Epidemiology of suicide attempts and deaths: a population-based study in Fars, Iran (2011-16)

Psychometric properties of the Persian short form of the Stigma of Suicide Scale

Objective

Suicide stigma is a major obstacle to suicide prevention, resulting in a decrease in mental help seeking. This study aimed to survey the psychometric characteristics of the Persian short form of the Stigma of Suicide Scale (SOSS).

Methods

This psychometric study was conducted on 956 people (EFA = 399 samples, CFA = 557) in 2022 to evaluate the validity (face, content, and structure validity) and reliability (Cronbach's alpha coefficient, McDonald Omega coefficient, and intraclass correlation coefficient) of the SOSS. The structural validity of the scale was assessed by confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).

Results

The scores of S-CVI/Ave and CVR for SOSS were 0.982 and 0.921, respectively. In the EFA section, three factors with eigenvalues above one were shown, and 60.60% variance of the scale was explained by these factors, and one question was eliminated due the factor loading less than 0.4 and also moving to an irrelevant factor. Finally, based on the goodness-of-fit indices (such as RMSEA = .077, CFI= .902, IFI= .903, GFI= .915), the Persian short form of SOSS was approved with 15 items and three factors of Glorification/Normalization (4 items), Stigma (7 items), Isolation/Depression (4 items). The McDonald Omega coefficient, Cronbach's alpha coefficient, and ICC for SOSS were 0.841, 0.834, and 0.881, respectively.

Conclusion

In this study, the Persian short form of the SOSS was approved with 15 items and 3 factors, and this scale is an appropriate instrument for determining the status of suicide stigma among general population.

Establishing a minimum data set for suicide and attempted suicide registry system in Iran

BACKGROUND

Suicidal behavior is a major cause of mortality and disability worldwide. Accurate and consistent collection of data on suicide, suicide ideation, and suicide attempts presents many challenges for public health practitioners, policymakers, and researchers. This study aimed to establish a minimum data set (MDS) for integrating data across suicide registries and other data sources.

METHODS

The MDS proposed in this study was developed in two-stepwise stages. First, an extensive literature review was performed in order to identify the potential data items. Then, we conducted a two-round Delphi stage to reach a consensus among experts regarding essential data items and a supplementary one-round Delphi stage for validating the content of the final MDS by calculating the individual item content validity index (CVI) and content validity ratio (CVR) and using other statistical tests.

RESULTS

After the literature review, 189 data items were extracted and sent to a panel of experts in the form of a questionnaire. In the Delphi stage and CVI calculation, 55 and 10 experts participated in kappa and CVR calculation, respectively. Finally, the MDS of the suicide registry was finalized with 84 data elements that were classified into four categories, including patient profile, socio-economic status, clinical and psychopathological status, and suicide circumstances.

CONCLUSIONS

The suicide MDS can become a standardized and consistent infrastructure for meaningful evaluations, reporting, and benchmarking of suicidal behaviors across regions and countries. We hope this MDS will facilitate epidemiological surveys and support policymakers by providing higher quality data capture to guide clinical practice and improve patient-centered outcomes.

Socio-demographic status and 12 years trend of completed suicide in East Azerbaijan Province, Iran, during the period 2007–2018

Background

The incidence rate of suicide has been increased in Iran over the past decades especially in East Azerbaijan Province which there are limited studies on suicide. We aimed to investigate the 12-year trend of suicide and demographic characteristics in East Azerbaijan Province during the period 2007–2018. We obtained the data on the suicide mortality and socio-demographic status from the Death Registry Information System (DRIS) and compared with legal medicine suicide statistics during the study period.

Results

A total of 2422 and 1783 suicide cases were reported by legal medicine and DRIS (average incidence rate 5.94 vs 4.4 per 100,000) in the 12-year period from 2007 to 2018, respectively. The suicide rate in males was more than two times that of females. The mean and median age of suicide was 34.07 and 31 years, respectively. The most common suicide method was hanging (51.9%). The incidence rate of suicide cases was decreasing between 2007 and 2014, however from 2015 to 2018 has been increased.

Conclusions

The incidence rate of suicide in this province has been increasing with a smooth slope. Community-based programs and measures should be taken to stop the growth rate of suicide.

Suicide by self-immolation in southern Iran: an epidemiological study

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.

The epidemiology of suicide in the elderly population in Southern Iran, 2011-2016

BACKGROUND

The epidemiology of suicide within the elderly is unique to each cultural setting. In most countries, despite the higher rate of suicide attempts among adolescents and young people, the rate of suicide deaths in the elderly is higher than other age groups. The purpose of this study was to investigate the suicide rates among persons 65 years and above in Fars, Iran.

METHODS

In this cross-sectional study, we investigated suicide cases (65 years and older) during 2011-2016 in Fars, Iran. The data were collected from the Mental Health and Suicide Surveillance Systems of Fars province, using filled forms that included suicide and demographic information. After eliminating duplications, suicidal rates were calculated.

RESULTS

Of 299 suicide attempts, 64.9% were men, and 69.6% were urban residents. The rate of suicide attempts and deaths were 21.47 and 4.52 per 100,000 population, respectively; and the case fatality rate (CFR) of suicide was 21.07% during the study period. The rate of suicide attempts and deaths in this population showed an increase during the study years.

CONCLUSIONS

Considering the increasing trend of suicide rates in the elderly in Fars, Iran, measures should be taken to facilitate the access of this group to the mental health care system and psychological counseling.