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Ahmed DR, Heun R. A systematic review of the epidemiology of suicide in Iraq and Kurdistan region. J Affect Disord 2024; 351:790-798. [PMID: 38341151 DOI: 10.1016/j.jad.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES The suicide rate has increased in Iraq in recent years, making it a major public health concern. This systematic review examines the prevalence of suicidal behaviours in the Iraq and Kurdistan region. MATERIALS AND METHODS This study adhered to the PRISMA guidelines, conducting searches on PubMed, MEDLINE, Web of Science, and Google Scholar. Out of 153 initially identified publications, only 18 full articles met the inclusion criteria, with 135 articles excluded due to reasons such as eligibility criteria, duplication, predatory publications and lack of relevance and lack of quality data. RESULTS The suicide crude rate in Iraq (excluding Kurdistan) rose from 1.09 to 1.31 per 100,000 between 2015 and 2016, while Kurdistan had an estimated rate of 3.83 per 100,000 during the same period. Limited data on reference group sizes and population figures make specific rate calculations challenging. Suicide is more prevalent among women, those aged 15-40, and individuals with mental disorders. Contributing factors include domestic violence, mental health issues, and traditional norms. Urban residents generally have higher suicide rates than rural residents. Common suicide behaviours include self-immolation, hanging, firearms, jumping from heights, and self-poisoning with pesticides. CONCLUSION The prevalence of suicide in Iraq, as indicated by this systematic review, requires urgent attention and effective public health initiatives. The interplay of social, economic, cultural, and psychological factors emphasizes the need for comprehensive prevention programs. Additionally, a crucial requirement is the implementation of a standardised method for collecting suicide data to improve epidemiological understanding.
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Affiliation(s)
- Darya Rostam Ahmed
- Department of Clinical Psychology, Faculty of Science and Health, Koya University, Koya KOY45, Kurdistan Region - F.R., Iraq.
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2
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Ahmed DR. The epidemiology of self-immolation in Iraq: A systematic review. Int J Soc Psychiatry 2023; 69:1551-1559. [PMID: 37139597 DOI: 10.1177/00207640231168787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Self-immolation is one of the most brutal suicide methods and is a significant social and medical problem throughout the world. Self-immolation is more common in low-income countries than in high-income countries. AIM The aim is to evaluate the trends in self-immolation and examine its frequency in Iraq. METHODS The PRISMA guideline was used to conduct this systematic review study. We searched for publications in English, Arabic and Kurdish in PubMed and Google Scholar. A total of 105 publications were identified through the search; however, 92 were eliminated due to duplication and irrelevant content. Finally, 13 full articles were included for data extraction. The inclusion criteria were articles that investigated self-immolation. However, letters to editors and media reports on self-immolation were excluded. The retrieved studies were selected, reviewed and then quality assessed. RESULTS This study included 13 articles. According to the findings, self-immolation accounted for 26.38% of all burn admissions in the Iraqi provinces and the Kurdistan region, with 16.02% of those occurring in the middle and southern provinces of Iraq and 36.75% in the Kurdistan region. It is more common in women than in men, especially among young, married, illiterate, or poorly educated people. Sulaymaniyah had a higher percentage of self-immolation than other governorates in Iraq, accounting for 38.3% of burn admissions. Cultural and social norms, domestic violence, mental health problems, family conflicts and financial problems were identified as the most common causes of self-immolation. CONCLUSION The prevalence of self-immolation is high among the Iraqi population, compared to other countries, particularly among the Kurdish population and in Sulaymaniyah. Self-immolation is relatively common among women. There are sociocultural factors that could contribute to this problem. Families must be restricted from having easy access to kerosene, and high-risk individuals should have access to psychological consultation to reduce the risk of self-immolation.
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Affiliation(s)
- Darya Rostam Ahmed
- Department of Clinical Psychology, Faculty of Science and Health, Koya University, Koya, Kurdistan Region - F.R., Iraq
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3
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Erlangsen A, Khan M, Su W, Alateeq K, Charfi F, Madsen T, Qin P, Morthorst BR, Thomsen M, Malik A, Bandara P, Fleischmann A, Saeed K. Situation Analysis of Suicide and Self-Harm in the WHO Eastern Mediterranean Region. Arch Suicide Res 2023:1-19. [PMID: 37837375 DOI: 10.1080/13811118.2023.2262532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
OBJECTIVE An estimated 41,000 lives are lost to suicide each year in World Health Organization Eastern Mediterranean Region Office (WHO EMRO) countries. The objective of this study was to conduct a situation analysis for suicide and self-harm in the WHO EMRO region. METHODS Data on suicide were obtained from the WHO Global Health Estimates for the years 2000-2019. Information on risk groups efforts to prevent self-harm and suicide in the EMRO region were retrieved through scientific studies, grey literature, and public websites. RESULTS During 2000-2019, the age-standardized suicide rate was 6.7 per 100,000 inhabitants, albeit there are concerns regarding data quality. Self-harm and suicide remain criminal acts in more than half of the countries. Few countries have a national plan for prevention of suicide. Toxic agents, such as pesticides and black henna, are easily available and frequently used for suicide in some areas, as are firearms and self-immolation. Successful prevention measures include means restriction and psychosocial interventions after self-harm. CONCLUSION Many WHO EMRO countries remain underserved in terms of mental health care. Decriminalization of suicide and means restriction might be further promoted. Online-based tools for mental health literacy and psychosocial therapy are other options to explore.
