The first COVID-19 triadic (homicide!)-suicide pact: Do economic distress, disability, sickness, and treatment negligence matter?

An unusual case of a triple suicide pact at the time of the COVID-19 pandemic

In December 2020, the World Health Organization (WHO) declared SARS-CoV2 a global pandemic. Home confinement, low social contacts, and fear of virus transmission played a major role as risk factors for suicides during the following period. Suicide pacts, in particular, showed a different pattern. A rare case of a triple suicide pact among members of the same family nucleus is presented. The victims were an elderly, severely ill woman and her adult children (a son and daughter), linked by a morbid relationship. The last time the family was seen alive was 40 days before the discovery. All corpses presented decompositional changes. After a full autopsy, the cause of death was determined to be a lethal intake of morphine for the mother and acute blood loss due to self-stabbing at the neck for the siblings. The younger woman was under the effects of a large amount of heparin. Toxicological analysis was positive for opioids and alcohol in both siblings. Suicide pacts have rarely been described during the COVID-19 pandemic. In the few cases reported, the victims were more often relatives than people in a romantic relationship. The involvement of three people is unusual, as is the use of different suicide methods among the victims. In the presented case, the elderly mother's imminent death from terminal cancer, her concern over dying in a nondomestic environment, and the siblings' fear of being alone likely led to the conception of the suicide pact. Social isolation and economic difficulties also played a contributing role.

Suicidal ideation among people with disabilities during the COVID-19 pandemic in Bangladesh: prevalence and associated factors

BACKGROUND

Evidence from pandemic and pre-pandemic studies conducted globally indicates that people with disabilities (PWDs) have a higher risk for suicidality. However, none of these studies has assessed suicidality among PWDs in Bangladesh.

AIMS

The purpose of this study was to determine the prevalence of and factors associated with suicidal ideation among PWDs during the COVID-19 pandemic in Bangladesh.

METHOD

Using a snowball sampling technique, a cross-sectional survey was conducted from February to April 2021 among PWDs from six districts in the northern region of Bangladesh. Information related to sociodemographic factors, clinical characteristics, behavioural factors and suicidal ideation was collected. Chi-squared test and logistic regression were used to describe the data and explain the relationship of factors associated with suicidal ideation.

RESULTS

The prevalence of COVID-19-related past-year suicidal ideation was 23.9%. The factors associated with suicidal ideation included: age above 35 years, being female, acquiring a disability later in life, lack of sleep and current substance use. In addition, higher education appeared to be a protective factor against suicidal ideation.

CONCLUSIONS

This study highlighted that PWDs had an increased risk of suicide; that is, one-fourth of them had past-year suicidal ideation. This may have been because of COVID-19-related restrictions and stressors. Thus, the government and policy makers need to pay more attention to developing effective suicide assessment, treatment and management strategies, especially for at-risk groups, to minimise the impact of the COVID-19 outbreak.

Urban parks as a potential mitigator of suicide rates resulting from global pandemics: Empirical evidence from past experiences in Seoul, Korea

Globally, the increased suicide rate of the general population has become a concern not only because of the COVID-19 pandemic, but also because of its associated socioeconomic insecurity, loss of jobs, and economic shocks. This study employed robust fixed-effects panel models to empirically identify the mitigating effects of infectious diseases, via urban parks, on the suicide rate, and to examine gender differences in this regard, based on previous experiences in Seoul, Korea. We found that the differentiating mitigating effect did not significantly affect suicide rates during the 2015 MERS epidemic. However, during the 2009 H1N1 pandemic, wherein the number of confirmed cases was very high and diffused nationwide, urban parks significantly reduced the suicide rates for both men and women. The role of parks as a mitigator was more enhanced in cities with a high number of confirmed cases if it was associated with economic shocks. However, this effect was significant only in the suicide rates of men, not women. During a pandemic, urban parks can help maintain social interaction and sustain physical activities (i.e., walking and exercise) while maintaining physical distance. National and local governments should develop urban parks to actively control the suicide rate influenced by movement restriction measures inevitably occurring during the spread of infectious diseases.

Does educational stress mediate the relationship between intolerance of uncertainty and academic life satisfaction in teenagers during the COVID-19 pandemic?

The present study aims to investigate the mediator role of educational stress in the relationship between intolerance to uncertainty and academic life satisfaction among teenagers. The sample consisted of 257 female and 202 male high school students with an average age of 16.03 (SD = 1.21) continuing their education in the spring semester of the 2020-2021 academic year in Turkey. The data were collected via an online survey. Analyses revealed that intolerance of uncertainty directly and indirectly via educational stress affects the academic life satisfaction of teenagers. Educational stress partially mediates the relationship. It was also found that the full mediation model has a good fit with the data. The academic life satisfaction of teenagers was harmed by their tendencies in tolerating the uncertainties they have been facing during the COVID-19 pandemic and elevated levels of educational stress.

