Gender and Geographical Distribution of Editorial Board Members of Three Leading Suicide Journals

Background: Despite the recent progress of women in academia, there is an underrepresentation of female editors in academic journals. Additionally, although suicide affects more low- and middle-income countries (LMICs) than high-income countries, little is known about the geographical distribution of editors in suicidology journals. Aims: We aimed to determine the gender and geographical distribution of the editorial board members (EBMs) of leading suicide journals. Method: Data were collected between November 27 and 29, 2022. We purposively selected suicidology journals, searched the journal websites, and extracted data on the gender and affiliated country of the EBM to identify the continent and income category of the country. Results: The proportion of female EBMs was 32.37% with better representation in senior positions. Only six positions (3.47%) were occupied by four individuals affiliated with LMIC backgrounds. The highest number of EBMs was located in North America (58.38%) while one member was from Africa. Limitations: Only three purposively selected journals were scrutinized. Conclusion: This study reveals that approximately one third of the editorial positions were occupied by women and less than 4% of editors were from LMICs, where suicide represents a significant burden.

Health-related quality of life (HRQoL) and associated factors in Bangladeshi adolescents during COVID-19

Background and Aims

The COVID-19 pandemic and its accompanying countermeasures significantly disrupt the health-related quality of life (HRQoL) of adolescents. We aimed to estimate the status and associated factors related to HRQoL of adolescents during the COVID-19 pandemic from the community population of Bangladesh.

Methods

This cross-sectional study followed two-stage sampling. From eight administrative divisions of Bangladesh, 2030 adolescents were enrolled. The KIDSCREEN-10 index was used to measure the HRQoL of adolescents. In addition to this, adolescents' data on sociodemographics, mental well-being, parenting style, insomnia, food insecurity, depression, anxiety and stress, resilient coping, screen-based activity, and anthropometry were taken for finding out the factors associated with HRQoL of adolescents. The hierarchical multilinear regression was performed to assess the association.

Results

More than 47% of adolescents were found to have moderate and high HRQoL, while 4.7% of adolescents experienced low HRQoL during data collection. Higher age (B: -0.671), having more siblings (B: -0.316), food insecurity (B: ‒2.010), depression (B: ‒0.321), anxiety (B: ‒0.362), and stress (B: ‒0.150) were found to have significantly negative associations with adolescents' HRQoL during the COVID-19 pandemic. Whereas, positive parenting (B: 0.409), inconsistent parenting discipline (B: 0.266), good mental health (B: 5.662), resilient coping (B: 0.306) were found to have significant positive relationships.

Conclusions

The findings from this study indicate that over 52% of the adolescents reported a moderate and lower level of HRQoL. In light of these results, it may be beneficial to prioritize interventions targeting psychological factors such as depression, anxiety, and stress.

Electroconvulsive therapy in South Asia: Past, present, and future

The practice of electroconvulsive therapy (ECT) varies both between and within countries. We aimed to review historical and current trends in ECT practices, perceptions, and legislations in South Asia, a region with a high burden of mental illness and suicide. We searched MEDLINE (PubMed) and Google Scholar databases for relevant literature on ECT from each country. Additionally, a team of country-specific investigators performed supplemental searches and contacted key country contacts for relevant information. Relevant data were abstracted under the following headings: ECT practices, perceptions, and legislations. Knowledge gaps and research priorities were synthesized. Modified bitemporal ECT, delivered using brief pulse devices, was most commonly offered across institutions. Schizophrenia, not affective illness, was the most common indication. Electroencephalographic monitoring of seizures was rarely practiced. Thiopentone or propofol was preferred for anesthetic induction, while the favored muscle relaxant was succinylcholine. In India and Sri Lanka, perceptions about ECT were largely favorable; not so in Pakistan and Nepal. Only India and Pakistan had laws that governed any aspect of ECT practice; ECT practice guidelines were available only in India. There is a lack of research on efficacy, ECT in special populations, continuation ECT practices, and interventions to improve ECT-related perceptions. Most regional institutions offered modified brief-pulse ECT, and schizophrenia was the most common indication. Knowledge of and attitude towards ECT varied between countries. There is a need to develop a regional ECT consortium to facilitate uniform training, advocacy efforts, and the development of regional practice guidelines.

Prevalence of Suicidal Behavior Among Students in South-East Asia: A Systematic Review and Meta-Analysis

OBJECTIVES

Estimation of rates of suicidal behaviors (ideation, plan, and attempt) would help to understand the burden and prioritize prevention strategies. However, no attempt to assess suicidal behavior among students was identified in South-East Asia (SEA). We aimed to assess the prevalence of suicidal behavior (ideation, plan, and attempt) among students in SEA.

METHODS

We followed PRISMA 2020 guidelines and registered the protocol in PROSPERO (CRD42022353438). We searched in Medline, Embase, and PsycINFO and performed meta-analyses to pool the lifetime, 1-year, and point prevalence rates for suicidal ideation, plans, and attempts. We considered the duration of a month for point prevalence.

