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Moftakhar L, Azarbakhsh H, Piraee E, Rezaei F, Mirahmadizadeh A. Suicide attempts and deaths by self-immolation: A population-based study in Fars (Iran), 2011-2019. MEDICINE, SCIENCE, AND THE LAW 2023; 63:22-30. [PMID: 35607282 DOI: 10.1177/00258024221099351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Self-immolation is a leading public health challenge with a relatively high mortality, especially in some low- and middle-income countries. This study aimed to investigate epidemiological factors of attempts and completed suicide by self-immolation during 2011-2019 in Fars province (Iran). Materials and methods: This retrospective cross-sectional study included 506 cases of attempted self-immolation suicide during 2011-2019 in Fars province (Iran). Demographic characteristics and suicide information were collected from the Fars Suicide Surveillance System. The first fatality rate and age-standardized mortality rates were calculated. Then, chi-square tests were performed to evaluate suicide trends and examine differences between qualitative variables and outcomes. Logistic regression was used to identify factors associated with self-immolation death. Result: The mean age of study participants was 32.11 ± 14.04 years. The highest age-standardized rates of attempt and completed self-immolation suicide were seen in the age group 25-34 years. The fatality rate of suicide by self-immolation was 61.89%, and the risk of death was around three times higher in people with a history of suicide attempts compared to those who had no history of suicide attempts. However, a family history of suicide attempts was shown to be a protective factor against completed self-immolation suicide. Conclusion: The rate of self-immolation is higher in women and young adults. The results of our study can assist health policy-makers to design comprehensive plans and determine the necessary strategies aimed at identifying vulnerable people, then preventing self-immolation suicide.
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Affiliation(s)
- Leila Moftakhar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Elahe Piraee
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Rezaei
- Shiraz University of Medical Sciences, Mental Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Abrams TE, McGarity SV. Psychosocial Determinants of Burn-Related Suicide: Evidence From the National Violent Death Reporting System. J Burn Care Res 2021; 42:305-310. [PMID: 32842149 DOI: 10.1093/jbcr/iraa152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Suicide is a unique phenomenon in humans. In 2017, over 47,000 Americans died by suicide, prompting a public health crisis. Suicide by burning, while one of the rarest forms of suicide, could be mitigated in part by early recognition and treatment of the underlying psychosocial factors. To date, investigators have attempted to tease out the risk factors associated with this phenomenon through the examination of burn center chart reviews and repository data, but these studies were limited by small sample sizes. In order to fill this gap in the literature, the authors analyzed 14 years of data (2003-2016) from the National Violent Death Reporting System. Suicides by burning (n = 722) were compared with a reference group containing all other suicide types (n = 166,949). Socio-demographic variables and psychosocial factors (eg, mental health, substance use, and alcohol use) were included in the model. Due to the imbalance between the target and reference groups, rare event data analysis was used to reduce potential small sample estimation bias. Results indicated that females (OR = 1.6, 95% CI: .50-2.83, P < .001), Caucasians (OR = 1.7, 95% CI: 1.1-2.7, P < .001), victims with schizophrenia (OR = 5.4, 95% CI: 3.7-7.8, P < .001), and victims with eating disorders (OR = 5.6, 95% CI: 1.9-8.6, P < .001) are significantly more likely to commit suicide by burning. These results contribute new knowledge to what is currently known about suicidal burn-related behaviors and supports interventions that focus on mitigating this insidious public health problem.
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Affiliation(s)
- Thereasa E Abrams
- College of Social Work, The University of Tennessee-Knoxville, Nashville
| | - Stephen V McGarity
- College of Social Work, The University of Tennessee-Knoxville, Nashville
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Aghakhani N, Lopez V, Parizad N, Baghaei R. "It was like nobody cared about what I said?" Iranian women committed self-immolation: a qualitative study. BMC Womens Health 2021; 21:75. [PMID: 33607973 PMCID: PMC7893762 DOI: 10.1186/s12905-021-01221-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Suicide-attempts have increased across the world and have become higher among females. There has been a high prevalence of self-immolation in Iran, mostly young married women admitted to the burn centers. This study aimed to explore the factors and experiences of self-immolation in Iranian married women to develop prevention strategies to prevent the personal, social, and economic impacts of suicide and suicide attempts. METHODS A qualitative descriptive approach using open-ended, in-depth, face-to-face interviews was conducted in a purposive sample of 16 married Iranian women aged 16-40 years in the burn centers in Urmia city, a place in northwest Iran. Conventional content analysis was used to analyze the data. RESULTS Three themes emerged from the data, including (1) antecedents of self-immolation, (2) suicidal ideation method, and (3) pathway to recovery. Each of these themes is supported by sub-themes. CONCLUSIONS The study highlights the demand for health professionals to support self-immolation survivors to continue their normal lives. According to survivors' needs, a comprehensive supportive program is recommended to support their pathways to recovery in all its complexities. Health professionals should also not forget that the survivors' family also will need help to overcome this trauma. A family counseling program may also be provided.
