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Senapati RE, Jena S, Parida J, Panda A, Patra PK, Pati S, Kaur H, Acharya SK. The patterns, trends and major risk factors of suicide among Indian adolescents - a scoping review. BMC Psychiatry 2024; 24:35. [PMID: 38195413 PMCID: PMC10775453 DOI: 10.1186/s12888-023-05447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Adolescence is an essential stage for the development of mental health, and suicide is among the leading cause of mortality for adolescents around the world. In India, the suicide rate among adolescents has been increasing in recent years. The scoping review was conducted to map the evidence and address gaps by examining the existing pattern, and trends, and identify the major risk factors of suicide among Indian adolescents. METHODS The study was conducted as per the Arksey and O'Malley scoping review framework and the Joanna Briggs Institute Reviewers' manual. The systematic search was performed using electronic databases such as PubMed, Google Scholar, EMBASE, and PsycINFO, by using specific keywords. After the screening, 35 articles were identified according to the inclusion criteria. RESULTS The evidence on the trends of suicide among adolescents showed that the suicide rate has shown an alarming increase in recent years. The evidence pattern showed that hanging and poisoning were the commonly selected methods used by adolescents. The most commonly reported risk factors were mental health problems (54.28%), negative or traumatic familiar issues (34.28%), academic stress (22.85%), social/lifestyle factors (20%), violence (22.85%), economic distresses (8.75%), relationship factor (8.75%). CONCLUSION By synthesizing and summarising the patterns, trends, and key risk factors of suicide among Indian adolescents, this scoping review provides a broad understanding of the literature already in existence. In order to effectively tackle these issues, the finding highlights the urgent need for extensive and targeted suicide prevention measures.
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Affiliation(s)
- Rachel Elizabeth Senapati
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Susangita Jena
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Jayashree Parida
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Arpita Panda
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | | | - Sanghamitra Pati
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Harpreet Kaur
- Division of Epidemiology and Communicable Diseases (ECD-Tribal Health), Indian Council of Medical Research (ICMR), New Delhi, India
| | - Subhendu Kumar Acharya
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India.
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Chawla N, Deep R, Gupta S, Vishwakarma A, Sen MS. Assessment of lethality and its clinical correlates in suicide attempters with mood disorders. Ind Psychiatry J 2022; 31:221-227. [PMID: 36419699 PMCID: PMC9678169 DOI: 10.4103/ipj.ipj_251_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/08/2022] [Accepted: 02/15/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Relatively limited literature is available on lethality assessment for suicide attempts in affective disorders from the Indian subcontinent. AIMS To assess the lethality and its clinical correlates in lifetime suicide attempters with mood disorders. METHODS A total of 100 lifetime suicide attempters, aged ≥18 years, with a DSM-5 diagnosis of bipolar disorder (BD) or major depressive disorder-recurrent (MDD-R) were recruited. Current euthymia was ascertained (Hamilton Depression Rating Scale (HAM-D) ≤7; Young Mania Rating Scale (YMRS) ≤4). Assessments were conducted using clinical pro forma, Risk-Rescue Rating Scale (RRRS), Columbia Suicide Severity Rating Scale (C-SSRS) and Barratt's Impulsiveness Scale (BIS). RESULTS Average age of the sample was 36.32 ± 11.76 years (48% males, 52% females). The mean duration of affective illness was 10.59 ± 8.32 years. Risk-rescue scores for lethality were significantly higher in males (vs females), bipolar disorder (vs unipolar), multiple attempters (vs single) and planned (vs unplanned) attempters. Risk-rescue score also showed a significant positive correlation with lifetime total and depressive episodes, and intensity of ideations, and a significant negative correlation with BIS-attention impulsiveness. Regression analysis [F (3,96) = 12.196, P < 0.001, adjusted R2 = 0.253] found that lifetime lithium prescription, intensity of suicidal ideations and attention impulsiveness explained 25.3% variance in lethality. CONCLUSION Absence of lifetime lithium, higher intensity of suicidal ideations and lower attentional impulsiveness predicted higher lethality of suicide attempts. Lethality of suicide attempts was found to be associated with a multitude of clinical factors, notably male gender, bipolarity, multiple attempts, planned attempts and number of total and depressive episodes. Assessment of lethality and its correlates can help to plan strategies towards risk prevention in mood disorders.
