Suicide in Developing Countries (1)

Vijayakumar, Lakshmi; Nagaraj, K; Pirkis, Jane; Whiteford, Harvey

doi:10.1027/0227-5910.26.3.104

Cited by 101 publications

(39 citation statements)

References 15 publications

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“…To the best of our knowledge, this is the first trial from a low- and middle-income country demonstrating the impact of interventions for a mental disorder on suicidal behaviours, a major public health priority in these countries. 26 The apparently larger absolute effects of the intervention in the short-term are in line with other trials for the treatment of common mental disorders, …”

Section: Discussionsupporting

confidence: 79%

Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months

et al. 2011

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This paper has been corrected post-publication in deviation from print and in accordance with a correction printed in the February 2012 issue of the Journal. BackgroundDepressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare.AimsTo test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders.MethodTwenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with (NCT00446407).ResultsA total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53–0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59–0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR = 0.64, 95% CI 0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities.ConclusionsTrained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.

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Section: Discussionsupporting

confidence: 79%

Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months

et al. 2011

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“…This also corresponds well with Durkheim's theory (19). Higher education has been associated with a high risk of suicide in several other studies (29,30). …”

Section: Discussionmentioning

confidence: 74%

Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics

Sumarokov

Brenn

Kudryavtsev

et al. 2014

International Journal of Circumpolar Health

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BackgroundTo describe suicide rates in the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) in 2002–2012, as well as associated socio-demographic characteristics.Study designRetrospective population-based mortality study.MethodsData from autopsy reports were used to identify 252 cases of suicide in the NAO in 2002–2012. Data on socio-demographic characteristics of these cases were obtained from passports and medical records at local primary health care units, and were then linked to total population data from the Censuses in 2002 and 2010. Suicide rates for the indigenous Nenets population and the non-indigenous population were standardized to the European standard population. The rates were also estimated according to different socio-demographic characteristics and compared by calculating relative risks.ResultsThe crude suicide rates were 79.8 per 100,000 person-years (PYs) in the Nenets population and 49.2 per 100,000 PYs in the non-indigenous population. The corresponding standardized estimates were 72.7 per 100,000 PYs and 50.7 per 100,000 PYs. The highest suicide rates in the Nenets population were observed in the age group 20–29 years (391 per 100,000 PYs), and in females aged 30–39 years (191 per 100,000 PYs). Socio-demographic characteristics associated with high suicide rates in the Nenets population were age 20–39 years, male, urban residence, having secondary school or higher education, being an employee or employer, and being single or divorced. Males aged 20–29 years, and females aged 30–39 and aged 70 years and above had the highest suicide rates in the non-indigenous population (137.5, 21.6 and 29.9 per 100,000 PYs, respectively). The elevated suicide rates observed in the non-indigenous population were associated with male sex, rural residence, secondary school education, being an employee or employer, and being single or divorced.ConclusionsSuicide rates in the NAO were substantially higher among the indigenous Nenets population than the non-indigenous population, and were associated with different socio-demographic characteristics.

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“…[1] The actual number of suicides is understandably more than the reported official figures as non-reporting, under-reporting, and misclassification are prevalent due to various socio-cultural stigmas, religious sanctions, legal issues, and insufficient registration systems. [2] It has been suggested that the annual suicide rate could be six to nine times the official rate. [1] There has been less work in systematic profiling of risk factors in developing countries compared to the developed counterparts.…”

Section: Introductionmentioning

confidence: 99%

Profile of risk factors associated with suicide attempts: A study from Orissa, India

Kar

2010

Indian J Psychiatry

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Context:Periodic systematic profiling of suicidal risk factors in developing countries is an established need.Aims:It was intended to study the risk factors associated with suicide attempts in Orissa, one of the most economically compromised states of India.Settings and Design:Cross-sectional study in a general hospital.Materials and Methods:Consecutive 149 suicide attempters were evaluated for psychosocial, situational, and clinical risk factors using the Risk Rescue Rating scale, Suicide Prevention Center scale, Lethality of Suicide Rating scale, and Presumptive Stressful Life Event scale. They were compared with healthy and psychiatric controls who had never attempted suicide.Statistical analysis:Chi-square for comparison of categorical variables, t-tests for comparison of means.Results:The male-to-female ratio was closer to one in adults and around 1:3 in adolescents. Younger age, lower-middle economic group, rural background, unemployed, school educated were more represented in this study. Compared to the controls, significantly more number of attempters had a family history of psychiatric illness and suicide, childhood trauma, medical consultation within one month, had experienced stressful life events and had expressed suicidal ideas. In a considerable proportion of attempts, risk was high and rescuability least; 59.1% had more than 50% chance of death. Suicide potential was high in almost half the cases. More than 80% of all attempters had psychiatric disorder; however, only 31.5% had had treatment.Factors like middle age, family history of psychiatric disorders, past psychiatric history, current psychiatric illness, communication of suicidal ideas, the use of physical methods, and high potential attempts, differentiated repeaters significantly from the first-timers. Major physical illness, family and marital conflicts, financial problems, and failure in examinations were more frequent life events. Childhood trauma, noted in around 40% of the attempters, was considerably associated with adolescent suicide attempts.Conclusions:Modifiable risk factors identified in this study have preventive implications.

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Suicide in Developing Countries (1)

Abstract: Epidemiological investigations of this kind have the potential to inform suicide prevention efforts in developing countries, and should be encouraged.

Cited by 101 publications

References 15 publications

Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months

Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months

Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics

Profile of risk factors associated with suicide attempts: A study from Orissa, India

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