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Freedland AS, Sundaram K, Liu NH, Barakat S, Muñoz RF, Leykin Y. Self-harm behaviors and their intentions: a cross-cultural analysis. J Ment Health 2023:1-9. [PMID: 37577971 DOI: 10.1080/09638237.2023.2245887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Self-harm behaviors (performed with either lethal and non-lethal intentions) are common, especially among individuals suffering from mood disorders, and the reasons individuals self-harm vary both by person and by the type of behavior. Understanding these variations may help clinicians determine levels of risk more accurately. AIMS To understand whether culture and gender are associated with the likelihood of engaging in specific self-harm behaviors and whether the intention (lethal, ambivalent, non-lethal) of these behaviors vary with culture and gender. METHODS 2826 individuals took part in an international multilingual online depression/suicidality screening study and reported at least one instance of self-harm in the past year. Participants were grouped into six broad cultural categories (Latin America, South Asia, Russian, Western English, Chinese, Arab). RESULTS 3-way (culture x gender x intent) interactions were observed for several self-harm behaviors (overdosing, self-burning, asphyxiating, poisoning, and jumping from heights), suggesting that individuals engage in each of these behaviors with different intentions depending on gender and culture. Cultures and genders likewise differed in the likelihood of engaging in several self-harm behaviors. CONCLUSIONS Clinicians should consider culture and gender when assessing for suicide risk, as similar self-harming behaviors may reflect different intentions depending on an individual's culture and gender.
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Affiliation(s)
- Anna S Freedland
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Kalpana Sundaram
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Nancy H Liu
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Suzanne Barakat
- Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Ricardo F Muñoz
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Yan Leykin
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
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5
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Pritchard C, Abdul Azeez EP, Mirza S. Women's health inequalities in 15 Muslim-populated countries: Evidence from population and mortality statistics. Health Care Women Int 2023:1-18. [PMID: 37450643 DOI: 10.1080/07399332.2023.2233093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/02/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
In this study, we examined health inequalities and the status of women as evidenced in the patterns of population and mortality statistics in fifteen Muslim-populated countries. Based on WHO data, female-to-male ratios were calculated to determine differential gender ratios of population and mortality, using Western gender patterns as a baseline. The socioeconomic contexts of the analysis were the percentage of women in parliaments data by OECD and the Gross National Income Per Capita PPP by the World Bank. The study results indicate that former USSR countries had fewer girls, suggesting gender selection, whilst fewer adult women in the Gulf States population indicate health inequalities. Female children's mortality was under-reported, inferring under-valuing girls. Higher female adult deaths in Egypt, Iran, and the Gulf States show greater discrimination. Women in the richest Muslim countries face more inequalities and less representation in Parliament. The implications of the study are discussed.
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Affiliation(s)
- Colin Pritchard
- Faculty of Health & Social Sciences, Bournemouth University, Poole, UK
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Saalim Mirza
- Black Country Healthcare NHS Foundation Trust, Dudley, UK
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Saied AA, Metwally AA, Ahmed SK, Omar RM, Abdulqadir SO. National suicide prevention strategy in Iraq. Asian J Psychiatr 2023; 82:103486. [PMID: 36753962 DOI: 10.1016/j.ajp.2023.103486] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Affiliation(s)
- AbdulRahman A Saied
- National Food Safety Authority (NFSA), Aswan Branch, Aswan 81511, Egypt; Ministry of Tourism and Antiquities, Aswan Office, Aswan 81511, Egypt.