Prevalence of Homicide-Suicide Incidents in Greece over 13 Years

Prevalence of homicide-suicides is difficult to determine in Greece due to the lack of a national tracking system. The aim of this study was to estimate the prevalence of the homicide-suicide incidents in Greece over the past 13 years, and to determine the circumstances under which they occurred, as well as the characteristics of perpetrators and victims. Two Internet search engines (google and yahoo), as well as the search engine of the major national news websites, were surveyed to identify the number of homicide-suicide cases that occurred in Greece from January 2008 to December 2020. Over the study period, 36 homicide-suicide incidents occurred in Greece, resulting in 36 suicides and 41 homicides. The above incidents reflect an annual homicide-suicide rate of 0.02 cases per 100,000 inhabitants. Most perpetrators were male (88.9%), whereas most victims were female (80.6%). Spousal-consortial cases accounted for 52.7% and familial cases for 41.7% of the total number of incidents. The use of firearms (mostly shotgun) was the most common method of homicide and suicide (58.3% and 63.9%, respectively). Women killed only their children, while men committed homicide and suicide mainly in the context of a former or current intimate partnership with the victim. Our results are in line with international homicide-suicide data. The establishment of a national surveillance system for homicides-suicides would be of paramount importance as it would facilitate accurate recording, identification of risk factors and characteristics of potential victims and perpetrators and it could ultimately be an aid to the prevention of such tragic events.

Suicidal Behavior in the First Wave of the COVID-19 Pandemic

PURPOSE OF REVIEW

Since the declaration of the COVID-19 pandemic, there have been numerous social changes to try to ​​contain the spread of the disease. These sudden changes in daily life have also changed the way we relate to others, in addition to creating a climate of uncertainty and fear. Therefore, the objective of this review is to compile published data of the consequences of suicidal behavior in the first months from the onset of the pandemic.

RECENT FINDINGS

The analysis reflects a concern about issues related to suicide since the beginning of the pandemic. A large number of online surveys have been released and have provided data on relatively large populations. The percentage of the population with suicidal ideation in that period seems to be approximately 5-15%. Many studies associate suicidal ideation with being young, female, and presence of sleep problems. Surveys of healthcare workers do not seem to indicate a higher prevalence of suicidal ideation compared to the general population. The incidence of suicide attempts seen in emergency departments did not seem to change, while the number of visits for other issues, unrelated to suicide, did decrease. The few studies on completed suicide do not indicate an increase in incidence in these first 6 months since March 2020, when the WHO declared the start of the pandemic. It does not seem that there have been major changes in the figures related to suicidal behavior in the studies from the first wave of the COVID-19 pandemic, although it is still too early to know the consequences it will have long term. The social and economic damages resulting from the pandemic will certainly take a long time to recover.

COVID-19 suicide and its causative factors among the healthcare professionals: Case study evidence from press reports

PURPOSE

Recent research has demonstrated the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic among the general population. However, COVID-19-related suicides among healthcare professionals (HCPs) have yet to be investigated.

FINDINGS

The present study utilized retrospective press media suicide reports and identified a total of 26 worldwide HCP COVID-19-related suicide cases (aged 22-60 years; 14 females; most of the cases from India). The cases comprised doctors (n = 11), nurses (n = 9), paramedics (n = 5), and one medical student. Being infected with the COVID-19 was the most common suicide reason, followed by work-related stress, and fear related to COVID-19 infection/transmission. Among the eight cases diagnosed with COVID-19, most were female (n = 6), and either doctors (n = 4) or nurses (n = 4).

PRACTICE IMPLICATIONS

The present findings will be helpful for human resources departments in healthcare workplaces in ensuring HCP's mental wellbeing.

COVID-19-Related Stressors and Mental Health Among Chinese College Students: A Moderated Mediation Model

This study aims to examine the relation between COVID-19-related stressors and mental health among Chinese college students during the pandemic outbreaks, and the possible mediator or moderator between them. Five hundred and fifty Chinese college students were invited to complete an anonymous survey, and the data were analyzed with SPSS 16.0 software. The results shows that the number of stressors has a negative direct and indirect (through risk perception of being infected with COVID-19 disease) impacts on college students' mental health. Adaptive coping is a protective factor of students' mental health, and could be regarded as a buffer that attenuates the negative effect of the COVID-19-related stressors on risk perception of being infected with COVID-19 disease (or mental health). With regard to demographic variables, females, junior and senior students, or students whose family residence was worst hit by the pandemic tend to report poorer mental health during the pandemic outbreak. These findings enrich our understanding about the impact of the COVID-19 pandemic on college population and have implications for university counseling services during times of acute, large-scale infective disease outbreaks.