RESULTS

The search identified 40 separate populations from which 46 were included in the analyses, as some studies included samples from multiple countries. The pooled prevalence of suicidal ideation was 17.4% (confidence interval [95% CI], 12.4%-23.9%) for lifetime, 9.33% (95% CI, 7.2%-12%) for the past year, and 4.8% (95% CI, 3.6%-6.4%) for the present time. The pooled prevalence of suicide plans was 9% (95% CI, 6.2%-12.9%) for lifetime, 7.3% (95% CI, 5.1%-10.3%) for the past year, and 2.3% (95% CI, 0.8%-6.7%) for the present time. The pooled prevalence of suicide attempts was 5.2% (95% CI, 3.5%-7.8%) for lifetime and 4.5% (95% CI, 3.4%-5.8%) for the past year. Higher rates of suicide attempts in the lifetime were noted in Nepal (10%) and Bangladesh (9%), while lower rates were reported in India (4%) and Indonesia (5%).

CONCLUSIONS

Suicidal behaviors are a common phenomenon among students in the SEA region. These findings call for integrated, multisectoral efforts to prevent suicidal behaviors in this group.

Marital status and suicidal behavior in South Asia: A systematic review and meta-analysis

Background and Aims

The connection between marital status and suicidal behavior has been poorly assessed in South Asia. We aimed to see the proportion of marital status in individuals with suicidal behavior in South Asian countries.

Methods

We followed PRISMA guidelines and registered the protocol in advance (PROSPERO 2023 CRD42023399906). A systematic search was conducted in Medline, Embase, and PsycINFO. Meta-analyses were performed to pool the proportion of married individuals with suicidal behavior (total [suicide + suicide attempts], suicide, and suicide attempt) in South Asian countries. We considered suicidal behavior consist of suicide and suicide attempts (nonfatal).

Results

Our search identified 47 studies for this review from 6 countries published from 1999 to 2022 with a sample size ranging from 27 to 89,178. The proportion of married individuals was 55.4% (95% CI: 50.1-60.5) for suicidal behavior, 52.7% (95% CI: 44.5-60.7) for suicides, and 43.1 (95% CI: 32.9-53.9) for suicide attempts. The proportion of married persons among suicide attempts varied significantly across countries (p = 0.016) which was highest (61.8%; 95% CI: 57.2-66.2) in India, followed by Bangladesh (52.5%; 95% CI: 41.8%-62.9%) and Pakistan (45.1%; 95% CI: 30.9-59.9). The pooled proportions did not differ significantly in relation to the quality of the studies (p = 0.633).

Conclusion

This review identified married persons died more than others by suicide in South Asian countries while single persons attempted suicide than married. As the current study did not assess any cause-and-effect association, a cautious interpretation is warranted while considering married marital status as a risk factor.

Prevalence, correlates and common methods of non-suicidal self-injury in South Asia: a systematic review

INTRODUCTION

The dynamics of self-harm vary substantially around the world, yet it is severely under-researched outside of a small number of high-income 'Western' countries. South Asia is disproportionately impacted by suicide, yet we know less about non-suicidal self-injury (NSSI) in the region.

OBJECTIVE

To review and summarise evidence on the prevalence, correlates and common methods of NSSI in South Asia.

METHODS

We searched Medline, Embase and PsycINFO for the period 1 January 2000 to 31 August 2023, for peer-reviewed observational studies. A total of 11 studies from eight South Asian countries that reported prevalence and/or correlates of NSSI were included in this review. We assessed the quality of the studies using the Study Quality Assessment Tools for Observational Cohort and Cross-Sectional Studies. We used meta-regression to describe the sources of heterogeneity. Abstracted data were summarised using thematic synthesis.

RESULTS

For non-clinical populations, the 12-month prevalence of NSSI ranged from 3.2% to 44.8%, and the lifetime prevalence ranged from 21% to 33%. For clinical populations, the 12-month prevalence of NSSI ranged from 5% to 16.4%, while the lifetime prevalence ranged from 2% to 27%. Male sex, unemployment, financial stress, history of suicidal behaviour and depression were associated with a higher risk of NSSI. Better access to counselling services, higher self-esteem and self-knowledge were associated with a lower risk of NSSI.

CONCLUSION

The burden of NSSI in South Asia appears to be high in both clinical and non-clinical populations. Further research, especially with general population samples, is needed to build evidence on the epidemiology, context and meaning of NSSI in South Asia to inform the design of context-specific interventions.

PROSPERO REGISTRATION NUMBER

CRD42022342536.

Psychometric evaluation and validation of Urdu Social Rank Scale for women with infertility in Pakistan

Background

Infertility negatively affects nearly all aspects of women's life and is a source of demotion in the rank/status of women that they have achieved after marriage. This social rank/status demotion due to infertility may result in depression and several other psychopathologies. No extant instrument is available to measure the phenomenon of social rank in women with infertility in Pakistan.

Objective

The aim of the current study was to evaluate the psychometric properties and validate the Social Rank Scale for women experiencing infertility in Pakistan.

Methodology

This study was conducted in four phases. The data were collected from women with primary infertility who visited hospitals all over Pakistan from 2016 to 2018. Social Rank Scale for Women with Infertility (SRS-WI) comprising of two scales, the Social Comparison Scale for Women with Infertility (SCS-WI) and the Submissive Behavior Scale for Women with Infertility (SBS-WI), was developed.