| | - Asmaa A Metwally
- cDepartment of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Aswan University, Aswan 81528, Egypt
| | - Sirwan Khalid Ahmed
- Department of Pediatrics, Rania Pediatric & Maternity Teaching Hospital, Rania, Sulaimani, Kurdistan-Region 46012, Iraq
| | - Rukhsar Muhmmad Omar
- Department of Kindergarten, College of Basic Education, University of Raparin, Rania, Sulaimani, Kurdistan-Region 46012, Iraq
| | - Salar Omar Abdulqadir
- Department of Psychiatric and Mental health Nursing, College of Nursing, University of Raparin, Rania, Sulaimani, Kurdistan-Region 46012, Iraq
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7
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Younis MS, Lafta RK. Suicide and suicidality in Iraq: a systematic review. Med Confl Surviv 2023; 39:48-62. [PMID: 36721333 DOI: 10.1080/13623699.2023.2170580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Suicide is the third-leading cause of death globally, predominantly among youth. We aimed at reviewing the available published literature and some reports about suicide, in an attempt to unveil aspects of this mental health problem in Iraq. Articles about suicide in Arab/Middle Eastern countries were also included to compare those populations of a similar race and religion. The estimated suicide rate in Iraq is 1.7/100000 population (mostly among youth), which is still lower than in western countries. However, underreporting is the reason actual numbers are not known and many who attempt suicide do not report it and so hide their intent to die. The most common method of suicide is self-hanging, followed by firearms, self-burning, and self-poisoning. Suicide and suicidality in Iraq are on the increase even though it is believed to be underreported. Many socio-demographic, psychological and environmental factors predispose to ideation, attempts, and completed suicides despite the religious and social taboos. Young females are more represented in suicide attempts and ideation using potentially lethal methods like self-burning as a consequence of higher rates of depression, community and domestic violence. A key component in suicide prevention is improving the accessibility and quality of mental and social health care services.
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Affiliation(s)
| | - Riyadh K Lafta
- College of Medicine, Mustansiriyah University, Baghdad, Iraq.,Global Health, University of Washington, Seattle, WA, USA
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8
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Policastro F, Rossi A, Sulaiman HM, Taib NI. Adaptation, Validity, and Reliability of the Patient Health Questionnaire (PHQ-9) in the Kurdistan Region of Iraq. Healthcare (Basel) 2023; 11:healthcare11040598. [PMID: 36833131 PMCID: PMC9957208 DOI: 10.3390/healthcare11040598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/29/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
AIM The Patient Health Questionnaire (PHQ-9) is widely used for detecting and screening depression in Iraq. However, no psychometric assessment has been performed on any Iraqi version. This study aims at studying the reliability and validity of the Iraqi Kurdish version of the PHQ-9 as tool for identifying depression. METHODS A cross-sectional study design was used; data were collected from 872 participants (49.3% female and 51.7% male) at Primary Health Care Centers (PHCCs) in the host community as well as from Internal Displaced Persons (IDPs) and refugee camps. Sociodemographic information was obtained; PHQ-9 for the diagnosis and screening of depression and Self Reporting Questionnaire 20 items (SRQ-20) for the screening of common mental illnesses were administered. Validity and reliability analyses were performed. RESULTS In total, 19% of the participants had a PHQ-9 total score equal to or higher than the clinical cut-off of 10 for diagnosing depressive disorder. The internal consistency of the PHQ-9 was good (Cronbach's alpha coefficient was 0.89). Good concurrent validity for PHQ-9 compared with SRQ-20 (71%, p < 0.001) was found. CONCLUSIONS The PHQ-9 demonstrates good psychometric properties and proves to be a good tool for detecting and screening depression.
