Background: Suicide is a public health problem too often neglected by researchers, health policy makers and the medical profession. In the year 2000, approximately one million people died of suicide which represents a global mortality rate of 16 per 100,000. According to WHO estimates for the year 2020 and based on current trends approximately 1.53 million people will die from suicide and 10-20 times more people will attempt suicide worldwide. This represents on average 1 death per 20 seconds and 1 attempt every 1-2 seconds. No nationwide survey on suicidal risk factors has yet been conducted in Bangladesh. Reports from police records, Media, court, hospitals and the focused study on selected population indicate that suicide is a public health problem in Bangladesh. The aim of this study was to unearth the potential risk factors of suicide or suicidal attempts and to assess psychiatric illness, non psychiatric co-morbidity, individual’s behavioral and physical factor, familial risk factors and socio-demographic risk factors of suicide and its attempts. Study Design and Setting: A case control study was carried out by members of the Department of Medicine, Shaheed Suhrawardi Medical College and Hospital at Mominpur,Haowlee and Jibonnagar unions under three Upazilla of district Chuadanga,. Statistical analyses were performed using SPSS 16. Results: A total 230 subjects (113 cases and 117 controls) were interviewed. Mean age among cases was 29.6±12.8 years and controls were 29.7±12.9 years.Majority of the participants, 65.5% of cases and 63.2% of controls were aged between 20-39 years. Among cases 38.9% were male and among the controls 42.7% were male.Among cases 30.1% and among controls 27.4% had less than 4 family members. More than half of the participants, among cases (58.4%) and among controls (55.6%) had between 4- 6 members in the family. Economic status was also similar in two groups.Problem of love affair (OR 5.2), Personal problem (OR 11.9), Feeling of economic hardship (OR 2.4) appeared to have statistically significant association with suicidal attempt. Problem with relatives (OR 3.8), death of near relative (OR 0.9) and poor academic performance (OR 1.6) didn’t appear to have any association with risk of suicidal attempt. History of chronic disease (OR 2.9) showed statistically significant association but long term physical disability (OR 4.4) and physical problems didn’t appear to have any significant association with suicidal attempt. History of suicidal attempt by any relative (OR 4.2) and previous attempt to suicide (OR 7.4) appeared as highly significant factor for suicide. Not being reared by biological parents (OR 3.2), marital disharmony (OR 4.0), Conflict within the family (OR 6.9) appeared to be strongly associated with suicidal attempts. Suicidal attempts of participants were significantly associated with sleeping disturbance (OR 2.3), uncertainty about future (7.2), impulsivity (OR 13.8), and history of criminal behavior (OR 2.1). Conclusion: Case control study on the risk factors of suicide in rural area of South-West Bangladesh revealed that the married female especially the younger age from unitary family of low income group are more vulnerable to commit suicide or parasuicide. Several emotional factors, presence of chronic diseases, familial suicidal predisposition, individual factor and mental state, premorbid persionality and psychiatric syndrome appeared to have significant association with suicidal attempts. DOI: http://dx.doi.org/10.3329/jom.v14i2.19653 J Medicine 2013, 14(2): 123-129

Most of the existing data on real-life management of bipolar disorder are from studies conducted in western countries (mostly United States and Europe). This multinational, observational cohort study aimed to describe the management and clinical outcomes of bipolar patients in real-life conditions across various intercontinental countries (Bangladesh, Egypt, Iran, Israel, Tunisia, and Ukraine). Data on socio-demographic and disease characteristics, current symptomatology, and pharmacological treatment were collected. Comparisons between groups were performed using standard statistical tests. Overall, 1180 patients were included. The median time from initial diagnosis was 80 months. Major depressive disorder was the most common initial diagnosis. Mood stabilizers and antipsychotics were the most common drugs being prescribed at the time of the study. Antidepressants (mainly selective serotonin uptake inhibitors [SSRIs]) were administered to 36.1% of patients. Patients with bipolar I disorder received higher number of antipsychotics and anxiolytics than those with bipolar II disorder (p < 0.001). Presence of depressive symptoms was associated with an increase in antidepressant use (p < 0.001). Bipolar disorder real-life management practice, irrespective of region, shows a delay in diagnosis and an overuse of antidepressants. Clinical decision-making appears to be based on a multidimensional approach related to current symptomatology and type of bipolar disorder.Bipolar disorder (BD) is a recurrent and chronic disease characterized by the occurrence of manic (or hypomanic), depressive, or mixed episodes. According to the World Health Organization, BD is one of the world's ten most disabling conditions 1 . Several studies have shown that a considerable proportion of BD patients (30-60%) in clinical remission live with significant functional impairment [2][3][4][5][6] . In the general population, the estimated lifetime prevalence of BD is approximately 0.2-5% and increases to 6% for a broad range of bipolar spectrum disorders [7][8][9][10]

This is a cross sectional-descriptive study which was conducted in one urban mahalla and two rural mauza of Dhaka district. Self reporting questionnaire (SRQ) was applied on 327 adult respondents and structured clinical interview for diagnosis (SCID-NP) was applied on every second SRQ positive and every fourth SRQ negative respondent. The prevalence of neurotic disorders, major depressive disorder and psychotic disorders was 7.0% (7/1000 population), 4.0% (40/1000 population) and 1.2% (12/1000 population) respectively. The prevalence of psychiatric disorder was found higher in female 13.9% than male 10.2% and in middle and lower socio-economic class. The study would be helpful in future community survey on mental health and in formulating national mental health program and facilitating their effective implementation.

Bangladesh Journal of Medicine, Vol 24 No 1, 2013, Page 14-19 DOI: http://dx.doi.org/10.3329/bjmed.v24i1.15030

Background: Severe mental illness like schizophrenia has far-reaching consequence for both patients and caregivers and their relatives and they also experience feeling of loss and grief. They are confronted with uncertainty and emotion of shame, guilt and anger like the patients they feel stigmatized and socially isolated. Caring for a family member with schizophrenia is an enduring stressor and causes considerable amount of burden. Objective: To assess mental health status of the caregivers of schizophrenia patients. Methodology: This descriptive cross sectional study was done among the caregivers of schizophrenia patients in outpatient and inpatient department of National Institute of Mental Health (NIMH), Dhaka, Bangladesh from September 2010 to February 2011. A semi-structured Questionnaire and General Health Questionnaire-28 (GHQ-28) were applied to the caregivers of schizophrenia patients who fulfilled the inclusion criteria. Among the respondents whose GHO-28 score were 4 or above Structured Clinical Interview for DSM-IV Axis I Non Patient (SCID-I/NP) version was applied to identify psychiatric disorders among the caregivers of schizophrenia.Results: Out of 272 respondents most of them were female (88.97%), housewife (72.42%) of 21 to 50 yrs age (80.51%). In this study 22.43% of respondents were suffering from different types of mental disorders. Among them major depressive disorder were most prevalent (11.8%). Other psychiatric disorders were found generalized anxiety disorder (4.8%), pain disorder (2.9%). Less common were panic disorder, social phobia, adjustment disorder and undifferentiated somatoform disorder (0.7% in each type).Conclusions: Significant proportions of the caregiver of schizophrenic patients were suffering from psychiatric disorders that did not get any psychiatric treatment.Journal of Current and Advance Medical Research 2015;2(1):12-17DOI:  http://dx.doi.org/10.3329/jcamr.v2i1.22581