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Affiliation(s)
- Nader Aghakhani
- Patient Safety Research Center, Clinical Research Institute, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, China
- School of Nursing, University of Tasmania, Hobart, Australia
| | - Naser Parizad
- Patient Safety Research Center, Clinical Research Institute, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Rahim Baghaei
- Patient Safety Research Center, Clinical Research Institute, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
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Mohammadi AA, Karoobi M, Erfani A, Shahriarirad R, Ranjbar K, Zardosht M, Modarresi MS, Afrasiabi Z. Suicide by self-immolation in southern Iran: an epidemiological study. BMC Public Health 2020; 20:1646. [PMID: 33143680 PMCID: PMC7641801 DOI: 10.1186/s12889-020-09778-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/26/2020] [Indexed: 12/03/2022] Open
Abstract
Background Self-immolation, as a method of suicide, is one of the most violent and extreme ways which is usually attempted by the ignition of inflammable materials, with more than 70% fatality rate. In the literature, Iran has been reported to have a high rate of self-immolation; therefore, this study aimed to evaluate the prevalence and epidemiological features of self-immolated patients. Methods In this retrospective cross-sectional multicenter study, data from burn patients from 2007 till 2017 due to self-immolation and suicide were enrolled in our study. Results Based on our data, 657 out of 3530 burn patients (18.6%) with a mean age of 31.15 (SD = 0.452) were documented as suicidal attempts; the majority were female (63.2%) and married (66.3%). Most of the patients were from rural areas (58.3%) with an education level of under diploma (63.2%). Of the patients in our study, 22 (8.7%) had comorbid systemic diseases and 115 (50.5%) had psychiatric disorders. Conclusion Due to the high prevalence of suicide by self-immolation among the Iranian population, further studies to evaluate the risk factors and clarify the high-risk group for more targeted approaches are recommended.
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Affiliation(s)
- Ali Akbar Mohammadi
- Burn and Wound Healing Research Center, Plastic and Reconstructive Surgery Ward, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Karoobi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Keivan Ranjbar
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mitra Zardosht
- Burn and Wound Healing Research Center, Plastic and Reconstructive Surgery Ward, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh-Sadat Modarresi
- Burn and Wound Healing Research Center, Plastic and Reconstructive Surgery Ward, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zari Afrasiabi
- Burn and Wound Healing Research Center, Plastic and Reconstructive Surgery Ward, Shiraz University of Medical Sciences, Shiraz, Iran
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Saadati M, Azami-Aghdash S, Heydari M, Derakhshani N, Rezapour R. Self-immolation in Iran: Systematic Review and Meta-analysis. Bull Emerg Trauma 2019; 7:1-8. [PMID: 30719460 PMCID: PMC6360006 DOI: 10.29252/beat-070101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 11/26/2018] [Accepted: 12/07/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To perform a systematic review and meta-analysis of self-immolation epidemiology and characteristics in Iran. METHODS This was a systematic review and meta-analysis study. PubMed, Scopus, Web of science and Science Direct were searched for English literature and SID and Magiran for Persian in the time period of 2000 to 2016. The retrieved studies were screened and reviewed then quality assessed. Random Effect model was applied for meta-analysis. The qualitative data were analyzed by content analysis method. RESULTS After literature screening, 39 studies included in the analysis. Women were subject to self-immolation more than men. The rate of self-immolation estimated to be 4.5 cases in every 100,000 populations and it was the reason of 16% of hospitalized burns. The average length of hospital stay calculated to be 12.24 (95% CI: 8.85-15.59) days. The total burnt surface area was 65.3% (95% CI: 56.71-73.89). Death due to self-immolation was 62.1%. The major risk factors of self-immolation were having mental health issues, family problems and characteristics and problems in relation/communication with spouses. CONCLUSION Despite the low rate of self-immolation in Iran, it comprises one sixth of the hospitalized burns. The mortality rate of self-immolation also is high and this highlights the importance of providing special care. Psychological consultations and mental health screening in the primary health care would help to prevent the self-immolation.