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Affiliation(s)
- Francesca Policastro
- Department of Medicine and Health Science, University of Trieste, 34100 Trieste, Italy
- Correspondence: ; Tel.: + 39-3288620607
| | - Alessandra Rossi
- Italian Association for Solidarity Among People (AISPO) NGO, Duhok 42001, Kurdistan Region of Iraq, Iraq
| | - Hushyar Musa Sulaiman
- Duhok Directorate General of Health, Ministry of Health, Duhok 42001, Kurdistan Region of Iraq, Iraq
| | - Nezar Ismet Taib
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, 75105 Uppsala, Sweden
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Al-Imam A, Motyka MA, Hoffmann B, Basil S, Al-Hemiary N. Suicidal Ideation in Iraqi Medical Students Based on Research Using PHQ-9 and SSI-C. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1795. [PMID: 36767164 PMCID: PMC9914454 DOI: 10.3390/ijerph20031795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Suicidal ideation is a spectrum of contemplations, wishes, and preoccupations with suicide. Its prevalence is ambiguous in Iraq, especially among the youth. We aim to survey the prevalence of suicidal ideation among Iraqi students and explore its risk factors. We surveyed Iraqi undergraduate medical students (n = 496) using two psychometric tools, the PHQ-9 and Beck's SSI-C. We also explored potential risk factors, including the students' attributes, socio-demographics, and history of mental illnesses. The current study included males (23.8%) and females (76.2%) in their early twenties (21.73 ± 0.11). Concerning PHQ-9 and SSI-C, most students had either moderate (28%) or mild depression (27.8%), while those with suicidal ideation accounted for an alarming 64.9%. The strongest association existed between the SSI-C and PHQ-9 scores (p = 0.001, OR = 4.70). Other associations existed with the personal history of mental illness (p < 0.001, OR = 2.87) and the family history of suicidality (p = 0.006, OR = 2.28). Path analysis highlighted four suicidal ideation predictors, including the PHQ-9 score (standardized estimate = 0.41, p < 0.001), personal history of mental illness (0.16, p < 0.001), previous psychiatric consultation (0.12, p = 0.002), and family history of suicidality (0.11, p = 0.005). Suicidal ideation is highly prevalent among Iraqi students. Univariable testing, multivariable analyses, and structural modeling yielded congruent results. The students' inherent rather than inherited attributes influenced the phenomenon the most, which is in harmony with Durkheim's theory on the social roots of suicide. We encourage psychiatrists and psychology counselors to be vigilant concerning these risk factors among potential suicidal ideation victims.
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Affiliation(s)
- Ahmed Al-Imam
- Department of Computer Science and Statistics, Doctoral School, Poznan University of Medical Sciences, Rokietnicka 7 St. (1st Floor), 61-806 Poznan, Poland
- Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| | - Marek A. Motyka
- Institute of Sociological Sciences, University of Rzeszow, 35-959 Rzeszów, Poland
| | - Beata Hoffmann
- Institute of Applied Social Sciences, University of Warsaw, 00-927 Warsaw, Poland
| | - Safwa Basil
- Department of Psychiatry, Baghdad Medical City, Baghdad 10047, Iraq
| | - Nesif Al-Hemiary
- Department of Psychiatry, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
- Psychiatry Council, The Iraqi Board for Medical Specializations, Baghdad 10047, Iraq
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Prevalence and Associated Factors of Suicidal Ideation among Almeda Textile Factory Workers in Adwa, Tigray, Ethiopia: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9459186. [PMID: 36588536 PMCID: PMC9800075 DOI: 10.1155/2022/9459186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/10/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
Background Suicidal ideation among textile factory workers is a major public health concern worldwide and is associated with a higher risk of completed suicide. However, there are limited studies that determined the prevalence and the potential determinants of suicidal ideation in Africa, including Ethiopia. Therefore, this study is aimed at exploring the prevalence of suicidal ideation and associated factors among textile factory workers in Almeda textile factory in Adwa, Ethiopia. Methods An institutional-based cross-sectional study design was conducted from May 3, 2020, to June 16, 2020, at Almeda textile factory in Adwa. A total of 409 workers were identified using a systematic random sampling technique. Data were collected using a self-administered questionnaire using suicidality module of Composite International Diagnostic Interview. Data were analyzed using SPSS version 22.0, and logistic regression model was employed. Adjusted odds ratio with a 95% confidence interval was computed, and statistical significance was declared at p value < 0.05. Result In this study, the prevalence of suicidal ideation was found to be 8.8% (95% CI: 6.1, 11.5). Working more than 48 hours per week (AOR = 2.88, 95% CI: 1.18, 7.04), depression (AOR = 3.90, 95% CI: 1.60, 9.50), work-related physical injury (AOR = 5.95, 95% CI: 2.37, 14.94), and interpersonal conflict (AOR = 3.54, 95% CI: 1.40, 8.90) were the significant factors associated with suicidal ideation. Conclusion and Recommendation. In this study, suicidal ideation among Almeda textile production workers was a significant problem. Factors including depression, work-related exposure to physical injury, long working hour, and interpersonal conflict can enlarge suicidal ideation.