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Affiliation(s)
- Nishtha Chawla
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Raman Deep
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Depression and suicidal behavior in South Asia: a systematic review and meta-analysis. Glob Ment Health (Camb) 2022; 9:181-192. [PMID: 36618741 PMCID: PMC9806989 DOI: 10.1017/gmh.2022.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/16/2022] [Accepted: 03/06/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Estimates of depression in suicidal behavior in South Asia would help to formulate suicide prevention strategies in the region that hasn't been assessed yet. OBJECTIVES We aimed to systematically assess the prevalence of depression in fatal and non-fatal attempts of suicide in eight South Asian countries. METHODS We searched Medline, Embase, and PsychINFO by specific search terms to identify articles assessing depression in fatal and non-fatal attempts of suicide in South Asian countries published between 2001 and 2020. Two separate meta-analyses were conducted for fatal and non-fatal attempts. Due to the high heterogeneity of studies (96-98%), random-effects models were used to calculate pooled prevalence rates. RESULTS A total of 38 studies was identified from five south Asian countries (India [27], Pakistan [6], Sri Lanka [3], Nepal [1], and Bangladesh [1]). The majority of studies (n = 27) were published after 2010. Twenty-two studies reported non-fatal attempts, and sixteen reported suicide. The prevalence of depression among non-fatal attempts ranged from 14% to 78% where the pooled prevalence rate was 32.7% [95% CI 26-39.3%]. The prevalence of depression among suicides ranged from 8% to 79% where the pooled prevalence estimate was 37.3% [95% CI 26.9-47.6%]. CONCLUSIONS This review revealed the pooled prevalence of depression among fatal and non-fatal suicidal attempts in South Asian countries, which seems to be lower when comparedto the Western countries. However, a cautious interpretation is warranted due to the heterogeneity of study methods, sample size, and measurement of depression.
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Beniwal RP, Sreedaran P, Chari U, Ashok MV, Bhatia T. Protocol of a Multi-centric Randomized Controlled Trial to Evaluate Efficacy of Telephone-Based Psychosocial Interventions on Future Suicide Risk in Suicide Attempters. Indian J Psychol Med 2020; 42:S39-S45. [PMID: 33487801 PMCID: PMC7802031 DOI: 10.1177/0253717620971199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Persons with previous history of a suicide attempt are at increased future risk of death by suicide. These vulnerable individuals, however, do not seek receive or seek help from mental health services. Telephone-based psychosocial interventions are potential strategies in augmenting mental health care in such persons. METHODS We aim to compare the efficacy of telephone-based psychosocial interventions (TBPI) with routine telephone reminders in persons with recent suicide attempts using a multi-site, parallel group, rater-blind, two-arm randomized controlled trial design in 362 participants. In the first group, participants will receive three sessions of TBPI comprising of brief supportive interventions, problem-solving strategies, and reminders for adherence to prescribed mental health treatment at weekly intervals. In the second group, participants will receive three telephone reminders for adherence to prescribed mental health treatment at weekly intervals. We will follow up participants for 6 months. Primary outcomes are suicidal ideation scores on Beck's Scale for Suicide Ideation and number of repeat suicide attempts. Secondary outcomes are scores on Beck's Hopelessness Scale, Beck's Depression Inventory, Connor-Davidson Resilience Scale and Visual Analogue Rating Scales for acceptability of interventions. Outcomes will be assessed at 1, 3, and 6 months after receiving telephone interventions or reminders. RESULTS The trial is currently underway after prospective registration under Clinical Trials Registry of India and has recruited 260 participants till August 15, 2020. CONCLUSION This study has potential to generate evidence on additional strategies for use along with standard mental health treatments in management of high-risk suicide behaviors.