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Affiliation(s)
- Mohammad Saadati
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- TabrizHealth Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahdieh Heydari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Derakhshani
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Rezapour
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Ahmadpanah M, Rahighi AH, Haghighi M. Female Gender, Marital and Family Problems, and Feelings of Guilt Are Related to Self-Immolation Suicide Attempts. Neuropsychobiology 2018; 76:51-58. [PMID: 29649810 DOI: 10.1159/000487859] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/21/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Self-immolation (SI) is considered one of the most painful, dramatic, and at the same time most inexplicable methods of suicide, with a high social impact. Prevalence rates are particularly high in Iran, and in north-western Iran specifically. Here, we report sociodemographic, psychological, and psychiatric characteristics of patients attempting self-immolation (PSIs), compared to patients with accident burns (PABs). METHOD Patients referred to the Burns Emergency Unit of the Besat Hospital (Hamadan, Iran) were enrolled in the present study between winter 2015 and summer 2016. After burn-related treatments and surgery, a thorough interview was undertaken covering sociodemographic characteristics, burn-related information, and psychiatric background. RESULTS A total of 79 patients were enrolled. Among these, 19 (31.7%) had attempted suicide via SI. Compared to the PABs, the PSIs were predominantly females; they reported family and marital problems as the main triggers for SI. The psychiatric interviews indicated that PSIs often suffered from major depressive disorders, adjustment disorders, and bipolar disorders. The prevailing feelings reported were guilt and shame. A binary logistic regression showed that feelings of guilt and marital and family problems predicted SI. CONCLUSIONS The prevalence of SI was surprisingly high. Marital and family conflicts as a proxy for highly distressing social interactions, along with female gender and feelings of guilt and shame were strongly associated with SI. Family and couple counseling specifically tailored to difficulties experienced by women might reduce the risk of SI.
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A Survey of the Suicidal Attempt Risk Factors in Adolescents in Southern Iran. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2017. [DOI: 10.5812/intjsh.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nisavic M, Nejad SH, Beach SR. Intentional Self-inflicted Burn Injuries: Review of the Literature. PSYCHOSOMATICS 2017; 58:581-591. [DOI: 10.1016/j.psym.2017.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/25/2017] [Accepted: 06/05/2017] [Indexed: 11/28/2022]
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9
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A comparison of suicidal behavior by burns five years before and five years after the 2011 Tunisian Revolution. Burns 2017; 43:858-865. [DOI: 10.1016/j.burns.2016.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 10/12/2016] [Accepted: 10/15/2016] [Indexed: 11/17/2022]
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10
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Ben Khelil M, Zgarni A, Zaafrane M, Chkribane Y, Gharbaoui M, Harzallah H, Banasr A, Hamdoun M. Suicide by self-immolation in Tunisia: A 10 year study (2005–2014). Burns 2016; 42:1593-1599. [DOI: 10.1016/j.burns.2016.04.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 04/29/2016] [Indexed: 11/16/2022]
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11
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Hajebi A, Ahmadzad-Asl M, Davoudi F, Ghayyomi R. Trend of Suicide in Iran During 2009 to 2012: Epidemiological Evidences from National Suicide Registration. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016. [DOI: 10.17795/ijpbs-4398] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Iemmi V, Bantjes J, Coast E, Channer K, Leone T, McDaid D, Palfreyman A, Stephens B, Lund C. Suicide and poverty in low-income and middle-income countries: a systematic review. Lancet Psychiatry 2016; 3:774-783. [PMID: 27475770 DOI: 10.1016/s2215-0366(16)30066-9] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 12/12/2022]
Abstract
Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events.
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Affiliation(s)
- Valentina Iemmi
- London School of Economics and Political Science, London, UK.