Results

The factor structure of 37 items of SCS-WI and of 21 items of SBS-WI was determined through exploratory factor analysis (EFA) on a sample of 215 women with primary infertility with an age range of 20-45 years (Mage = 31.03; SD = 6.18). Principal component analysis with varimax rotation method yielded a three-factor solution for SCS-WI, and 32 items were retained for SCS-WI that accounted for 62.38% variance. For SBS-WI, a uni-factor solution was obtained, and 20 items were retained for SBS-WI, which collectively accounted for 42.01% variance. The factor structure for both scales was confirmed via confirmatory factor analysis among a sample of 210 participants with good model fit indices.

Conclusion

The study provides acceptable psychometric properties of the SRS-WI in Pakistan. Testing of psychometric properties in different groups of samples would justify the generalized use of the instrument.

Long-Term Changes in the Quality of Media Reporting of Suicide Following a Celebrity Suicide in India

Online portals of selected English and local language newspapers and television channels were searched to identify suicide news reports published one year after the celebrity suicide (ACS). These reports (n = 1952) were compared with the corresponding period of the previous year, immediately following the celebrity suicide (ICS) (n = 2486), and a three-month period before the celebrity suicide (BCS) (n = 1381) to assess longitudinal changes in quality of media reporting. There was a decline in reporting of several potentially harmful characteristics over time such as mentioning the deceased's age and gender (p < .001 for both), and location of suicide (p < .001). The quality of media reporting of suicide was significantly better at one year compared to the period immediately following celebrity suicide. This change was mainly driven by an improvement in the reporting quality of English news reports while local language reports continued to remain poorly adherent to reporting guidelines.

Filicide in Bangladesh: A case indicating the need for psychosocial support among mothers during peripartum

We report a case of filicide which is an under-researched entity in Bangladesh. A 28-year-old lady visited with complaints of irregular eating followed by self-induced vomiting, poor anger control, irregular sleep, hopelessness, and suicidal thoughts for the last year. On the third visit, she admitted that she killed her 32-day-old baby by keeping it in a refrigerator. The case raises some forensic psychiatric complexities as the patient confessed it to the psychiatrist while family members know it as an accidental aspiration. It indicates the complex nature and dire need for psychosocial support in Bangladesh.

Dysfunctional schema modes as determinants of psychiatric comorbidities: a study in a cohort of people with epilepsy

INTRODUCTION AND AIMS

Symptomatology of epilepsy and its' associated alteration in brain processes, stigma of experiencing seizures, and adverse sequelae of anti-epileptics have been demonstrated to impact behaviour and exacerbate psychopathology. This study examines the role of dysfunctional schema modes in People with Epilepsy (PWE) and their association with psychiatric symptoms.

METHODS

Semi-structured interviews were conducted with 108 PWE treated with anti-epileptics for at least one year and with no history or mental disorder or psycho-active substance use. Clinical symptoms were measured utilising the Symptom Checklist-90 (SCL-90) with schema modes measured utilising the Schema Mode Inventory (SMI).

RESULTS

Maladaptive coping and child schema modes were significantly higher in individuals from lower socio-economic status group (p < 0.01), with several maladaptive schema modes more prevalent in males. Hostility symptoms were increased in individuals from lower socio-economic classes and were more prevalent early in disease course. Several psychological symptoms including somatisation, interpersonal, obsession, depression, paranoia, hostility, phobia, anxiety, and psychoticism, were predicted by various maladaptive schema modes (p < 0.001).

CONCLUSION

This study highlights the impact of maladaptive schemas, suggesting that PWE might benefit from the introduction of appropriate psychotherapeutic interventions such as schema-focused therapy, particularly if from lower socio-economic classes or in the early stages of theirdisease course.

Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis

BACKGROUND

Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention.

AIMS

We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries.

METHOD

We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts.

RESULTS

From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean.

CONCLUSIONS

The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.

Filicide in South Asia: Demography, risk factors, psychiatric, and legal aspects

Background & Objective: Filicide is an act of killing a child up to the age of 18 years committed by his or her parent(s) or parental figure(s), including guardians and stepparents. There is absence of data and research regarding filicide in South Asia. The present study aimed to address the empirical lacuna in South Asia and to expand the literature in order to broaden the understanding of filicide. Method: The search was conducted in the databases of PubMed, PubMed Central, Scopus, and Google Scholar. The original articles, quantitative studies, case studies, and full-length articles were included for the present review. Publications in only the English language, which clarified that the child was killed by parent(s) in eight South Asian countries from 2000 to 2020 were included. Results: A total of 13 reports of filicide were found in the eight South Asian countries; 12 from India and 1 from Pakistan. The most common method of filicide was by administering poisonous substances and burning by parents, depression was responsible for 7 cases of filicide, schizophrenia was responsible for one case. Conclusion: The review identified that there is a scarcity of research on filicide in South Asia. Rigorous research and investment for the compilation of data on filicide are needed to reduce it in South Asia. This may further help in the protection of lives of children as well as for taking steps for rehabilitation of parents and society.

Suicide in Bangla Movie and Drama: A Content Analysis

We aimed to assess how suicidality has been depicted in Bangla movies and dramas. We conducted a search on YouTube by using search terms to identify movies and dramas with suicidal scripts. The search was performed between February and May 2022 resulting in 71 items consisting of 35 Bangla movies and 36 Bangla dramas. We scrutinized the contents of movies and dramas against our pre-designed instrument and we assessed their quality against World Health Organization guidelines. Among the 71 suicidal behaviors, 46.5% were suicides, 72% of the suicidal behavior was noted in young adults, 63.9% were unmarried, and 69% attempts were found in prominent characters. Hanging was found as the most prominent method (25.4%) and premarital and extramarital affairs and sexual harassment were the most prominent risk factors (60.6%). The potentially harmful characteristics were present in almost all events whereas potentially helpful contents were mentioned very minimally.