Suicide and Suicidal Behaviors in the Context of COVID-19 Pandemic in Bangladesh: A Systematic Review

BACKGROUND

Without integration of the available information, appropriate suicide preventive actions can be hindered. Therefore, this study attempts to review the Bangladeshi COVID-19-related suicide studies for the first time.

METHODS

For conducting a systematic review, the PRISMA guideline was adhered. Bangladeshi literatures concerning the COVID-19 pandemic related to either suicide case or suicidal behavior were identified within 1 to 10 April 2021, from the databases like PubMed, Scopus, PsycINFO, Web of Science, CINAHL, etc. Finally, a total of 9 literatures were included in this review.

RESULTS

Four literatures were cross-sectional studies assessing the prevalence and risk factors of suicidal behavior, and the rest five were retrospective suicide studies concerned with either case study (n=3) or case-series study (n=2). The prevalence of suicidal ideation was identified to be ranging between 5% and 19.0%, whereas the rate increased over time of the pandemic inception. Significant risk factors concerning suicidal behavior included the factors related to (i) socio-demographic variables: female gender, being divorced or widows or widowers or single in marital status, having lower levels of education, being urban residence, belonging to higher socioeconomic class, being unemployed, and having no children, (ii) behavior and health-related variables: lack of physical exercise, cigarette smoking, alcohol consuming, abnormal sleep status, more exposure to social media, and suffering from the higher number of physical health problems; (iii) COVID-19 pandemic-related variables: lower knowledge of COVID-19, lack of preventive COVID-19 behaviors, higher levels of COVID-19 fear, living in highly COVID-19 infected area, higher economic loss due to the pandemic, and experiencing relatives or acquaintances' death by the COVID-19; (iv) psychopathological variables: depression, anxiety, stress, insomnia, suicidal thought history, suicide attempt history, and family with a history of suicide.

CONCLUSION

Implementing cost-effective mental health strategies along with social and community awareness for increasing help-seeking behaviors of suicide risky individuals is highly suggested.

Interest Consistency Can Buffer the Effect of COVID-19 Fear on Psychological Distress

In the context of a recent outbreak of the coronavirus disease (COVID-19), the present study investigated the buffering effect of grit on the relationship between fear of COVID-19 and psychological distress. The data were collected from 224 Japanese participants (98 females; mean age = 46.56, SD = 13.41) in July 2020. The measures used in this study included the Fear of COVID-19 Scale (FCV-19S), Short Grit Scale, and Depression, Anxiety, and Stress Scale 21 (DASS). The results of mediation analyses revealed significant indirect effects of consistency of interest, a major component of grit, on psychological distress (depression: estimate = .042; 95% CI: [.008, .088], anxiety: estimate = .021; 95% CI: [.001, .050], and stress: estimate = .030; 95% CI: [.004, .066]); we also found non-significant indirect effects of perseverance of effort, another major component of grit, on psychological distress. These results suggest that consistency of interest buffers the psychological distress induced by fear of COVID-19. Based on these results, it can be concluded that individuals with higher consistency of interest are less likely to experience worsening of their mental health, even if they experience fear of COVID-19 during the pandemic.

Suicide among adolescents and youths during the COVID-19 pandemic lockdowns: A press media reports-based exploratory study

PROBLEM

Suicide incidences among adolescents and youths during the Coronavirus Disease 2019 (COVID-19) lockdowns have been reported across the world. However, no studies have been carried out to investigate cumulative nature, patterns, and causative factors of such suicide incidences.

METHODS

A purposive sampling of Google news between 15 February and 6 July was performed. After excluding duplicate reports, the final list comprised a total of 37-suicide cases across 11 countries.

FINDINGS

More male suicides were reported (21-cases, i.e., 56.76%), and the mean age of the total victims was 16.6 ± 2.7 years (out of a total of 29 cases). About two-thirds of the suicides were from three countries named India (11-cases), UK (8-cases), and the USA (6-cases). Out of 23-student victims, 14 were school-going students. Hanging was the most common suicide method accounting in 51.4% of cases. The most common suicide causalities were related to mental sufferings such as depression, loneliness, psychological distress, and so forth, whereas either online schooling or overwhelming academic distress was placed as the second most suicide stressors followed by TikTok addiction-related psychological distress, and tested with the COVID-19.

CONCLUSIONS

The finding of the temporal distribution of suicides concerning lockdowns may help in exploring and evolving public measures to prevent/decrease pandemic-related suicides in young people.