| | | | - Ernestina Coast
- London School of Economics and Political Science, London, UK
| | | | - Tiziana Leone
- London School of Economics and Political Science, London, UK
| | - David McDaid
- London School of Economics and Political Science, London, UK
| | | | | | - Crick Lund
- University of Cape Town, Cape Town, South Africa
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Poverty and suicide research in low- and middle-income countries: systematic mapping of literature published in English and a proposed research agenda. Glob Ment Health (Camb) 2016; 3:e32. [PMID: 28596900 PMCID: PMC5454768 DOI: 10.1017/gmh.2016.27] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/03/2016] [Accepted: 10/14/2016] [Indexed: 11/06/2022] Open
Abstract
Approximately 75% of suicides occur in low- and middle-income countries (LMICs) where rates of poverty are high. Evidence suggests a relationship between economic variables and suicidal behaviour. To plan effective suicide prevention interventions in LMICs we need to understand the relationship between poverty and suicidal behaviour and how contextual factors may mediate this relationship. We conducted a systematic mapping of the English literature on poverty and suicidal behaviour in LMICs, to provide an overview of what is known about this topic, highlight gaps in literature, and consider the implications of current knowledge for research and policy. Eleven databases were searched using a combination of key words for suicidal ideation and behaviours, poverty and LMICs to identify articles published in English between January 2004 and April 2014. Narrative analysis was performed for the 84 studies meeting inclusion criteria. Most English studies in this area come from South Asia and Middle, East and North Africa, with a relative dearth of studies from countries in Sub-Saharan Africa. Most of the available evidence comes from upper middle-income countries; only 6% of studies come from low-income countries. Most studies focused on poverty measures such as unemployment and economic status, while neglecting dimensions such as debt, relative and absolute poverty, and support from welfare systems. Most studies are conducted within a risk-factor paradigm and employ descriptive statistics thus providing little insight into the nature of the relationship. More robust evidence is needed in this area, with theory-driven studies focussing on a wider range of poverty dimensions, and employing more sophisticated statistical methods.
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Karim H, Schwebel DC, Bazargan-Hejazi S, Mohammadi R, Choubsaz M, Heidari Zadie Z, Ahmadi A. What factors play a role in preventing self-immolation? Results from a case-control study in Iran. J Inj Violence Res 2015; 7:59-63. [PMID: 26081518 PMCID: PMC4522316 DOI: 10.5249/jivr.v7i2.550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 10/07/2014] [Indexed: 11/22/2022] Open
Abstract
Background: To investigate factors related to prevention of self-immolation in west of Iran. Methods: In a case-control study, 30 consecutive cases of deliberate self-inflicted burns admitted to the regional burn center (Imam Khomeini hospital in Kermanshah province, Iran) were compared with controls selected from the community and matched by sex, age, district-county of residence, and rural vs urban living environment. The following characteristics relevant to preventing self-immolation were collected from all cases and controls: main domestic fuel used in the household, awareness about complications of burn injuries, and use of counseling services. Results: Descriptive analyses revealed that kerosene was the main domestic fuel in the household for 83% of cases. Not surprisingly, the main means of self-immolation in 93% of the patients was kerosene, with other fuels such as petrol and domestic gas used in remaining cases. The majority of cases and controls were aware of the potential complications of burn injuries. Use of counseling services was more common in controls. Conclusions: All three aspects of preventing self-immolation – having kerosene and other fuels in the home, being aware of the complications of burn injuries, and using counseling services were present in both the cases and controls. This suggests a large portion of residents in rural Iran are potential self-immolation victims. Increasing preventive strategies may reduce risk of suicide by self-immolation.
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Affiliation(s)
| | | | | | | | | | | | - Alireza Ahmadi
- Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. E-mail:
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Evaluation of Demographic and Clinical Characteristics of Patients who Attempted Suicide by Self-Inflicted Burn Using Catalyzer. Int Surg 2015; 100:304-8. [PMID: 25692434 DOI: 10.9738/intsurg-d-13-00189.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Our aim was to assess demographic and clinical characteristics of patients treated at our units who attempted suicide by self-incineration, and to compare the results of burns with or without catalyzer use. Twenty patients who attempted suicide by self-incineration were examined in terms of clinical and demographic characteristics. Average age of the study population was 35 years (range 13-85 years). Average percentage of total body surface area burn was 53% (9%-100%). Six (30%) patients used gasoline and 5 (25%) used paint thinner in order to catalyze burning. Of these 11 patients who used a catalyzer, 5 (45.4%) had inhalation injury and 7 (63.6%) died. Among 9 patients who did not use any catalyzer, 1 (11.1%) had inhalation injury and 4 (44.4%) died. In general, inhalation injury was diagnosed in 6 patients (30%) while 11 (55%) patients died. A high morbidity and mortality rate was found in patients who used a catalyzer.