Exploring Women's Decision-Making Power and HIV/AIDS Prevention Practices in South Africa

Decisions regarding sexual and reproductive health significantly impact women's health and their protection against HIV/AIDS and other sexually transmitted infections. These decisions also impact females' ability to reach their reproductive goals. Women's autonomy is recognized to be vital to women's access to reproductive healthcare, the use of contraceptives, the capacity to avoid or receive treatment for STIs (including HIV), and other reproductive and sexual health issues. This research investigated the association between the decision-making power of South African women (of reproductive age) and their knowledge and practices regarding HIV/AIDS preventive measures. The present study used data from the South Africa Demographic and Health Survey 2016. A total of 8514 women aged 15-49 years who participated in the survey were used for this research. The mean age of the women was 30.21 years, with an SD of 9.86. Approximately 38.5% of the women decided on contraceptive use, and only 11.7% of women's partners and 49.8% of respondents were jointly involved in the decision-making process of contraceptive use. All HIV preventive measures under study were statistically significantly associated with high decision-making power; the use of a condom by the husband or partner of the women was the most significant; husbands or partners of the women with high autonomy were three times more likely to use condoms.

Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries

BACKGROUND

Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.

METHODS

We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation.

FINDINGS

We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries' COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries' income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well.

INTERPRETATION

Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue.

FUNDING

None.

Historical Highlights on Electroconvulsive Therapy Practice in Iraq: A Brief Narrative

ABSTRACT

Electroconvulsive therapy (ECT) is an established treatment option for severe psychiatric disorders. Electroconvulsive therapy practice began in Iraq in 1946, primarily to treat patients with schizophrenia. Since then, it has developed and expanded to treat mood disorders and major depression. Initially, both modified and unmodified ECT was administered to patients in Ibn Rushd and Al Rashad mental hospitals in Baghdad. The ongoing political turmoil from 3 wars, economic sanctions, and internal conflicts halted the development of mental health services across the country; ECT provision was not an exception. The practice of unmodified ECT-without general anesthesia-ceased in 2009, after the recommendations of the Royal College of Psychiatrists' Iraq Subcommittee. This closure reduced the availability and accessibility of ECT clinics nationwide because of limited access to general anesthesia. This article explores the nature of ECT services, in the context of Iraq's health care system, sociocultural norms, instability, and international codes of practice. This brief report uses the first author's work experience, few available data, and personal communication to describe the brief history of ECT practice in Iraq. This report is a baseline document for future ECT practice regulation in Iraq.

Rate and Associated Factors of Suicidal Behavior among Adolescents in Bangladesh and Indonesia: Global School-Based Student Health Survey Data Analysis

OBJECTIVE

Suicidal behavior among adolescents is a major public health problem that is understudied in South East Asian Muslim-majority countries. We aimed to investigate the rate and associated factors of suicidal behavior among adolescents in Bangladesh and Indonesia.

METHODS

The Global School-based Student Health Survey data of Bangladesh and Indonesia were used in this study. The data consist of a total of 9052 school-aged students from Bangladesh (2570, 28.4%) and Indonesia (6482, 71.6%). Suicidal behavior was assessed using three questions that measure suicidal ideation, suicidal plan, and suicidal attempts.

RESULTS

The overall rate of suicidal behavior (suicidal ideation, suicidal plan, and suicidal attempts) was 8.8%, and no significant difference between the two countries (8.9% in Bangladesh and 8.7 in Indonesia) was observed (p=0.81). Factors that independently increased the likelihood of suicidal behavior include female gender, missed class, physical fight four times or more, experienced bullying, anxiety, loneliness, rarely eating fruit, current alcohol use, and sedentary behavior (p < 0.05). Meanwhile, factors that independently decreased the likelihood of suicidal behavior include parental supervision and having close friends, either one, two, three persons, or more (p < 0.05).

CONCLUSION

The study revealed rates and risk factors of suicidal behaviors among the school-going adolescents of two Muslim-majority countries in South East Asia. Prevention strategies should be considered guided by the risk factors for school-going adolescents.

Suicide prevention in Bangladesh: The role of family

BACKGROUND

Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed.

OBJECTIVES

We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh.

METHODS

We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing suicidality and family dynamics in Bangladesh.

RESULTS

Risk factors for suicide prevailing in the family have been organized, and several strategies for coping with family risk factors, including marital discord and family conflict have been proposed for testing empirically.

CONCLUSIONS

The family has an important role to play in suicide prevention in Bangladesh. However, potential prevention strategies and their effectiveness have been untapped in the country. Studies are warranted to test the effectiveness of the proposed strategies.

Pornography—Is It Good for Sexual Health? A Systematic Review

Aim:

The topic of pornography use is controversial. It is important to understand how young people use pornography and determine whether pornography use has adverse effects on health and well-being.

