Suicidal Behavior in the Mediterranean Countries

International trends in male youth suicide and suicidal behaviour

OBJECTIVE

Suicide and suicidal behaviour strongly contribute to overall male youth mortality. An understanding of worldwide data contextualises suicide and suicidal behaviour in young men within any given country.

METHOD

Members and colleagues of the World Federation of Societies of Biological Psychiatry's Task Force on Men's Mental Health review the relevant data from several regions of the world. The review identifies notable findings across regions of relevance to researchers, policymakers, and clinicians.

RESULTS

Male suicide and suicidal behaviour in adolescence and emerging adulthood within North America, Latin America and the Caribbean, Europe, the Mediterranean and the Middle East, Continental Africa, South Asia, East Asia, China, and Oceania share similarities as well as significant points of divergence.

CONCLUSIONS

International data provide an opportunity to obtain a superior understanding of suicide and suicidal behaviour amongst young men.

Development of a context-specific trauma scale among a Palestinian adult population living amidst military violence

The current study aimed to develop a context-specific trauma scale in the Palestinian context. The sample of our study consisted of 490 Palestinian adults - 230 males and 260 females. Our scale ended up with 32 items to measure traumatic symptoms in the Palestinian context. Results of exploratory factor analysis and confirmatory factor analysis revealed a stable construct of a five-factor structure of the Palestinian specific-context trauma: (1) re-experiencing trauma, (2) avoidance and numbing, (3) hyperarousal, (4) somatic symptoms and (5) psychological symptoms. Reliability of the scale was further established by assessing the test-retest and internal consistency of all subscales. Convergent validity for the context-specific trauma scale was conducted by testing the association between the scale and two existing measures - the WHOQOL-BREF and the Impact of the Event Scale (IES-R). We recommend using our scale in empirical studies incorporating spoken or written disclosure about traumatic experiences. The scale should also be considered when working with clinical and non-clinical groups who have experienced politics-related trauma.

The association between posttraumatic stress symptoms and suicidal ideations among Palestinians: The mediating role of spirituality, social support and mindfulness

The current study aimed to test whether social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideation among Palestinians. The study sample consisted of 520 Palestinian adults selected using online tools. The findings of the study revealed that posttraumatic stress symptoms positively correlated with suicidal ideations (r = .32, p < .01), and negatively correlated with social support (r = -.34, p < .01), spirituality (r = -.16, p < .05) and mindfulness (r = -.72, p < .01), whereas suicidal ideations negatively correlated with social support (r = -.46, p < .01), spirituality(r = -.27, p < .01) and mindfulness (r = -.72, p < .01). Results of the path analysis showed that social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideations. Developing intervention programs to enhance social support, mindfulness and spirituality to mitigate the effect of ongoing traumatic experiences among Palestinians is crucial to reducing suicidal ideations. Further studies are also recommended to investigate the role of potentially protective factors that may reduce suicidal ideations and appropriate techniques to deal effectively with traumatic and stressful events.

Stress, Anxiety, and Depression Levels among University Students: Three Years from the Beginning of the Pandemic

BACKGROUND

Three years after the outbreak of the COVID-19 pandemic, psychological distress among college students remains increased. This study assesses stress, anxiety, and depression levels among students of the Aristotle University of Thessaloniki by the end of the third year of the pandemic (November 2022), revealing demographic characteristics and probable stressors.

METHODS

A questionnaire was distributed in November 2022 via the academic students' e-mails. The evaluation was performed with the DASS21 survey tool. The correlation analysis and the effect size calculation were performed with the t-test.

RESULTS

The majority of participants were undergraduates, on their first or second academic year, female students (67%), age of 18 to 21, unmarried or single (91%), and vaccinated against COVID-19 infection (83.4%). Severely increased levels of stress, anxiety, and depression (21.3%, 23.3%, and 25.1%, respectively) were measured. The normal and mild levels of stress, anxiety, and depression were 64.0%, 66.5%, and 57.2%, respectively. Female and younger students were at a higher risk of extremely severe stress, anxiety and depression prevalence (ORs up to 2.07, p-Values < 0.00001). Participants who were receiving psychological or psychiatric treatment exhibited severe stress, anxiety, and depression levels (ORs above 2.9, p-Values < 0.00001).

CONCLUSIONS

Despite the undeniable withdrawal of the COVID-19 pandemic, the community of the Aristotle University of Thessaloniki presents high stress, anxiety, and depression levels, similar to those reported during the first year of the pandemic (November 2020). Stressors and risk factors were according to the reported literature and previous studies on Greek students. Academic psychological support offices should consider the students' "profile" in order to evaluate properly the potential risk for emotional and psychological distress. Evidence suggest that new technology (virtual reality, tele-psychiatry or tele-support apps and sessions) should also be implemented in universities.