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16
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Ahmadi A, Schwebel DC, Bazargan-Hejazi S, Taliee K, Karim H, Mohammadi R. Self-immolation and its adverse life-events risk factors: results from an Iranian population. J Inj Violence Res 2014; 7:13-8. [PMID: 25618437 PMCID: PMC4288291 DOI: 10.5249/jivr.v7i1.549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 11/18/2014] [Indexed: 11/04/2022] Open
Abstract
Background: Despite considerable loss of life by deliberate self-burning in low and middle-income countries, few scholars have examined psychiatric factors such as adverse life events that may be related to self-immolation. Methods: This case-control study investigated adverse life-events as risk factors for self-immolation patients admitted to a burn center serving the western region of Iran. Variables investigated included the following adverse life-events: unplanned pregnancy, infertility, homelessness, financial hardship, problems with friends, intimate relationship break-up , school or university failure, anxiety about school/university performance, problems at work, personal history of suicide attempts, family history of suicide attempts, individual history of mental disorders, and malignant disease. Results: Financial hardship (OR=3.35, 95% CI=1.19-9.90), intimate relationship break-up (OR=5.45, 95% CI=1.20-11.99), and personal history of suicide attempts (OR=7.00, 95% CI=1.38-35.48) were associated with increased risk of self-immolation. Conclusions: This study suggests that financial hardship, intimate relationship break-ups, and personal history of suicide attempts are risk factors for self-immolation. Other variables studied did not play a role as individually protective or risk factors for self-immolation. Further study is needed to substantiate findings of this study and direct research toward tailoring culturally sensitive, empirically-supported interventions for prevention of self-immolation.
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Affiliation(s)
| | | | | | | | - Hosein Karim
- Department of Cardiology, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Gauthier S, Reisch T, Bartsch C. Self-burning – A rare suicide method in Switzerland and other industrialised nations – A review. Burns 2014; 40:1720-6. [DOI: 10.1016/j.burns.2014.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/06/2014] [Accepted: 02/11/2014] [Indexed: 11/17/2022]
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18
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Ahmadi M, Ranjbaran H, Azadbakht M, Heidari Gorji M, Heidari Gorji A. A survey of characteristics of self-immolation in the northern iran. Ann Med Health Sci Res 2014; 4:S228-32. [PMID: 25364594 PMCID: PMC4212382 DOI: 10.4103/2141-9248.141964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Suicide is an action deliberately initiated and performed by a person with complete awareness of its fatal outcome, prevalence of which is very rare in developed countries, but it is reported with more frequency in Middle East including Iran. Aim: This study was carried out to analyze the characteristics, mortality, and related factors of burned patients who attempted to suicide by self-immolation in Northern Iran. Materials and Methods: In this retrospective study, the archived files of 101 cases that referred to the main burn care center located in northern Iran (Included: Mazadaran, Golestan cities) - cause of suicide attempting by self-immolation during 2 years 2010-2011, analyzed. A record sheet designed to extract data such as: Age, education, occupation, gender, residence, marital status, drug abuse, and extent of the burn injuries as a percent of burned total body surface area (TBSA). Results: The incidence rate of suicide attempted cases were 1.98/100,000 person-years. The mean ages for cases were 31.8 (13.6). The mean age for males and females were 36.1 (14.8) and 30.1 (12.9) years, respectively. In, about 84% (84/101) of the patient's burned TBSA was more than 40% (41/101). Burn injuries were more frequent, larger, and included higher mortality in females than males. Kerosene was the most common used material to self-burning. The mortality rate was about 74% (74/101), which showed a high mortality rate in this study. Other social factors such as marital status, employment, and education level have a role as individually protective or risk factors for self-burning. Conclusion: Finding of the current study manifested high rate of suicide by self-immolation among young, married, and low educated women in Northern Iran. It implies a social problem, and need to an arrangement of a cultural program aimed to improving health, psychological habits and educational level.