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Affiliation(s)
- Ram Pratap Beniwal
- Dept. of Psychiatry and Drug De-Addiction, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Science & Dr RML Hospital, New Delhi, India
| | - Priya Sreedaran
- Dept. of Psychiatry, St John’s Medical College, Bengaluru, Karnataka, India
| | - Uttara Chari
- Dept. of Clinical Psychology, St John’s Medical College, Bengaluru, Karnataka, India
| | - Ashok MV
- Dept. of Psychiatry, St John’s Medical College, Bengaluru, Karnataka, India
| | - Triptish Bhatia
- Indo-US Projects, NCU-ICMR, Dept. of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Science & Dr RML Hospital, New Delhi, India
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Alafia J, Manjula M. Emotion Dysregulation and Early Trauma in Borderline Personality Disorder: An Exploratory Study. Indian J Psychol Med 2020; 42:290-298. [PMID: 32612335 PMCID: PMC7320739 DOI: 10.4103/ijpsym.ijpsym_512_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 09/25/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) research is in its nascent stage in India though studies have estimated its prevalence in psychiatric conditions. Trauma experiences and emotion regulation difficulties are well documented in BPD in the international literature. Thus, it is imperative to examine the role of trauma experiences and their relation to emotion dysregulation in BPD in the Indian context. MATERIALS AND METHODS This study used both self-report and semistructured interview data from 34 adults with BPD who presented for outpatient or inpatient psychiatric treatment and compared them with a gender-matched control group. The tools used were the International Personality Disorder Examination, Kessler-10, Early Trauma Inventory Self Report-Short Form, modified-Positive And Negative Affect Scale, Cognitive Emotion Regulation Questionnaire, and Difficulties in Emotion Regulation Scale (DERS). RESULTS The BPD group reported higher negative affect, increased use of maladaptive emotion regulation strategies and a deficit of adaptive strategies, after depression scores were controlled for. General abuse, physical punishment, and emotional abuse were significantly higher in the BPD group. The high occurrence of childhood emotional abuse and negative affect in BPD patients emerged as a major correlate accounting for 68.4% of the variance in DERS scores. CONCLUSIONS Although we obtained results similar to the western literature on BPD pathology, sociocultural factors such as family and economic conditions, cultural differences in symptom expression of BPD, and treatment forms used in India warrant further research.
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Affiliation(s)
- J Alafia
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - M Manjula
- Department of Clinical Psychology, Behavioral Medicine Unit, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Knipe D, Williams AJ, Hannam-Swain S, Upton S, Brown K, Bandara P, Chang SS, Kapur N. Psychiatric morbidity and suicidal behaviour in low- and middle-income countries: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002905. [PMID: 31597983 PMCID: PMC6785653 DOI: 10.1371/journal.pmed.1002905] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/23/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psychiatric disorders are reported to be present in 80% to 90% of suicide deaths in high-income countries (HIC), but this association is less clear in low- and middle-income countries (LMIC). There has been no previous systematic review of this issue in LMIC. The current study aims to estimate the prevalence of psychiatric morbidity in individuals with suicidal behaviour in LMIC. METHODS AND FINDINGS PubMed, PsycINFO, and EMBASE searches were conducted to identify quantitative research papers (any language) between 1990 and 2018 from LMIC that reported on the prevalence of psychiatric morbidity in suicidal behaviour. We used meta-analytic techniques to generate pooled estimates for any psychiatric disorder and specific diagnosis based on International classification of disease (ICD-10) criteria. A total of 112 studies (154 papers) from 26 LMIC (India: 25%, China: 15%, and other LMIC: 60%) were identified, including 18 non-English articles. They included 30,030 individuals with nonfatal suicidal behaviour and 4,996 individuals who had died by suicide. Of the 15 studies (5 LMIC) that scored highly on our quality assessment, prevalence estimates for psychiatric disorders ranged between 30% and 80% in suicide deaths and between 3% and 86% in those who engaged in nonfatal suicidal behaviour. There was substantial heterogeneity between study estimates. Fifty-eight percent (95% CI 46%-71%) of those who died by suicide and 45% (95% CI 30%-61%) of those who engaged in nonfatal suicidal behaviour had a psychiatric disorder. The most prevalent disorder in both fatal and nonfatal suicidal behaviour was mood disorder (25% and 21%, respectively). Schizophrenia and related disorders were identified in 8% (4%-12%) of those who died by suicide and 7% (3%-11%) of those who engaged in nonfatal suicidal behaviour. In nonfatal suicidal behaviour, anxiety disorders, and substance misuse were identified in 19% (1%-36%) and 11% (7%-16%) of individuals, respectively. This systematic review was limited by the low number of high-quality studies and restricting our searches to databases that mainly indexed English language journals. CONCLUSIONS Our findings suggest a possible lower prevalence of psychiatric disorders in suicidal behaviour in LMIC. We found very few high-quality studies and high levels of heterogeneity in pooled estimates of psychiatric disorder, which could reflect differing study methods or real differences. There is a clear need for more robust evidence in order for LMIC to strike the right balance between community-based and mental health focussed interventions.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - A. Jess Williams
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | | | | | | | - Piumee Bandara
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences and Department of Public Health, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Nav Kapur