Methods:

A comprehensive systematic literature search was conducted in 4 electronic databases (PubMed, Google Scholar, CINAHL plus, and Cochrane library) with appropriate MeSH terms “sexual health” and “pornography” and Boolean operators “AND” and “OR,” using SPIDER search strategy tools (sample, phenomenon of interest, design, evaluation, and research type). 11 articles were proceeded with systematic review after critical appraisal following PRISMA guidelines.

Results:

The major findings of the study imply that traditional and unimaginative activities depicted in some pornography and sexualized media are harmful because they impose restricted and circumscribed concepts of sex and sexuality. As a result, sexism, sexual objectification, neoliberal sexual consumerism, and sexual variety are reproduced and reinforced rather than promoted. FPU is linked to better levels of sexual comfort and self-acceptance and reduced levels of anxiety, shame, and guilt over sexual behavior. Pornography consumption has also been linked to increased arousal and orgasm responses, a greater interest in sex, acceptance of various sexual acts, and more sexual experimentation.

Conclusion:

Watching pornography may be a healthy phenomenon if it is occasional, not impairing the personal and social life; however, it can become pathological if watched excessively and impairs the individual’s functioning.

Assessing the Quality of Suicide Reporting in Online Newspapers in Uttar Pradesh, India, According to World Health Organization Guidelines

Background: Sensitive media reporting has an important role in suicide prevention. However, there is no research on the quality of media reporting of suicide in newspapers of Uttar Pradesh (UP), India. Aim: The present study aimed to assess the quality of newspaper reports of suicide against the World Health Organization (WHO) reporting guidelines. Method: Suicide news content of four purposively selected newspapers published between March 1, 2019 and February 29, 2020, were scrutinized. A total of 501 news reports from UP were included. Results: The most commonly reported attribute was the gender of the deceased and the method of suicide. Almost half of the newspapers reported the occupation of the deceased in the title. Mental illness was attributed as a cause of suicide among 23.75% of the news reports. Less than 2% of the news reports referred to expert opinion, research evidence, national or global statistics on suicide, suicide prevention measures, or information about suicide helpline. There was a significant difference in the quality of reporting between the vernacular newspapers and English dailies. Limitations: Only four online newspapers were analyzed retrospectively. Conclusion: The quality of media reporting of suicide in UP is found to be poor despite its negative effect on suicide.

Newspaper reporting of suicide in Nepal: Quality assessment against World Health Organization media guidelines

Background

Sensible media reporting of suicide is a population-based suicide prevention strategy. However, the quality of media reporting of suicide has not been assessed in Nepal.

Objectives

We aimed to assess the newspaper reporting status of suicide in Nepal with reference to World Health Organization (WHO) media guidelines for suicide reporting.

Method

We retrospectively searched eight major newspapers in Nepal between January 2020 and May 2021 and assessed 167 news reports against WHO suicide reporting guidelines.

Results

Potentially harmful characteristics were found to be reported in both the title and main text of the reports. About half of them mentioned sex (48.5%) and 38.3% mentioned the location of suicide in the title. Of the 167 reports, 74.3%, 95.2%, 34.7%, 92.2%, 98.8%, and 52.7% mentioned the name, sex, occupation, method of suicide, the location of suicide, and life events, respectively, in their main content. On the other hand, only 6% and 2.4% of reports mentioned linkage of suicides with mental illness and substance abuse, respectively. While lesser than 1% of reports narrated educative information regarding suicide prevention, none mentioned contact information for help-seeking for the vulnerable.

Conclusion

Newspaper reporting of suicide in Nepal poorly adheres to WHO guidelines, substantiated by the high presence of potentially harmful characteristics and negligible presence of potentially helpful characteristics.

Quality of media reporting of suicide in Iraq

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.

History of psychiatry in Nepal

The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.

Studies on Sexual Behavior During COVID-19 Pandemic: A Bibliometric Analysis

Sexual relations suffered from a drastic change because of the pandemic of the COVID-19 and its controlling measures. We performed a bibliometric review of articles conducted on sexual behavior through this COVID-19 pandemic. We performed a search in the Scopus database on August 14, 2021. The search was carried out by the mentioned search terms: “sex* act*” OR “Sex* Behav*” AND “COVID-19.” A total of 230 published articles was identified in the Scopus database, out of which 130 research works were funded and 23.91% (n = 55) articles had international collaborations. R Stephenson published the highest number of papers (n = 4) whilst SK Kar had the maximum number of citations (n = 39) and the highest number of citations per article (13). Universidade de São Paulo and the University of California were the most productive organizations whilst the USA outnumbered the other countries. Sexually Transmitted Infections (n = 13) and Elsevier (61) published the highest number of papers as a journal and publisher, respectively. It is the first bibliometric review on studies that assessed impact of the COVID-19 pandemic on human sexual activities during which identified that more than half of the articles were funded which is a promising sign for the researchers from this field and for those who are keen to work in this field.

Literacy and stigma of suicide in Bangladesh: Scales validation and status assessment among university students

BACKGROUND

Increased suicide literacy and reduced stigma toward suicide facilitate the care-seeking for suicidal behavior. However, no attempt has been identified to determine these two vital aspects in Bangladesh.

OBJECTIVES

We aimed to validate the literacy of suicide scale and stigma of suicide scale into Bangla along with the determination of the level of suicide literacy and stigma toward suicide.