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Affiliation(s)
- M Ahmadi
- Department of Health Affairs, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Ranjbaran
- Department of Health Affairs, Mazandaran University of Medical Sciences, Sari, Iran
| | - M Azadbakht
- Department of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ma Heidari Gorji
- Education and Development Centre, Mazandaran University of Medical Sciences, Sari, Iran
| | - Am Heidari Gorji
- Department of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran ; Department of Traditionaland Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Rezaie L, Schwebel DC. Research priorities for suicide by self-immolation: Beyond quantitative approaches. Burns 2013; 39:536. [DOI: 10.1016/j.burns.2012.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 07/07/2012] [Indexed: 11/16/2022]
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20
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DiPoce J, Guelfguat M, DiPoce J. Radiologic Findings in Cases of Attempted Suicide and Other Self-Injurious Behavior. Radiographics 2012; 32:2005-24. [DOI: 10.1148/rg.327125035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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22
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Peck MD. Epidemiology of burns throughout the World. Part II: intentional burns in adults. Burns 2012; 38:630-7. [PMID: 22325849 DOI: 10.1016/j.burns.2011.12.028] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 11/28/2011] [Accepted: 12/27/2011] [Indexed: 10/14/2022]
Abstract
A significant number of burns and deaths from fire are intentionally wrought. Rates of intentional burns are unevenly distributed throughout the world; India has a particularly high rate in young women whereas in Europe rates are higher in men in mid-life. Data from hospitalized burn patients worldwide reveal incidence rates for assault by fire and scalds ranging from 3% to 10%. The average proportion of the body surface area burned in an assault by fire or scalds is approximately 20%. In different parts of the world, attempted burning of others or oneself can be attributed to different motives. Circumstances under which assaults occur fall largely into the categories of interpersonal conflict, including spousal abuse, elder abuse, or interactions over contentious business transactions. Contributing social factors to assaults by burning include drug and alcohol abuse, non-constructive use of leisure time, non-participation in religious and community activities, unstable relationships, and extramarital affairs. Although the incidence of self-mutilation and suicide attempts by burning are relatively low, deliberate self-harm carries a significant risk of death, with an overall mortality rate of 65% worldwide. In those who resort to self-immolation, circumstantial themes reflect domestic discord, family dysfunction, and the social ramifications of unemployment. Preventing injurious burn-related violence requires a multifaceted approach, including legislation and enforcement, education, and advocacy. Better standardized assessment tools are needed to screen for risks of abuse and for psychiatric disorders in perpetrators.
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Seoighe D, Conroy F, Hennessy G, Meagher P, Eadie P. Self-inflicted burns in the Irish National Burns Unit. Burns 2011; 37:1229-32. [DOI: 10.1016/j.burns.2011.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 04/10/2011] [Accepted: 04/19/2011] [Indexed: 11/29/2022]
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Poeschla B, Combs H, Livingstone S, Romm S, Klein MB. Self-immolation: Socioeconomic, cultural and psychiatric patterns. Burns 2011; 37:1049-57. [DOI: 10.1016/j.burns.2011.02.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/21/2011] [Accepted: 02/27/2011] [Indexed: 11/25/2022]
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Moniz P, Casal D, Mavioso C, Videira-Castro J, Angélica-Almeida M. The self-inflicted burns-Typology and its prognostic relevance in a 14-year review of self-inflicted burns in a tertiary referral centre. Burns 2011; 37:322-7. [DOI: 10.1016/j.burns.2010.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 07/21/2010] [Accepted: 07/22/2010] [Indexed: 11/29/2022]
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26
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Rezaie L, Khazaie H, Soleimani A, Schwebel DC. Is self-immolation a distinct method for suicide? A comparison of Iranian patients attempting suicide by self-immolation and by poisoning. Burns 2011; 37:159-63. [DOI: 10.1016/j.burns.2010.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2009] [Revised: 07/09/2010] [Accepted: 07/12/2010] [Indexed: 10/19/2022]
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27
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Ahmadi A, Mohammadi R, Schwebel DC, Yeganeh N, Hassanzadeh M, Bazargan-Hejazi S. Psychiatric disorders (Axis I and Axis II) and self-immolation: a case-control study from Iran. J Forensic Sci 2010; 55:447-50. [PMID: 20070465 DOI: 10.1111/j.1556-4029.2009.01268.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to investigate preexisting psychiatric disorders in self-immolation patients. In a case-control study, 30 consecutive cases of deliberate self-inflicted burns, admitted to the regional burn center, were compared with 30 controls. Mental disorders were assessed via detailed clinical interview. Descriptive data revealed that 67% of self-immolation patients had adjustment disorder (all female), 10% drug and alcohol abuse/dependence (all male), 7% dysthymia, 3% major depression, 3% anorexia nervosa, 3% primary insomnia, 7% borderline personality disorder (50% male), 7% depressive personality disorder (100% female), and 3% antisocial personality disorder. In bivariate comparisons, adjustment disorders emerged as related to risk of self-immolation (odds ratio = 13.00). This study suggests that adjustment disorder is a risk factor for self-immolation. As a result, it has been suggested that increasing education about problem-solving approaches, and coping skills for females and at-risk groups are appropriate prevention programs and strategies in Iranian communities.
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Affiliation(s)
- Alireza Ahmadi
- Department of Anesthesiology, Critical Care and Pain Management, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Klinge K, Chamberlain DJ, Redden M, King L. Psychological adjustments made by postburn injury patients: an integrative literature review. J Adv Nurs 2009; 65:2274-92. [DOI: 10.1111/j.1365-2648.2009.05138.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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