Suicide in Rural Central India: Profile of Attempters of Deliberate Self Harm Presenting to Padhar Hospital in Madhya Pradesh

Risk Factors for Attempted Suicide and Suicide Death Among South-East Asian Women: A Scoping Review

Worldwide, attempted suicide and suicide death are one of the leading causes of morbidity and mortality. Women in South-East Asia are especially vulnerable, as almost 50% of all global female suicides occur in the 11 countries of the WHO South-East Asia Region. This scoping literature analysis aimed to identify and analyze the predictors or risk factors for attempted suicide and suicide death among South-East Asian women. A scoping literature review was conducted. Five databases-PubMed, MEDLINE, EBSCOhost, PsycINFO, and EMBASE-were searched. Forty studies and twelve literature reviews were eligible for inclusion. Women in South-East Asia, particularly those who are young and married, living in poverty, with low or no education, living in rural areas, with no employment outside the home, with lower socioeconomic position, and living within joint families are highly vulnerable to suicidality. This review identified gender disadvantage, infertility, domestic abuse, intimate partner violence, family conflicts, husband's alcohol misuse, child marriage, forced marriages, and dowry disputes as the most significant predictors of attempted suicide and suicide death among South-East Asian women. A better understanding of the phenomenon is essential to develop effective gender-specific and culturally appropriate suicide prevention strategies or interventions.

Consultation-liaison psychiatric service utilization by suicide attempters

CONTEXT

There is sparse Indian literature on consultation-liaison psychiatric (CLP) service utilization by suicide attempters who generally present first to the accident and emergency departments and are seen by the psychiatrist only after the initial stabilization.

AIMS

The aim of the study is to study the psychiatric referral, review, and psychopharmacological intervention rates among suicide attempters and to study factors associated with psychiatric referral.

SETTINGS AND DESIGN

Retrospective, medicolegal case register-based, explorative analysis of suicide attempters presents to a rural tertiary care hospital in south India.

SUBJECTS AND METHODS

Eight hundred and twenty-nine medicolegal case files of individuals whose diagnosis was recorded as either suicidal attempt, deliberate or intentional self-harm, and poisoning or hanging were analyzed for different variables.

STATISTICAL ANALYSIS USED

Descriptive frequencies, Pearson's Chi-square and logistic regression analysis to know the association of psychiatric referral with different variables, were performed using the Statistical Package for the Social Sciences, version 16.

RESULTS

A little more than half of the suspected suicide attempters (51.4%) were referred for psychiatric review, and majority of those referred (93.7%) were reviewed by the psychiatrist. Psychiatric referral was significantly associated with a relatively younger age, positive past and family history of suicidal behavior, mode of attempt (pesticide poisoning and attempted hanging were more likely to be referred), and a longer duration of hospitalization.

CONCLUSIONS

The low referral rate but an overwhelming review rate among those referred shows that probably referrer factors are responsible for this and so CLP for suicide attempters needs to be strengthened by sensitizing the referring doctors on the importance of the psychiatric referral and the need to avoid discharge within the first 24 h.