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El Hayek S, Cherro M, El Harake N, Ghossoub E. Self-immolation in the Arab world: A systematic review. Burns 2022; 49:757-769. [PMID: 37129972 DOI: 10.1016/j.burns.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022]
Abstract
Self-immolation is the act of setting fire to oneself. Recent spikes in self-immolation events have been noticed in the Arab world, specifically in the aftermath of the Arab Spring in 2011. We aimed to examine the literature assessing the characteristics and patterns of suicide by self-immolation in the Arab world. We registered our systematic review in Prospero. We searched PubMed, Medline, PsycInfo, Embase, and Scopus databases from inception until 9 July 2022, along with other sources, following the PRISMA 2020 guidelines. We collected relevant articles tackling suicide by self-immolation in the Arab world via title and abstract screening followed by full-text screening. We then conducted a narrative synthesis of the results. Out of 326 records from databases and 17 additional records identified through other sources, 31 articles (27 quantitative and 4 qualitative) were included. The studies came from Iraq (n = 16), Tunisia (n = 6), Kingdom of Saudi Arabia (n = 3), Jordan (n = 2), Libya (n = 2), Bahrain (n = 1), and Egypt (n = 1). The quantitative studies had a sample size ranging from 22 to 600 self-inflicted burn victims. Studies showed that self-immolators were mostly married women with low educational level and low socioeconomic status. Self-immolation was more likely to happen at home, usually following marital conflicts. Kerosene was the accelerant used the most. Depression was the most comorbid mental health diagnosis. Studies highlighted that self-immolation was being increasignly used as a form of protest. Self-immolation is not uncommon in the Arab world. Specific interventions directed at the population at risk are warranted.
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Affiliation(s)
- Samer El Hayek
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michele Cherro
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadia El Harake
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elias Ghossoub
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon.
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Quality of Media Reporting of Suicide in Nepal. PSYCHIATRY JOURNAL 2022; 2022:5708092. [PMID: 35845252 PMCID: PMC9282984 DOI: 10.1155/2022/5708092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022]
Abstract
Objectives. Suicide is a major public health concern. Sensible media reporting of suicide is one of the important prevention strategies. There has been no report assessing the quality of media reporting of suicide in Nepal. We aimed to assess the quality of newspaper reporting of suicide in Nepal against the World Health Organization (WHO) reporting guidelines. Methods. We undertook a content analysis study of articles from the online archives on reporting of suicide deaths in six English language (daily or weekly) newspapers published in Nepal over the two-year duration from a period between January 1, 2019, and December 31, 2020. Also, we compared them with the World Health Organization (WHO) guidelines. Results. A total of 165 English newspaper articles reporting on suicide were analyzed. 163 (98.8%) of news were published in the main section of the newspaper, and the mean length was 17.6 sentences. The name and age of the person who died of suicide were mentioned in about 69.1% (
) and 53.3% (
) articles, respectively. The most common method of suicide reported in the news articles was hanging (45.5%,
), followed by poisoning (11.5%,
). About 97.6% (
) of news articles violated the recommendation provided in the WHO guidelines. Conclusions. The adherence to the WHO guidelines for media reporting of suicide in Nepal was found to be poor, with a large majority of news reports having at least one potentially harmful media characteristic. Only a small minority of news reports included potentially helpful information to prevent suicide.
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Arafat SMY, Ahmad AR, Saeed AK, Menon V, Shoib S, Kar SK. Quality of media reporting of suicide in Iraq. Int J Soc Psychiatry 2022; 68:443-448. [PMID: 33736514 DOI: 10.1177/00207640211003928] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mass media has an important role in influencing the suicidal behavior of the general population. However, the quality of news reporting of suicide has not been assessed in Iraq. AIM We aimed to assess the quality of news reports in Iraq while reporting the suicidal behaviors. METHODS The search was done on Google in November and December 2020 with the search term 'suicide news in Iraq' and accessible news reports distributed in Kurdish, Arabic, and English languages were taken out. We scrutinized the news reports to identify the reporting characteristics and compared them with the World Health Organization (WHO) guidelines. RESULTS A total of 130 news reports were analyzed; among them 23.8% were Kurdish, 63.8% were Arabic, and 12.3% were in the English language. About 31.5% of the reports mentioned the name and 40.8% mentioned the occupation. The name of method was mentioned in 88.5%, mono-causality was found in about 34.6%, the term 'suicide' was mentioned in the headline in 94.6%, and method of suicide was mentioned in the headline of about 27.7% of the reports. Only 5.4% of the reports traced mental illness, 6.9% mentioned expert opinion, and none of the reports mentioned prevention program, and educative information. CONCLUSION The study revealed that news reports of suicidal behavior in Iraq are poorly adherent to the WHO reporting guidelines. Further studies are warranted to identify the responsible factors and culture-specific prevention strategies.
