Socio-cultural features and sex profile of the individuals with serious suicide attempts in southeastern Turkey: a one-year survey

Attempted suicide and suicide of young Turkish women in Europe and Turkey: A systematic literature review of characteristics and precipitating factors

BACKGROUND

The increased risk of suicidal behaviour among Turkish women living in Europe and Turkey is a serious public health problem. This study compares and synthesises the empirical evidence of demographic, social, psychological and interpersonal characteristics and precipitating factors in the suicides and attempted suicides of Turkish women in Europe and Turkey.

METHODS

We systematically searched eight databases (PsycINFO, PubMed, Med Line, Web of Science, Smart Cat, Safety Lit, BASE and Ulakbim), using search terms in English, Turkish, German and Dutch, as well as the reference lists of the retrieved papers. We extracted data on countries/regions, population characteristics, sample characteristics, recruitment, method of data collection, type of suicidal behaviour (suicide or attempted suicide) and precipitating factors and characteristics. The results were qualitatively synthesised.

RESULTS

We retrieved nine studies on attempted suicide in Europe (from Germany, Switzerland and the Netherlands), 17 studies on attempted suicide in Turkey and 10 studies on suicide in Turkey (36 in total). Overall, we found similar precipitating factors and characteristics of attempted suicide and suicide in Turkey and Europe, including socio-demographic factors (young age and not being enrolled in the labour market), poverty and, to some extent, mental illness. Moreover, conflicts with family or spouses and violence against women, including so-called honour violence, were particularly common for women living in or originating from traditional areas in Turkey.

CONCLUSION

The framework of intersectionality is relevant to understanding our results, because structural inequalities in gender roles, gender role expectations as well as power imbalances among socio-economic classes collectively impact the suicidal behaviour of Turkish women. Moreover, the importance of violence against women points to the cultural continuity of the patriarchal and oppressive structures of Europe and Turkey. Suicide prevention efforts should address cultural attitudes underlying violence against women and girls through community education programmes, cultural and gender-sensitive care provision and jurisdiction.

Linguistic adaptation and psychometric properties of the Columbia-Suicide Severity Rating Scale among a heterogeneous sample of adolescents in Turkey

OBJECTIVE

The Columbia-Suicide Severity Rating Scale is a semistructured, interview-based assessment tool, which is increasingly being used for clinical and research purposes across the globe, despite its limited psychometric evaluation outside of English-speaking populations. The aim of this study was to linguistically adapt the measure and investigate reliability, validity, and factor structure of the Turkish version of the Columbia-Suicide Severity Rating Scale in a heterogeneous sample of psychiatric and nonpsychiatric outpatient adolescents.

METHOD

The study included four clinical groups: two psychiatric, nonsuicidal outpatient groups (depression group (N = 50) and nondepression group (N = 50)), suicidal group (N = 43), and nonpsychiatric general practitioners' group (N = 70). All participants were interviewed with the Columbia-Suicide Severity Rating Scale and suicidality module of the Mini International Neuropsychiatric Interview for children and adolescents. They also completed the Suicide Probability Scale, Child Depression Inventory, Beck Hopelessness Scale, and their parents filled in the Child Behavior Checklist.

RESULTS

The scale was found to be a solidly reliable measure with good internal consistency and agreement among interviewers. It correlated in the expected direction with self- and parent-report measures of associated constructs (e.g., depression) as well as suicidality. Consistent with the developers' intent of theoretical subscales, a three-factor solution (i.e., the severity of suicidal ideation, the intensity of suicidal ideation, and suicidal behavior) fit the data well, and it fit the data significantly better than the alternative models. Last, the Turkish Columbia-Suicide Severity Rating Scale successfully discriminated the adolescents with a recent history of suicide attempts from other clinical groups.

CONCLUSION

The Turkish version of the Columbia-Suicide Severity Rating Scale is a reliable and valid instrument to assess suicide risk among adolescents.

Suicidal Behaviors Among Muslim Women

Abstract. Background: The literature on Muslim women's suicidality has been growing. Comprehensive reviews are, however, unavailable, and theory needs development. Aims: This article reviews and integrates theories and findings about Muslim women's suicidality. Method: Two databases (PsycINFO and Web of Science) were searched for publications about Muslim women's suicidality. Results: There is significant variability in Muslim women's patterns of suicidality across Muslim-majority communities and countries. Muslim women represent half to nearly all cases of nonfatal suicidal behavior. According to the official records of Muslim-majority countries, women's suicide mortality is lower than that of men. Community studies, however, show that in some areas, Muslim women have significantly higher suicide rates than Muslim men. Both nonfatal and fatal suicidal behaviors are most common among uneducated and poor rural young women. Muslim women's typical suicide methods vary by locale, and include self-burning, hanging, and poisoning. With regard to contexts and meanings, a recurring female script is that of suicidality as protest against and desperate escape from the oppressive regulation as well as the abuse many women endure within their families and societies. Conclusion: Understanding and preventing Muslim women's suicidality, and the socially sanctioned oppression it is often a response to, require system-level – not just individual-level – analyses and interventions as well as a human rights perspective.

Intimate Partner Violence and Associated Coping Strategies among Women in a Primary Care Clinic in Port Harcourt, Nigeria

Context:

Intimate partner violence (IPV) is an important gender-based, social, and public health problem, affecting women globally.

Aims:

The aim was to report the prevalence of IPV and describe the coping strategies of the victims.

