicide rates per 100,000 in this young population vary between 3.1 and 0 (mean rate worldwide, approximately 0.6/100.000; male-female ratio, 2:1). Suicide occurs only in vulnerable children; this vulnerability begins with parental mood disorder and impulsive aggression, and family history of suicide. Childhood affective and disruptive disorders and abuse are the most often reported psychiatric risk factors. Suicide becomes increasingly common after puberty, most probably because of pubertal onset of depression and substance abuse, which substantially aggravate suicide risk. Biologic findings are scarce; however, serotonergic dysfunction is assumed. The most common precipitants are school and family problems and may include actual/anticipated transitions in these environments. Suicides in children and young adolescents up to 14 years of age often follow a brief period of stress. Cognitive immaturity/misjudgment, age-related impulsivity, and availability of suicide methods play an important role. Psychologic autopsy studies that focus on suicides in this age group are needed.
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