- University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Menon V, Kattimani S, Sarkar S, Mathan K. How do repeat suicide attempters differ from first timers? An exploratory record based analysis. J Neurosci Rural Pract 2016; 7:91-6. [PMID: 26933353 PMCID: PMC4750350 DOI: 10.4103/0976-3147.168435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Evidence indicates that repeat suicide attempters, as a group, may differ from 1st time attempters. The identification of repeat attempters is a powerful but underutilized clinical variable. Aims: In this research, we aimed to compare individuals with lifetime histories of multiple attempts with 1st time attempters to identify factors predictive of repeat attempts. Setting and Design: This was a retrospective record based study carried out at a teaching cum Tertiary Care Hospital in South India. Methods: Relevant data was extracted from the clinical records of 1st time attempters (n = 362) and repeat attempters (n = 61) presenting to a single Tertiary Care Center over a 4½ year period. They were compared on various sociodemographic and clinical parameters. The clinical measures included Presumptive Stressful Life Events Scale, Beck Hopelessness Scale, Coping Strategies Inventory – Short Form, and the Global Assessment of Functioning Scale. Statistical Analysis Used: First time attempters and repeaters were compared using appropriate inferential statistics. Logistic regression was used to identify independent predictors of repeat attempts. Results: The two groups did not significantly differ on sociodemographic characteristics. Repeat attempters were more likely to have given prior hints about their act (χ2 = 4.500, P = 0.034). In the final regression model, beck hopelessness score emerged as a significant predictor of repeat suicide attempts (odds ratio = 1.064, P = 0.020). Conclusion: Among suicide attempters presenting to the hospital, the presence of hopelessness is a predictor of repeat suicide attempts, independent of clinical depression. This highlights the importance of considering hopelessness in the assessment of suicidality with a view to minimize the risk of future attempts.
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Affiliation(s)
- Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Siddharth Sarkar
- Department of Psychiatry, Sree Balaji Medical College and Hospitals, Chennai, Tamil Nadu, India
| | - Kaliaperumal Mathan
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
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Poreddi V, Thimmaiah R, Ramu R, Selvi S, Gandhi S, Math SB. Gender Differences Related to Attitudes Toward Suicide and Suicidal Behavior. Community Ment Health J 2016; 52:228-32. [PMID: 26293749 DOI: 10.1007/s10597-015-9913-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 08/10/2015] [Indexed: 11/29/2022]
Abstract
This descriptive study examined gender differences related to attitudes toward suicide among randomly selected urban residents. Data was collected using a standardized questionnaire through face-to-face interview. Our findings revealed that men hold more pro preventive attitudes to help persons with suicidal thoughts (80.3 %, p = 0.05) and agreed that suicidal attempts are impulsive (78.6 %, p = 0.01). However, they hold permissive attitude to help persons with incurable diseases and expressing death wishes to die (66 %, p = 0.05). A majority of men (78.6 %) than women agreed that "suicidal attempt is essentially a cry for help" (χ (2) = 11.798, p = 0.05). These gender differences need to be taken into consideration when developing appropriate programs to prevent suicide. Further, decriminalizing the law, high-quality research and raising awareness about suicide prevention among the general population is crucial in developing countries like India.
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Affiliation(s)
- Vijayalakshmi Poreddi
- Department of Nursing, College of Nursing, National Institute of Mental Health and Neuro Sciences, Institute of National Importance, Bangalore, 560 029, India.
| | - Rohini Thimmaiah
- Department of Psychiatry, Videhi Medical College, Bangalore, India
| | - Rajalakshmi Ramu
- Department of Nursing, College of Nursing, National Institute of Mental Health and Neuro Sciences, Institute of National Importance, Bangalore, 560 029, India
| | - Sugavana Selvi
- Department of Nursing, College of Nursing, National Institute of Mental Health and Neuro Sciences, Institute of National Importance, Bangalore, 560 029, India
| | - Sailaxmi Gandhi
- Department of Nursing, College of Nursing, National Institute of Mental Health and Neuro Sciences, Institute of National Importance, Bangalore, 560 029, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (Institute of National Importance), Bangalore, India
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Yang L, Jia CX, Qin P. Reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) among suicide attempters and comparison residents in rural China. BMC Psychiatry 2015; 15:76. [PMID: 25886490 PMCID: PMC4426543 DOI: 10.1186/s12888-015-0458-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is an important public health problem and is closely associated with suicidal behavior in the population. Although the Center for Epidemiologic Studies Depression Scale (CES-D) is widely used for assessment of depression, the psychometric characteristics of this scale have not been explored in studies of suicide attempters and local residents in rural areas. METHODS In this study, reliability and validity of CES-D were assessed in 409 suicide attempters and 409 comparison residents from rural China and through internal consistency analysis and confirmatory factor analysis (CFA). RESULTS Cronbach's alpha values of the CES-D were 0.940 and 0.895 in, respectively, suicide attempters and comparison residents. CES-D scores were significantly correlated with the scores of Trait Anxiety Inventory (TAI) and Beck Hopelessness Scale (BHS) in both the suicide attempters and the comparison residents. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) with 14 items (excluding items 9, 10, 13, 15, 17, and 19) had the best fit in these two populations. CONCLUSIONS The CES-D scale has satisfactory reliability and validity when used for assessing depression in suicide attempters and comparison residents in rural China.
