Suicidal behaviors and suicide risk among Bangladeshi people during the COVID-19 pandemic: An online cross-sectional survey

Abstract

Background: Suicide, a major public health concern, is a leading cause of injury and death worldwide. The present study aims to assess suicidal behaviors and suicide risk among Bangladeshi people during COVID-19. Methods: A cross-sectional online survey was conducted from July 10 to July 20, 2020, involving 1,415 Bangladeshi residents ages 18 years or older. Data was collected via an anonymous online questionnaire. The Suicide Behaviors Questionnaire-Revised was used to assess suicide risk. The depression and anxiety subscales of the Depression Anxiety Stress Scale 21 were used to assess depression and anxiety. Logistic regression analyses and Pearson's correlation were performed to examine the association of variables. Results: The prevalence of suicide ideation and planning among Bangladeshi people during the COVID-19 pandemic was 19.0% and 18.5%, respectively. Having suicidal risk during the COVID-19 pandemic was reported by 33.5% participants. Suicide risk was associated higher with females, divorced or widowed marital statuses and low educational attainment (i.e., secondary or below and higher secondary/diploma). Additionally, living in high COVID-19 prevalent areas, having economic loss due to the COVID-19 pandemic, relatives or acquaintances die from COVID-19, direct contact with COVID-19 patient(s), and fear of COVID-19 infection were associated with suicide risk. Conclusions: The COVID-19 pandemic imposes significant psychological consequences on people, thus, concerned authorities should pay attention to people's mental health and focus on suicide prevention and awareness during and after the COVID-19 pandemic.

Suicide and Suicidal Behaviors in the Context of COVID-19 Pandemic in Bangladesh: A Systematic Review

“… 21 But compared to the unmarried participants, either divorced or widows or widowers were found being at 6.369 folds of suicidality risk in another study. 24 Similarly, a lower level of education was reported increasing the risk of suicidal ideation; that is, 2.694 and 1.690 times higher risk was found for the education levels of secondary or below, and higher secondary/diploma, respectively; than the graduate or higher as education level. 24 Mamun et al 21 reported that suicidal ideation risk increased in a commensurate manner with the residence of the village to district and divisional cities.…”

“… 24 Similarly, a lower level of education was reported increasing the risk of suicidal ideation; that is, 2.694 and 1.690 times higher risk was found for the education levels of secondary or below, and higher secondary/diploma, respectively; than the graduate or higher as education level. 24 Mamun et al 21 reported that suicidal ideation risk increased in a commensurate manner with the residence of the village to district and divisional cities. In contrast, another study observed that 2.34-times higher risk of suicidal ideation among the urban participants compared to rural ones.…”

“…Participants who reported having lower knowledge about COVID-19, lack of preventive COVID-19 behaviors, and a higher level of fear of COVID-19 infection were at higher suicidal ideation risk. 21 , 24 Likewise, other COVID-19 related risk factors such as living in highly COVID-19 exposure area increased 1.347-times higher suicide risk, whereas 2.295 and 1.299 times higher suicide risk was identified for the participants reporting economic loss due to the COVID-19 pandemic and experiencing relatives or acquaintances’ died from the COVID-19, respectively. 24 …”

“… Tasnim et al 2020 23 Online survey, Nonprobability sampling April to May, 2020 3331 University students; 21.4 ± 1.9 y Self-developed item: “During the COVID-19 outbreak, have you ever seriously thought about killing yourself?” Considered the COVID-19 inception time with a binary response (Yes/No) SI: 12.8% Female, higher socio-economic status, urban residence, not performing physical exercise, abnormal sleep status (more or less sleep), not satisfied with studies, cigarette smoking status, suicidal thought history, suicide attempt history, family history of suicide, depression, anxiety, and stress. Rahman et al 2021 24 Online survey, Convenience sampling 10 to 20 July, 2020 1415 General population; 25.42 ± 8.78 y 4-item Suicide Behaviors Questionnaire-Revised Considered 4 months for the assessment with standard cutoff points (eg, SR ≥7/18). SI: 19.0% SP: 18.5% SR: 33.5% Female, marital status of divorced, widows, or widowers (compared to unmarried), lower education levels, living in highly COVID-19 exposure area, economic loss due to the COVID-19 pandemic, relatives or acquaintances who died from COVID-19, fear of COVID-19 infection, depression, and anxiety Abbreviations : SB, suicidal behavior; SI, suicidal ideation; SP, suicide plane; SR, suicide risk; GP, general population; HCPs, healthcare professionals.…”

“… 23 Finally, during the month of July, 19.0% and 18.5% of the participants reported suicidal ideation and suicide plan, respectively, where 33.5% of people at high risk of suicide were also found. 24 …”