Psychological autopsy study in Bangladesh: An unmet need to formulate preventive strategy of suicide

An unusual complex suicide involving a chainsaw and a hanging: a case report

BACKGROUND

Suicides or suicidal attempts with power tools such as band or circular saws are rarely encountered in forensic medicine practice; in the forensic literature, only a few cases have been reported. We present the case of a "combined suicide" (self-injurious actions using different methods and involving various bodily sites) carried out with uncommon deadly methods: chainsaw and hanging.

CASE PRESENTATION

A 58-year-old Caucasian man was found dead by his wife, hanging from the basement ceiling of the cellar in which he lived. During the investigation of the crime scene, external examination revealed a wide incised wound in the umbilical area showing the muscular and adipose tissues below. On inspection of the garden around the courtyard, the police found a chainsaw with blood spatter on both the blade and the handle. The blade appeared to be compatible with the abdominal injuries.

CONCLUSIONS

Since the corpse presented this incised wound, it was crucial to establish the manner and the causes of death, as well as to exclude any third-party involvement. In this case, the presence of multiple injuries, potentially lethal, required a differential diagnosis between suicide or homicide. A detailed post-mortem examination, in association with a precise study of the circumstantial data, led the authors to assume that they were dealing with a "complex suicide."

Risk factors of geriatric depression among elderly Bangladeshi people: A pilot interview study

Globally, geriatric depression (GD) has been recognized to be one of the most prevalent problems among the elderly. However, there is an only one previous Bangladeshi study addressing the issue. Consequently, the present study investigated GD and its associated risk factors. A semi-structured face-to-face interview was conducted among 168 self-reported healthy elderly residents (59.5% female) aged 60-80 years in Patuakhali city and the neighboring village. Measures included the Geriatric Depression Scale-15, socio-demographic variables, psychosocial factors, physical health-related factors, lifestyle factors, and dietary factors. Results showed the GD prevalence rate was 36.9% (n = 62). Risk factors for GD included living in a rural area, having no history of chronic disease, having a history of previous personal and/or family depression, not engaging in daily life activities, not exercising regularly, having no hobbies, having a poor diet, and not engaging in religious practices regularly. The GD prevalence rate was generally higher compared to previous studies in other countries. This may have been due to the inclusion criterion of selecting self-reported healthy elderly individuals. It is recommended that a nationally representative study is carried out to assess the actual figure of GD in Bangladesh. The findings are helpful for depression-reducing intervention programs.

Psychological Implications of Unemployment Among Bangladesh Civil Service Job Seekers: A Pilot Study

Background: Recent trends suggest that university graduates seeking jobs are more susceptible to common mental disorders, such as depression, anxiety, or stress. However, the mental health issues among unemployed graduates has not been explored in Bangladesh yet. Aims: This study aimed to assess for the first time the prevalence and associated risk factors of depression, anxiety, and stress among Bangladesh Civil Service (BCS) job seekers. Three hundred four graduates residing in Rajshahi, Bangladesh, who were preparing to attend the 40^th BCS examination, the most sought-after employment opportunity in the country, were surveyed. Methods: Measures included socio-demographics, field of study, and career-related variables, and the Bangla Depression Anxiety Stress Scale (DASS-21). Chi-square test, Fisher exact test, and binary logistic regression with "depression," "anxiety," and "stress" as the dependent variables were carried out to identify the factors associated with these. Results: Overall, the prevalence of moderate to extremely severe depression, anxiety, and stress was 49.3%, 53.6%, and 28.3%, respectively, with no detectable differences between genders. Insecurity related to a BCS job (OR = 0.41; CI = 0.26-0.65, p < 0.001; ref: job insecurity), family and social pressure to obtain a BCS job (OR = 4.58; CI = 1.67-12.56, p < 0.001), and stress (OR = 8.33; CI = 4.47-15.51, p < 0.001) emerged as independent predictors for depression. In addition, having part-time job was associated with anxiety (OR = 2.38; CI = 1.34-4.23, p = 0.003), and security in a BCS job and serving the nation through this job were negatively associated with stress (OR = 0.59; CI = 0.35-0.98, p = 0.042 vs. OR = 0.59; CI = 0.36-1.00, p = 0.05). Conclusion: The relatively high rates of depression, anxiety, and stress among graduate job seekers should prompt implementation of market force initiatives that incorporate interventions related to the major risk factors uncovered herein.