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Affiliation(s)
- Li Yang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, 250012, Shandong, China.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan, 250012, Shandong, China. .,Shandong University Center for Suicide Prevention Research, Jinan, 250012, Shandong, China.
| | - Ping Qin
- Shandong University Center for Suicide Prevention Research, Jinan, 250012, Shandong, China. .,National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Menon V, Kattimani S, Sarkar S, Muthuramalingam A. Gender differences among suicide attempters attending a Crisis Intervention Clinic in South India. Ind Psychiatry J 2015; 24:64-9. [PMID: 26257486 PMCID: PMC4525435 DOI: 10.4103/0972-6748.160936] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Studying gender differences among suicide attempters is important for identifying gender-specific risk factors and for planning management and prevention. Our objective was to delineate gender differences among a well-defined group of suicide attempters. MATERIALS AND METHODS This record-based study was conducted among patients presenting to a Crisis Intervention Clinic in a Tertiary Care Hospital in South India. Information was gathered regarding sociodemographic and clinical characteristics. Hopelessness was measured using Beck Hopelessness Scale (BHS), and stress was evaluated using Presumptive Stressful Life Events Scale (PSLES). RESULTS The sample comprised of 162 males and 137 females. Males were significantly older and were more likely to be employed as compared to females. Alcohol use was significantly more in males and number of men who attempted suicide under intoxication was significantly higher. Females had a greater proportion of attempts with the use of plant poisons and medication overdose. There was no significant difference between two genders on BHS though differences were noted on types of stresses reported on PSLES. CONCLUSION Gender-specific differences were noted with regard to substance use, mode of attempt and types of stressors experienced. Identifying these factors might help us to design targeted interventions to prevent further attempts.
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Affiliation(s)
- Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Siddharth Sarkar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Avin Muthuramalingam
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Kulkarni RR, Rao KN, Begum S. Comorbidity of psychiatric and personality disorders in first suicide attempters: a case-control study. Asian J Psychiatr 2013; 6:410-6. [PMID: 24011689 DOI: 10.1016/j.ajp.2013.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 05/02/2013] [Accepted: 05/12/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Comorbid psychiatric and personality disorders in suicide attempters pose greater estimated risk of suicide than psychiatric disorders alone. The current study aimed to evaluate prevalence and pattern of psychiatric and/or personality morbidity and comorbidity in first-time suicide attempters in comparison to the age and sex matched community sample. METHODS Socio-demographic variables, family background, psychiatric morbidity and comorbidity in survivors of first suicide attempt were compared to age and sex matched community controls. Structured (Mini International Neuropsychiatric Interview plus) and semi-structured (International Personality Disorder Examination) clinical interviews were utilized to evaluate for axis-I and axis-II (personality) diagnosis. Risk-rescue rating was administered to assess medical seriousness of suicide attempt. RESULTS Individuals who made a first suicide attempt showed significantly lower educational achievement (P<0.0001; OR 1.56; 95% CI 0.89-2.74), but no significant difference in other socio-demographic variables compared to the controls. Cases had high family history of psychiatric illnesses (31% vs. 7%; P<0.0001; OR 5.97; 95% CI 2.48-14.35); high prevalence of psychiatric disorders (89% vs. 25%; P<0.0001; OR 24.27 95% CI 11.21-52.57), personality disorders (52% vs. 24%; P<0.0001; OR 3.43; 95% CI 1.88-6.28), comorbidity of psychiatric and personality disorders (51.6% vs. 19.5%; P=0.022; OR 3.01; 95% CI 1.14-7.92), and high overall prevalence of any axis-I and/or axis-II (personality) morbidity (93% vs. 41%; P<0.0001; OR 19.12; 95% CI 8.05-45.43), compared to controls. CONCLUSION Survivors of first suicide attempt are at nineteen times increased odds of having psychiatric morbidity and/or comorbidity, especially with personality disorders. Personality evaluation and management in such individuals may result in better comprehensive approach to health care.
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Affiliation(s)
- Ranganath R Kulkarni
- Department of Psychiatry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
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