METHODS

We conducted this study between April and June 2021. Data were collected from medical school and university students by Google form. We used a questionnaire consisting of four segments (i.e., sociodemographic questionnaire, a questionnaire for suicidal behavior, Bangla literacy of suicide scale [LOSS-B], and Bangla stigma of suicide scale [SOSS-B]) for data collection. We tested the psychometric properties of the scales in a sample of 529 students and examined factors associated with suicide stigma and literacy.

RESULTS

The mean age of the students was 22.61 ± 1.68 (range 18-27) years, 274 (51.8%) were males, 476 (89.9%) were graduate students, and 490 (92.6%) were unmarried. The mean score of LOSS was 4.27 ± 1.99 ranging from 0 to 10. Factor analysis revealed acceptable psychometric properties of SOSS-B. The literacy was significantly higher in females, students of medicine, having a family history of suicidal attempts, and a history of student nonfatal attempts, while stigma was significantly lower among the females and a history of past attempts.

CONCLUSIONS

This study revealed the level of literacy and stigma and culturally tested the psychometric properties of the LOSS-B and SOSS-B among university students in Bangladesh.

The Rising Scourge of Mental Illness and Infodemic: An Outcome of Social Media and COVID-19

COVID-19 was accompanied with the increasing broadcast of fake news, misinformation and excessive information via social media platforms. This phenomenon has been termed "infodemic", to describe an overwhelming amount of mostly fake, false or inaccurate information which spreads rapidly and impacts negatively on achieving a solution. It would therefore be desirable to use a cautious approach which utilizes culturally sensitive and country specific measures to deal with this occurrence. We aim to raise awareness, likewise draw the attention of global scientific community on this topic of public and mental health concern and it calls for further comments on this issue.

Psychological Autopsy Studies of Suicide in South East Asia

BACKGROUND

Psychiatric disorders have been identified as an important risk factor for suicide. However, different psychological autopsy studies have revealed different prevalences at different times and places.

OBJECTIVE

We aimed to see the distribution of psychological autopsy studies and the prevalence of mental disorders among suicides and identify major risk factors in Southeast Asian countries.

METHOD

We scrutinized psychological autopsy studies published in the World Health Organization (WHO) South-East Asia (SEA) region countries. We also searched the available bibliographies to identify the studies in the region so that all the possible articles could be included.

RESULTS

Out of the 11 countries, 14 psychological autopsy studies were identified in five SEA countries (Bangladesh [1], India [9], Indonesia [1], Nepal [1], and Sri Lanka [2]). Seven studies (50%) used a case-control study design, and eight (57.1%) were carried out in urban settings. The prevalence of psychiatric disorders in case-control studies was from 37% to 88%. Stressful life event was identified as a major risk factor in all the case-control studies.

CONCLUSION

Psychological autopsy studies have not been conducted in 6 out of 11 countries of the SEA region. The presence of pre-existing psychiatric morbidity and stressful life events were the two most common risk factors noted across settings, even though there is wide heterogeneity in samples, study design, instruments, and study settings.

Thwarted belongingness, perceived burdensomeness, and acquired capability for suicide among university students of Bangladesh: Scales validation and status assessment

BACKGROUND

Identification of prior mental events of suicide attempts has immense importance in suicide prevention. However, it has not been studied in Bangladesh as there was no available psychometrically valid instrument measuring it.

OBJECTIVES

We aimed to test the psychometric properties of the interpersonal needs questionnaire (INQ-15) and acquired capability for suicide scale-fearlessness about death (ACSS-FAD) in Bangla along with the determination of the level of thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.

MATERIALS AND METHODS

We collected data between 29 March and 14 April 2022 from 1,207 students of medical colleges and universities in Bangladesh by Google form. We assessed the psychometric properties of Bangla INQ and ACSS-FAD scales and examined factors associated with thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.

RESULTS

The mean age of the participants was 22.82 ± 1.68 (range 18-29) years, 51% were females, 84% were graduate students, and 92% were unmarried. Both of the scales revealed acceptable levels of reliability. Confirmatory factor analysis revealed a two-factor structure of Bangla INQ after dropping three items from thwarted belongingness domain (item 9, 11, and 12) and a single factor structure for Bangla ACSS-FAD after dropping three items (item 1, 4, and 6). Perceived burdensomeness was significantly higher in females, students with a history of mental illness, family history of suicide, and the history of suicidal attempts. Fearlessness about death was significantly higher among females, non-Muslim participants, and history of suicidal attempts.

CONCLUSION

The current study revealed psychometric properties of two suicide scales (INQ and ACSS-FAD) in Bangla that can be used in subsequent studies. Prevention strategies targeting to females, persons with psychiatric disorder, history of previous attempt(s) should be prioritized specially among the young age group.

Variations in newspaper reporting of suicidal behavior in the WHO-South-East Asian region

BACKGROUND

South-East Asia is a densely populated region, comprising of 11 low- and middle-income countries and contributing to 39% of global suicides. There are serious challenges to suicide prevention in the region such as lack of high-quality suicide data, underreporting and poor quality of media reporting. The current report aimed to assess the variations in newspaper reporting of suicidal behavior in the World Health Organization-South-East Asian countries.

METHODS

We analyzed the contents of nine research articles on media reporting of suicide, published from four South-East Asian countries (four from Bangladesh, three from India, one each from Indonesia and Bhutan) that used similar methods and presented results in a nearly similar fashion.