Effect of COVID-19 pandemic on mental health among Bangladeshi healthcare professionals: A cross-sectional study

The COVID-19 has been spreading across the world since December 2019. The pandemic has created tremendous fear of death from infection and awful psychological pressure on healthcare professionals (HCPs). The measures of psychological effects of the COVID-19 outbreak on the Bangladeshi HCPs are unknown. The present study aimed to assess the mental health outcomes of Bangladeshi HCPs and associated risk factors. We conducted this cross-sectional study from July 15 to September 20, 2020. A total of 355 HCPs aged between 20 and 60 years residing in Bangladesh participated in this study. All the participants completed a self-administered questionnaire through Google Forms consisting of socio-demographic characteristics and mental health outcomes. We measure loneliness, depression, anxiety, and sleep disturbance using the UCLA loneliness scale-8, patient health questionnaire-9, 7-item generalized anxiety disorder scale, Pittsburgh sleep quality index. The present study observed the prevalence of loneliness, depression, anxiety, and sleep disturbance among HCPs were 89%, 44%, 78%, and 87%, respectively. The factors significantly associated with the development of mental health problems among HCPs were working environment, economic condition, education level, area of residence, marital status, gender differences, professional category, body mass index, and smoking habit. Moreover, we have seen significant correlations among the different mental health outcomes. In Bangladesh, a large portion of HCPs reported mental health issues during the COVID-19 pandemic. COVID-19 pandemic incredibly impacted the psychological health of Bangladeshi healthcare professionals. Appropriate supportive programs and interventional initiatives might help the HCPs with mental health problems during and after this pandemic.

Validation of the FCV-19 Scale and Assessment of Fear of COVID-19 in the Population of Mozambique, East Africa

PURPOSE

This study aimed to validate the Portuguese version of the Fear of COVID-19 Scale (FCV-19S) and investigate its association with sociodemographic and pandemic-related variables in the population of Mozambique.

PARTICIPANTS AND METHODS

A cross-sectional online survey recruited 387 Mozambicans aged 18 to 70 years. The psychometric properties of the Portuguese version of the FCV-19S were evaluated using confirmatory factor analysis and Rash analysis. Additionally, the association of the FCV-19S with sociodemographic and pandemic-related variables was investigated using the two-sample t-test, one-way analysis of variance, and logistic regression.

RESULTS

The unidimensional factor structure of the Portuguese version of the FCV-19S was confirmed, and the scale showed good internal consistency reliability. The FCV-19S properties tested from the Rasch analysis were satisfactory. Women and those with lower education levels had higher scores of fear. Moreover, significantly higher levels of fear were observed among those being in an at-risk group for COVID-19, having family members or friends diagnosed or with death confirmed by COVID-19, and not being confident that they would receive adequate care from the public health services in case of COVID-19 infection.

CONCLUSION

The Portuguese version of FCV-19S has strong psychometric properties and can be used to assess the fear of COVID-19 in the Portuguese-speaking population of Mozambique. As the adverse impacts of the COVID-19 pandemic on mental health represents a challenge to clinical psychiatry, and information on mental health in African countries is still scarce, our findings may assist in the planning of public mental health policies, aimed mainly at specific segments of the population, such as women and people in extreme poverty.

Symptoms of anxiety disorders in Iranian adolescents with hearing loss during the COVID-19 pandemic

BACKGROUND

Anxiety symptoms have been reported in many populations during the COVID-19 pandemic, but not in adolescents with a hearing loss. This study aimed to investigate the presence of symptoms of anxiety disorders (ADs) in adolescents with hearing loss (HL) during the COVID-19 pandemic, 2020.

METHODS

In this cross sectional study, 56 adolescents with HL (aged 12 to 18 years) including 23 deaf, and 33 hard of hearing (HH) were selected from four counties located in western Iran using a census method. Adolescents with HL filled out the self-report of the Screen for Child Anxiety Related Emotional Disorders (SCARED).

RESULTS

The results showed that the presence of symptoms of ADs in adolescents with HL was 37.5%, and higher in deaf than in HH adolescents (60.9% in deaf vs. 21.2% in HH, p = 0.003). Among the subscales, only the Social Anxiety Disorder (39.1% in deaf vs. 90.1 in HH, p = 0.009) and the School Avoidance (52.2% in deaf vs. 24.2% in HH, p = 0.031) significantly differed. The mean score of Panic Disorder, Social Anxiety Disorder, and Anxiety Disorders in the deaf adolescents were higher than in HH ones.

CONCLUSIONS

Our study showed the presence of significant symptoms of ADs in a sample of Iranian adolescents with HL, especially in deaf adolescents, during the COVID-19 pandemic.