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Affiliation(s)
- S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh
| | - Araz Ramazan Ahmad
- Department of Administration, College of Humanities, University of Raparin, Ranya, Iraq.,Department of International Relations & Diplomacy, Faculty of Administrative Sciences and Economics, Tishk International University, Erbil, Iraq
| | | | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Rainawari, Srinagar, Jammu and Kashmir, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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14
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Hashim HT, Ramadhan MA, El Rassoul AEA. Medico - legal cases admitted to the department of forensic medicine in Dhi Qar governorate in 2018. Med Confl Surviv 2021; 37:260-266. [PMID: 34461781 DOI: 10.1080/13623699.2021.1971826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Mishkin K, Maqsood SS, Ahmed HM. Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq. Matern Child Health J 2021; 25:1043-1049. [PMID: 33905065 DOI: 10.1007/s10995-021-03142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Maternal depression, which includes depression in the prenatal and postpartum periods, is estimated to affect between 10 and 20% of women globally but the rate is higher in the Middle East. Research focused on maternal depression in Iraq is limited to one study focused on postpartum depression. This paper identifies the prevalence and factors associated with antenatal depression among pregnant Iraqi women. METHODS Women seeking maternal health services at primary health centers were invited to participate. Data were collected by trained midwifery students in Erbil, Iraq. Responses to the PHQ-2 PRIME-MD depression questions were used to identify depressive symptoms. Chi-square and logistic regression analyses were used to analyze findings. RESULTS Of the 179 participants, 86 (48%) reported depressive symptoms. In bivariate analysis, antenatal depression was associated with gestational age (p = 0.03), first prenatal visit in the second trimester (p = 0.003), loss of appetite (p = 0.003), not having help at home (p = 0.03), and use of prenatal vitamins (p = 0.002). Gravida approached significance (p = 0.07). In adjusted analysis, women reporting loss of appetite were more likely to report depressive symptoms (OR = 3.09, 95% CI: 1.47-6.51). DISCUSSION Consistent with other research from the region, nearly half the women reported depressive symptoms. Because lack of appetite is associated with depressive symptoms, women reporting loss of appetite should be prioritized for depression screening in time-constrained settings.
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Affiliation(s)
- Kathryn Mishkin
- Department of Health Policy, Management, Behavior, University at Albany, Albany, NY, USA.
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Abstract
BACKGROUND Studies focusing on adolescent suicide in Arab countries are particularly scarce, with the few available undertaken from within an epidemiological paradigm. OBJECTIVE This study aimed to understand Jordanian adolescents' perceptions, beliefs, and attitudes toward suicide. METHODS A qualitative design using 12 dual-moderator focus group discussions was conducted in public schools. Participants were selected from the three main regions of the country (rural southern, urban central, and suburban northern). Participants included Jordanian adolescent boys and girls, aged 14-17 years, who reported experiencing mild to moderate depressive symptoms. A relational content analysis approach was used for coding data, and a content analysis was used to identify salient thematic categories. Data were analyzed using NVivo software. RESULTS Four themes emerged, including perceived risk factors, perceived protective factors, active and passive suicidal ideations, and e-games and Internet influences. Main risk factors were depression; anxiety; stigma, shame, and isolation; family issues; life pressures; and guilt. Conversely, religiosity, perceived positive family functioning, and availability of long-term goals seemed to confer resilience to adolescents' suicidal ideation and behavior. Passive suicidality (having death wishes without any plans to complete suicide) was noticed most among participants who feared jeopardizing the family's reputation if they committed suicide. Several boys with active suicidal ideations used the Blue Whale Challenge e-game to learn how to complete suicide and relinquish their problems. DISCUSSION Suicide is a multifactorial problem requiring multimodal strategies. Evidence from this research suggests that those most passionate about the outcome of interest are encouraged to redouble efforts to reduce modifiable risk factors, enrich protective factors, target the underlying psychiatric illness that informs suicidal ideations and behavior, and research the effect of social media and Internet activity more deeply. Parents are advised to monitor the online activities of their children and familiarize themselves with the digital applications they use.
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Al-Amin H, Singh R, Abdulrazzak M, Ghuloum S. Psychosocial and Clinical Profiles of the Cases Visiting the Emergency Department Due to Accidental Self-harm and Suicide Attempts in Doha, Qatar: A Retrospective Study. Community Ment Health J 2021; 57:315-324. [PMID: 32506256 PMCID: PMC7835152 DOI: 10.1007/s10597-020-00650-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 05/27/2020] [Indexed: 11/24/2022]
Abstract
The aims of this study were to retrospectively assess the profiles of subjects with suicide attempts and self-harm in Doha, Qatar; and whether the available data were complete. We reviewed all the records of fatal and non-fatal suicides together with accidental self-ham cases seen in the major Emergency Department in Doha, over a one-year period. There was 37 completed suicide, mostly male expatriates in mid 30 s who died by hanging. In cases with suicide intent (N = 270), more males were admitted to Psychiatry than women. Overdose was the common method and the majority had mood disorders. In self-harm cases with no suicide intent (N = 150) the majority were not seen by Psychiatry. The profiles of suicide cases in Qatar are similar to those reported internationally. However, there is a major need to establish a comprehensive system to register and assess all self-harm patients in Qatar.