RESULTS

Personal identifying information of the deceased was very frequently mentioned in the newspaper reports across the countries. Suicide notes were reported more commonly in India (9.5-18%) than Bangladesh (4.2-7.5%) and Indonesia (9.5%). No educative material was found in any of the newspaper reports of Bangladesh and Indonesia while it was rarely reported in Bhutan and India.

CONCLUSION

Our findings from the four South-East Asian countries suggest that there are variations between the countries while presenting the news reports of suicidal behavior. These findings would help to formulate and regulate the media guidelines for the specific country.

A 47‐year‐old man passing putrid semen through saliva and sweat: A case of Dhat syndrome

Dhat syndrome is a culture‐bound syndrome in which patients believe that they pass Dhat (semen) with their urine, feces, sweat, and saliva that causes lethargy, apathy, dysphoria, and depression. Here, we report a case of a 47‐year‐old man who presented with complaints of burning sensation in the whole body, especially in the pubic region, and insomnia for the last 5 years. This case could be enlightening for clinicians in South Asia in daily clinical practice and family physicians in Western countries where immigrants from Dhat syndrome prevailing countries could present with complex cultural myths and superstitious beliefs.

Dhat syndrome is a culture‐bound syndrome in which patients believe that they pass Dhat (semen) with their urine, feces, sweat, and saliva that causes lethargy, apathy, dysphoria, and depression. Here, we report a case of a 47‐year‐old man who presented with complaints of burning sensation in the whole body, especially in the pubic region, and insomnia for the last 5 years. We consider Dhat syndrome as the patient has the belief that he has been losing his semen through his saliva, sweat, feces, and urine, which is the reason for his current illness.

Population attributable fractions of clinical and social risk factors for suicide in Bangladesh: Finding from a case-control psychological autopsy study

BACKGROUND

Our knowledge of suicide in low-income countries is limited. Understanding the importance of factors that contribute to suicide risk will allow for the appropriate allocation of limited resources. In order to prioritize suicide prevention activities in Bangladesh, we estimate the fractions of suicides attributable to key risk factors.

METHODS

Using data from matched cases (100) and controls (100) as part of a psychological autopsy study in Dhaka, we estimate the population attributable fraction for key clinical (psychiatric disorders and physical disability), and social (life events, psychical and/or sexual abuse, unemployment, and social isolation) risk factors for suicide in Bangladesh.

RESULTS

Assuming a causal relationship, life events were responsible for the largest proportion of suicide deaths (85.9%; confidence interval [CI], 79.6-90.2), followed by mental disorder (49.5%; CI, 45.3-53.4). The population attributable fraction for the risk factors was 42.9% (CI, 40.6-45) for depression, 11% (CI, 8.9-13) for sexual abuse, and 34.9% (CI, 10.1-52.9) for social isolation.

CONCLUSIONS

The study determined the population attributable fraction of risk factors for suicide in Bangladesh. Prevention strategies should be prioritized on the management of the aftermaths of adverse life events, treatment of psychiatric disorders, sexual abuse, and social isolation in the country.

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.

Suicide methods in South Asia over two decades (2001-2020)

BACKGROUND

Suicide is a global preventable public health problem. About a quarter of all suicides in the world occur in South Asia. As means restriction is an important suicide prevention strategy, gaining knowledge of the common suicide methods and their changing trends in each country and region is crucial.

AIMS

We aimed to assess the suicide methods in South Asian countries over the last two decades.

METHODS

A search was performed in PubMed, PubMed Central, Scopus, and Google Scholar with the search terms. Original articles of quantitative studies, published in the English language, from 2001 to 2020, with full-accessible text, that rank different methods of suicide in eight South Asian countries, were included.

RESULTS

A total of 68 studies were found eligible for review. The Maximum number of studies were found from India (n = 38), followed by Bangladesh (n = 12), Pakistan (n = 9), Sri Lanka (n = 6), and Nepal (n = 3). Hanging (n = 40, 55.8%) and poisoning (n = 24, 35.3%) were the two most common suicide methods reported, in that order. Hanging followed by poisoning were the commonest suicide methods in Bangladesh, India, and Pakistan while in Sri Lanka, poisoning was the preferred method to hanging. There is a decline in suicide by poisoning and an increase in suicide by hanging in Sri Lanka, Bangladesh, and India. Although hanging is still the commonest method in Pakistan, the use of firearms is growing in recent years (2011-2020).

CONCLUSIONS

There is a steady decline in the incidence of suicides by poisoning following pesticide regulations in South Asian countries. However, there is heterogeneity of study methods, probable under-reporting of suicide, and lack of robust suicide data.

Suicidal cut-throat wound during LSD intoxication

Lysergic acid diethylamide (LSD) is a potent hallucinogenic drug affecting the mood and perception of an individual. Although LSD-induced self-inflicted cut-throat wounds and self-harm injuries are extremely rarely reported behaviors, some reports are coming out in recent days that may complicate the depiction of scenarios in forensic psychiatry settings.

Quality of online news reporting of suicidal behavior in Myanmar: Adherence to the World Health Organization reporting guidelines

BACKGROUND

Media reporting of suicide has an essential role in the suicidal behavior of the general population.