Settings and Design:

It was conducted in the general outpatient clinic of a tertiary care hospital using a cross-sectional design.

Materials and Methods:

A random sample of consenting women living in an intimate partnership for a minimum of 1 year were served with a three part structured questionnaire which sought information on sociodemographic characteristics, the experience of IPV and the Brief COPE Inventory.

Statistical Analysis Used:

SPSS version 17.0 software, Microsoft word and Excel were used in data handling and analysis. Means, percentages, standard deviations, and Chi-square were calculated. P < 0.05 was considered to be significant.

Results:

Of the 384 participants, 161 (41.9%) were physically abused. IPV was significantly common among women ≤40 years of age, married couples (78.5%), unemployed and in Christians. It was precipitated by argument with husband (19.25%) and financial demands (44.10%). The employed coping strategy with the highest score was religion. The least score was found in substance abuse.

Conclusion:

There was significantly high prevalence of domestic violence against women in this study. Hence, routine screening is advocated by family physicians to elicit abuse in order to avoid the more devastating psychological consequences after the incidence so as to institute appropriate treatment as multiple episodes of abuse appears to be cumulative in effect. The reason for violence mainly borders around the argument with husband and finance issues. The coping strategies utilized by the participants minimally involve substance abuse, but more of a religion.

Suicide rates among Turkish and American youth: a cross-cultural comparison

This study compares youth (<24 years) suicide rates in Turkey and the United States; a demographic and cross-cultural comparison and exploration of possible causative factors. Publicly available data were compared for children, adolescents, and young adults for years 1992-2004. The mean general population suicide rate in Turkey (per 100,000) was, male = 3.53 and female = 2.31 (for the US, males = 18.37, females = 4.31); for ages below 15 years the rate was, males = 0.28 and females = 0.39 (for the US, males = 1.09 and females = 0.38); while for aged 15-24 years the rate was, males = 4.58 and females = 5.22 (for the US, males = 18.84 and females = 3.36). The patterns for Turkey are: (a) Female youth had a higher suicide rate than male youth; this was the reverse of the U.S. pattern, (b) Youth suicide increased during the time period in Turkey, whereas it was relatively stable in the US, (c) However, suicide rates in Turkey were generally lower than the US, (d) Fifty percent of all female suicide victims in Turkey were under the age of 24 years (versus 11% in the US). Possible psychosocial causative factors may include (a) negative social status of females (forced marriage, young marriage age, low literacy, honor killings); (b) substantial rural to urban migration which disrupts ties and exposes migrants to a less traditional cultural system; (c) shortage of mental health services; (d) and possibly, reduced religious education enrollment may be an additional factor.

Cortical and subcortical abnormalities in late-onset depression with history of suicide attempts investigated with MRI and voxel-based morphometry

Late-onset major depression is thought to have a biological (vascular) basis, which could be a result of brain structure change. Vascular lesions can affect both the gray matter (GM) and white matter (WM), while most previous studies addressed WM abnormality. This study explored the disease- and symptom (history of suicide attempt) -related GM morphometry in elderly male patients with late-onset depression. A total of 70 patients with depression admitted to our geriatric psychiatric ward were investigated, and 26 age-matched males were recruited as controls. We used T1-weighted magnetic resonance imaging (MRI) to obtain cerebral structural information and adopted voxel-based morphometry (VBM) to investigate brain volume change related to disease (depression vs control) and symptom (depression with history of suicide attempt vs depression without history of suicide attempt). Late-onset depression was associated with smaller volumes in several regions of GM (insula and the posterior cingulate region) and WM (subcallosal cingulate cortex, floor of lateral ventricles, parahippocampal region, insula, and the cerebellum). Compared with nonsuicidal counterpart, suicidal depression was associated with decreased GM and WM volume in the frontal, parietal, and temporal regions, and the insula, lentiform nucleus, midbrain, and the cerebellum. Marked regional volume reduction was noticed at dorsal medial prefrontal cortex. Our results demonstrate that the development of suicidal behaviors in major depression is related to widespread but discrete volume reduction in several cortical and subcortical structures, fitting with the hypothesis that decreased cerebral volume in certain regions renders biological susceptibility to attempt suicide during depressive states.

Preliminary spatiotemporal analysis of the association between socio-environmental factors and suicide

BACKGROUND

The seasonality of suicide has long been recognised. However, little is known about the relative importance of socio-environmental factors in the occurrence of suicide in different geographical areas. This study examined the association of climate, socioeconomic and demographic factors with suicide in Queensland, Australia, using a spatiotemporal approach.

METHODS

Seasonal data on suicide, demographic variables and socioeconomic indexes for areas in each Local Government Area (LGA) between 1999 and 2003 were acquired from the Australian Bureau of Statistics. Climate data were supplied by the Australian Bureau of Meteorology. A multivariable generalized estimating equation model was used to examine the impact of socio-environmental factors on suicide.

RESULTS

The preliminary data analyses show that far north Queensland had the highest suicide incidence (e.g., Cook and Mornington Shires), while the south-western areas had the lowest incidence (e.g., Barcoo and Bauhinia Shires) in all the seasons. Maximum temperature, unemployment rate, the proportion of Indigenous population and the proportion of population with low individual income were statistically significantly and positively associated with suicide. There were weaker but not significant associations for other variables.

CONCLUSION

Maximum temperature, the proportion of Indigenous population and unemployment rate appeared to be major determinants of suicide at a LGA level in Queensland.