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Affiliation(s)
- Hassen Al-Amin
- Department of Psychiatry, Weill Cornell Medicine, Doha, Qatar
| | - Rajvir Singh
- Department of Cardiology, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Abdulrazzak
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Suhaila Ghuloum
- Department of Psychiatry, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar. .,Weill Cornel Medicine-Qatar, Doha, Qatar.
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Pritchard C, Iqbal W, Dray R. Undetermined and accidental mortality rates as possible sources of underreported suicides: population-based study comparing Islamic countries and traditionally religious Western countries. BJPsych Open 2020; 6:e56. [PMID: 32482190 PMCID: PMC7345585 DOI: 10.1192/bjo.2020.38] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Four Western countries (Greece, Ireland, Italy and Portugal) with strong Orthodox and Catholic traditions have been associated with the underreporting of death by suicide, and underreported suicides are sometimes found among deaths recorded as 'undetermined' or 'accidental'. AIMS This population-based study tests whether there are any significant difference in patterns of suicides, undetermined deaths and accidental deaths between these four Western countries and 21 predominately Islamic countries. METHOD World Health Organization age-standardised death rates per million population were used to compare suicide rates with combined undetermined death and accidental death (UnD+AccD) rates, from which odds ratios were calculated. Substantial odds ratios (OR > 2.0) were taken as indicative of likely underreporting of suicides. The Islamic countries come from four different historico-cultural regions, described as: less-traditional Islamic countries; former USSR countries; Gulf Arab states; and Middle Eastern and North African countries. χ2-tests were used to determine any significant differences between the Western comparator countries and the Islamic regions. RESULTS For the Western comparator countries, the average suicide rate was 66 per million population, the average undetermined death rate 56 per million and the average accidental death rate 58 per million, yielding a suicide:UnD+AccD odds ratio (OR) of 1.73. The average values for the other three groups were as follows. Less-traditional Islamic countries: suicide rate, 31 per million; UnD+AccD rate, 101 per million; suicide:UnD+AccD OR = 3.3. Former USSR countries: suicide rate, 61 per million; UnD+AccD rate, 221 per million; suicide:UnD+AccD OR = 3.6. Gulf Arab states: suicide rate, 10 per million; UnD+AccD rate, 76 per million; suicide:UnD+AccD OR = 8.6. Middle Eastern and North African countries: suicide rate, 6 per million; UnD+AccD rate, 151 per million; suicide:UnD+AccD OR = 25.2. The patterns of these mortalities in the Islamic countries was significantly different from Western comparator countries. CONCLUSIONS The results indicate underreporting of suicides in Islamic countries. This might inadvertently lead to reduced access to mental health preventive services in both Western and Islamic countries.
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Affiliation(s)
- Colin Pritchard
- Faculty of Health and Social Sciences, Royal London House, Bournemouth University, UK
| | - Wajid Iqbal
- Royal South Hants Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rosslyn Dray
- Faculty of Health and Social Sciences, Royal London House, Bournemouth University, UK
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Rezaeian M, Khan MM. Suicide Prevention in the Eastern Mediterranean Region. CRISIS 2020; 41:S72-S79. [DOI: 10.1027/0227-5910/a000669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract. The WHO Eastern Mediterranean Region (EMR) consists of 22 countries including Afghanistan, Bahrain, Djibouti, Egypt, Iraq, Islamic Republic of Iran, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates (UAE), and Yemen. According to Global Burden of Disease (GBD) data, death from self-harm has increased by 100% between 1990 and 2015 in this region. Although this increase is substantial, it appears trivial in comparison to the 1027% increase in deaths due to war and legal interventions. This might partly explain why suicide prevention does not have a high priority in these countries and why there are currently no suicide prevention strategies in place. Despite the above, some important activities in the area of suicide prevention have been carried out in the region. And while peace and stability may take time to come to the region, it should not prevent suicide prevention programs from being developed and implemented.