AIMS

The aim of this study is to assess the quality of online news reports of suicidal behavior in Myanmar against the World Health Organization (WHO) reporting guidelines.

METHODS

We performed a content analysis of all available suicide-related news reports published in vernacular online newspapers of Myanmar.

RESULTS

A total of 285 reports were analyzed, consisting of 87.4% suicides and 12.6% nonfatal suicidal attempts. Potentially, harmful information reported in the text includes the methods of suicide (100%), the word or term in Burmese related to suicide (89.5%), the name of the person (56.5%), life event (50.5%), and photo or suicidal person (17.9%). Meanwhile, helpful information such as prevention programs and the contact information for suicide services to the readers have been infrequently reported.

CONCLUSION

The study found that the newspaper reporting of suicide in Myanmar is grossly nonadherent to the WHO media guidelines.

The invisible pain of women: sexual coercion, psychological distress and somatic symptoms

INTRODUCTION

Sexual coercion among married women is a widely concealed and a serious public health concern that may impede physical, sexual and psychological health of women.

PURPOSE

We aimed to investigate the associations between sexual coercion, psychological distress and somatic symptoms among married women.

METHODS

This cross-sectional study was carried out from September 2018 to March 2019 at the International Islamic University, Pakistan. A sample of 200 married women with equal proportion of working and home bound women was selected whilst using non-probability purposive sampling technique from the cities of Rawalpindi and Islamabad (Pakistan). Information about study variables were gathered through Sexual Coercion in Intimate Relationship Scale, Kessler Psychological Distress Scale and Somatic Symptoms Scale. Linear regression analysis, a moderation analysis and a t-test was carried out using SPSS 23.

RESULTS

Sexual coercion was positively related to psychological distress and somatic symptoms among married women (p<.001). As a predictor variable, sexual coercion explained a variance of 53% in psychological distress and 35% in somatic symptoms. Additionally, home bound married women were more prone to suffer from sexual coercion, distress of psychological nature and somatic symptoms than married working women (p<.001).

DISCUSSION

Overall, women who experience sexual coercion have poorer psychological health. Study findings support the notion that husbands may act coercively to acquire or retain an impersonal sense of control and power more on home bound women. Additionally, working status might be a reason that work will positively contribute to the mental health of working women that needs further exploring.

Neutrophil-to-lymphocyte ratio and C-reactive protein in non-fatal suicidal attempts: A cross-sectional pilot study in Bangladesh

BACKGROUND

Precise identification of risk factors for suicide has been found as fundamentally challenging for the stakeholders. In search of that, the determination of potential biological markers of suicide has been scrutinizing in recent days. However, replicative studies across the culture and time are warranted to utilize the biomarkers in decision-making while considering suicide prevention.

OBJECTIVES

We aimed to measure the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in non-fatal suicidal attempts.

METHODS

This cross-sectional study was conducted from August 2020 to May 2021. Data were collected from 26 hospitalized patients after an immediate non-fatal suicidal attempt. We collected blood samples and assessed the complete blood count, NLR, and CRP. Data were analyzed by Statistical Package for the Social Science version 24.0 and Microsoft Excel software. We performed the independent Mann-Whitney U test to determine the variations between the groups. A value <.05 was considered as the level of significance.

RESULTS

The mean age of the study population was 24.1 (±7.3), more than half of them (n = 19, 73.1%) were female. The mode of attempt was either hanging (n = 13, 50.0%) or poisoning (n = 13, 50.0%). The previous attempt was noted in 12 (46.2%) cases. The mean CRP level was 16.8 (±30.2) mg/L and the mean NLR level was 8.3 (±6.8) for the total sample. Both the CRP and NLR were significantly higher among those who attempted hanging (P = .019 and .001).

CONCLUSIONS

The current study revealed preliminary findings on CRP and NLR among non-fatal suicides in Bangladesh where both of the parameters were significantly higher in non-fatal hanging.

Emotional Bonding and Sexual Activity During COVID-19 Lockdown: A Cross-National Pilot Study

Background:

The COVID-19 pandemic and lockdown measures have affected the sexuality and emotional bonding among the couple across the world.

Objectives:

We aimed to assess the effects of the COVID-19 pandemic and lockdown on the married people’s emotional bonding and sexual relationships in 3 south Asian counties (Bangladesh, India, and Nepal).

Methods:

A cross-sectional online survey was conducted among Bangladesh, India, and Nepal residents from April 3 to April 15, 2020. The survey was designed in English. The participants were selected through convenience sampling technique, the link of the online questionnaire was shared with the participants. Only participants older than 18 years and above, married, and living with their spouses were included in the study.

Results:

A total number of 120 respondents were included finally for analysis from the participating countries (India, Nepal, and Bangladesh). The mean age of the participants was 35.42 (±5.73) years; the majority were males under the age of 40 years and had completed postgraduation as their qualification. Among the study participants, more than half (53.8%) of the women reported being sexually active during the lockdown, whereas 41% of the men reported being sexually active. Among the sexually active participants, most women (57.7%) reported that they perceived positive emotional bonding with their partners. Nevertheless, there was no significant difference observed when compared with men. There are variations in responses. However, no significant association was identified.

Conclusion:

There are a few insights from the study, that is, there was no significant difference found in almost 3 countries in emotional intimacy. There had been a trend that there is improved emotional bonding with their partners, although no significant difference was observed.