Corporal punishment bans and adolescent suicide rates: An international ecological study

BACKGROUND

Exposure to corporal punishment during childhood is associated with suicidal behaviors during adolescence. To date, the protective effects of national policies governing the use of corporal punishment have rarely been studied for adolescent suicide outcomes.

OBJECTIVE

To investigate contemporaneous and lagged associations between national legislation banning corporal punishment and adolescent suicide rates.

PARTICIPANTS AND SETTING

We used population-level administrative and mortality data from 97 countries spanning the years 1950 to 2017.

METHODS

Negative binomial models were used to investigate the relationship between the existence of official corporal punishment bans in countries and national adolescent suicide mortality rates and the potential time lag between the enactment of such bans and reductions in adolescent suicide rates.

RESULTS

National policies that permitted corporal punishment in all settings (homes, schools, daycares, and alternative care) were associated with a higher relative risk (RR) for suicide in females aged 15-19 (RR = 2.07, p = .03), as were policies allowing corporal punishment in schools specifically (RR = 2.01, p = .02). Partial bans of corporal punishment and bans of school corporal punishment showed lagged effects on suicide rates which peaked after 12 years for females aged 15-19 and after 13 years for males aged 15-19.

CONCLUSIONS

Study findings add to a body of evidence that suggests that official policies banning corporal punishment may promote adolescent health and well-being. The benefits of such policies in terms of reduced risk for adolescent suicide appear to peak approximately 12 to 13 years after enactment of the legislation.

An Exploratory Analysis of Fifteen Years Suicide Trends Using Population-Level Data From Croatian Committed Suicides Registry

Objectives

The provide a descriptive analysis of the available population-level aggregated data on committed suicides in the Republic of Croatia, in the 2004-2018 period, showing emerging trends in suicide incidence focusing on sex/age/geographical distribution of suicides and the primary and secondary causes of suicide mortality, as well as making comparisons with similar neighboring neighboring countries.

Methods

The aggregated suicide data were obtained from the Croatian Committed Suicides Registry, a national registry maintained by the public health authority. The raw data extract was organized into tables according to several variables (age, sex, place of birth, place of residence, and cause of death). Simple descriptive statistics were performed on the structured data.

Results

Despite being among the highest in the world and EU, the number of committed suicides in Croatia is in decline since 2004. A higher number of suicides by males was observed when compared to females. Most of the suicides occur during spring and summer. The wealthier, northern continental region of the country had the highest average rate of committed suicides per 1,00,000 population, contrary to some of the findings in the published literature associating economic instability with suicide. The most common way to commit suicide for both sexes in all age groups is self-harm by hanging, strangulation and suffocation. Suicide by firearm and explosive devices discharge remains higher than the global average.

Conclusions

Despite its steadily declining incidence rates in the past 20 years, suicides remain a major public health challenge in Croatia. Results may bolster the Ugro-Finnish suicide hypothesis, linking higher suicide rates to regions with populations of Hungarian descent.

Psychological autopsy study and risk factors for suicide in Muslim countries

BACKGROUND

Suicide and risk factors have been poorly studied in the Muslim-majority countries that hinder the formulation of prevention strategies and affect suicide prevention eventually.

OBJECTIVES

We aimed at identifying and analyzing the psychological autopsy studies assessing the risk factors for suicide conducted in Muslim-majority countries.

METHODS

We did a search to trace all the available psychological autopsy studies in the Muslim countries with the search term "psychological autopsy study in Muslim countries." We also checked the available bibliographies to identify the psychological autopsy studies in the Muslim countries so that all the possible studies could be included.

RESULTS

Out of the Muslim countries, only eight psychological autopsy studies were identified in five countries (Bangladesh [1], Indonesia [1], Iran [1], Pakistan [2], and Turkey [3]). Six studies adopted a case-control study design, and all were carried out in urban settings. The prevalence of psychiatric disorders among case-control studies varied from 52.8% in Turkey to 96% in Pakistan. Psychiatric illness, self-harm, and stressful life events were the commonly replicated risk factors for suicide across studies.

CONCLUSIONS

Psychological autopsy studies have been conducted only in five Muslim countries revealing that the risk factor for suicide is certainly under-researched in the incumbent countries. This review identified a similar list of risk factors for suicide, namely, psychiatric disorder, past non-fatal attempts, and adverse life events compared to the Western countries even though the rate varies.