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Affiliation(s)
- Mohsen Rezaeian
- Epidemiology and Biostatistics Department, Rafsanjan Medical School, Occupational Environmental Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Murad Moosa Khan
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
- International Association for Suicide Prevention (IASP), Washington DC, USA
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Male depressive traits in relation to violent suicides or suicide attempts: A systematic review. J Affect Disord 2020; 262:55-61. [PMID: 31707247 DOI: 10.1016/j.jad.2019.10.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/09/2019] [Accepted: 10/28/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Male sex is a consistently reported risk factor for violent suicide. It has been suggested that this association may be driven by so-called male depression - as operationalized by the Gotland Male Depression Scale (GMDS). The aim of this systematic review was to investigate if males dying by or attempting suicide with violent methods, display symptoms compatible with male depression. METHODS This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search of PubMed, Embase and PsycINFO was performed using search terms covering: male sex, violent suicide/suicide attempt, and symptoms of male depression from the GMDS. Subsequently, a qualitative synthesis of studies meeting predefined inclusion criteria was carried out. RESULTS A total of 28 studies reporting on 91,933 violent suicides and 113 violent suicide attempts were included in the qualitative synthesis. The suicide/suicide attempt methods reported in these studies were predominantly shooting, hanging or drowning. The only two symptoms from the GMDS that was reported in relation to violent suicides/suicide attempts was overconsumption of alcohol or drugs and suicide attempts in the biological family. No studies had systematically assessed suicide victims or attempters for symptoms of male depression. LIMITATIONS Publication-, selection-, and information biases may have affected this review. CONCLUSIONS Symptoms of male depression are rarely reported in relation to violent suicides/suicide attempts. The most likely explanation for this finding is that there has been little focus on this potential association. Future studies should address this void.
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Knipe D, Williams AJ, Hannam-Swain S, Upton S, Brown K, Bandara P, Chang SS, Kapur N. Psychiatric morbidity and suicidal behaviour in low- and middle-income countries: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002905. [PMID: 31597983 PMCID: PMC6785653 DOI: 10.1371/journal.pmed.1002905] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/23/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psychiatric disorders are reported to be present in 80% to 90% of suicide deaths in high-income countries (HIC), but this association is less clear in low- and middle-income countries (LMIC). There has been no previous systematic review of this issue in LMIC. The current study aims to estimate the prevalence of psychiatric morbidity in individuals with suicidal behaviour in LMIC. METHODS AND FINDINGS PubMed, PsycINFO, and EMBASE searches were conducted to identify quantitative research papers (any language) between 1990 and 2018 from LMIC that reported on the prevalence of psychiatric morbidity in suicidal behaviour. We used meta-analytic techniques to generate pooled estimates for any psychiatric disorder and specific diagnosis based on International classification of disease (ICD-10) criteria. A total of 112 studies (154 papers) from 26 LMIC (India: 25%, China: 15%, and other LMIC: 60%) were identified, including 18 non-English articles. They included 30,030 individuals with nonfatal suicidal behaviour and 4,996 individuals who had died by suicide. Of the 15 studies (5 LMIC) that scored highly on our quality assessment, prevalence estimates for psychiatric disorders ranged between 30% and 80% in suicide deaths and between 3% and 86% in those who engaged in nonfatal suicidal behaviour. There was substantial heterogeneity between study estimates. Fifty-eight percent (95% CI 46%-71%) of those who died by suicide and 45% (95% CI 30%-61%) of those who engaged in nonfatal suicidal behaviour had a psychiatric disorder. The most prevalent disorder in both fatal and nonfatal suicidal behaviour was mood disorder (25% and 21%, respectively). Schizophrenia and related disorders were identified in 8% (4%-12%) of those who died by suicide and 7% (3%-11%) of those who engaged in nonfatal suicidal behaviour. In nonfatal suicidal behaviour, anxiety disorders, and substance misuse were identified in 19% (1%-36%) and 11% (7%-16%) of individuals, respectively. This systematic review was limited by the low number of high-quality studies and restricting our searches to databases that mainly indexed English language journals. CONCLUSIONS Our findings suggest a possible lower prevalence of psychiatric disorders in suicidal behaviour in LMIC. We found very few high-quality studies and high levels of heterogeneity in pooled estimates of psychiatric disorder, which could reflect differing study methods or real differences. There is a clear need for more robust evidence in order for LMIC to strike the right balance between community-based and mental health focussed interventions.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - A. Jess Williams
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | | | | | | | - Piumee Bandara
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences and Department of Public Health, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Nav Kapur
- University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Eidan AJ, AL-Harmoosh RA, Al-Amarei HM. Estimation of IL-6, INFγ, and Lipid Profile in Suicidal and Nonsuicidal Adults with Major Depressive Disorder. J Interferon Cytokine Res 2019; 39:181-189. [DOI: 10.1089/jir.2018.0134] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ali J. Eidan
- Department of Basic Medical Science, Faculty of Nursing, University of Kufa, Najaf, Iraq
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Affiliation(s)
- Rajiv Tandon
- Department of Psychiatry, University of Florida, Gainesville, FL.
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