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Factors Related in Suicide Attempts in Admitted Poisoned Patients

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Factors Related in Suicide Attempts in Admitted Poisoned Patients Factors Related in Suicide Attempts in Admitted Poisoned Patients Bita Dadpour1 (MD); Faezeh Madani Sani2 (Medical Student); Mahboubeh Rahimi Doab3 (MSc); Ashraf Gerami4 (BSc); Parisa Rajaei5 (MSc); Mahdi Talebi6* (MD) 1. Addiction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2. Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad ,Iran. 3. Cardiac Anesthesia Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Addiction Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 5. Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 6. Department of Family Medicine, Addiction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. A R T I C L E I N F O A B S T R A C T Article type: Introduction Suicide is considered as a public health problem. Original Article Approximately 0.9% of all deaths worldwide are due to suicide. This study was performed to identify risk factors of suicide attempts among patients who Article history: admitted in a medical toxicology centre during three months. Received: 22-Apr-2015 Materials and Methods: A cross sectional study was carried out; all Accepted: 13-May-2015 admitted patients in our medical toxicology centre due to suicidal attempt who completed consent form were included from December to March 2013. A Keywords: researcher designed questionnaire was prepared and its validity and reliability Risk factor was confirmed; it was fulfilled by a psychologist via clinical interview. Data Suicide were analyzed by SPSS software 11.5 and results were discussed. Poisoning Results: 198 participants included; of whom 67.2% were female and 94.9% were less than 45 year old. Among the patients, approximately 48% of the patients were married; 27.77% were employed. More than 96% suffered from severe depression, 3.53% of the patients had psychotic symptoms. Personality disorders, previous suicidal attempt, unemployment, full stressed family, family history of suicidal attempt, moderate to severe depression and a history of dependence on antipsychotic drugs and lack of family support were identified as risk factors for suicide. Conclusion: Attention to personality trait and family environment can be mainly effective in long-term prevention of suicide, treatment of physical illness in patients with chronic health conditions, evaluation and treatment of psychiatric issues in addition to family and social problems, and organizing educational courses to families with suicide history can be helpful. Please cite this paper as: Dadpour B, Madani Sani F, Rahimi Doab M, Gerami A, Rajaei P, Talebi M. Factors Related in Suicide Attempts in Admitted Poisoned Patients. Patient Saf Qual Improv. 2015; 3(3):247-251. Introduction Suicide is considered as a public health problem. victims of suicide in the general population. For Approximately 0.9 % of all deaths are due to suicide. example, a survey was carried out on 134 people whom It is estimated that about 1,000 people per day lose their suicidal decisions and thoughts were assessed by their lives due to suicide throughout the world though it medical examiner in S.T (Louis centre). Louis centre in has been increased to 2 to 3 times at the ages of 15-24 one year. 98 % of them were quite weak physically (94 years (1). % had a psychiatric disorder). 68 % suffered from one More precisely, suicide is considered as a multi- or two psychiatric disorders. 45 % suffered of mood factorial behavior. Risk factors for suicide include: disorders and 23 % of alcoholism (alcohol abuse or Psychiatric disorders, social, psychological and alcohol dependency) (3). In term of age of the suicide biological factors and finally genetic and medical victims, there are significant differences between disorders (2, 3). Important information about the causes young and old people. Studies conducted in San Diego of suicide has been obtained by psychiatric studies on and Rochester revealed that substance abuse disorders © 2014 mums.ac.ir All rights reserved. *Corresponding Author: Mahdi Talebi, Department of Family Medicine, Addiction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Email: [email protected] Dadpour et al Suicide Attempt and antisocial personality disorder occur often among Medical Toxicology Centre (MTC) of Mashhad have a suicide victims aged less than 30 years whereas suicidal and intentional manner and MTC is the only cognitive and affective disorders were more common referral and specialized clinical toxicology centre in among suicide victims aged 30 years and more (3). east of Iran , This investigation was carried out aimed Predisposing stress factors associated with suicide in at studying on factors related to suicidal attempt. the subgroups less than 30 years include: divorce, layoffs, unemployment, legal problems; while at more Materials and Methods than 30 years of age, the most of the predisposing risk A cross sectional study was carried out on 198 cases factors has been physical diseases (1). The incidence who were admitted in MTC due to suicidal attempt and patterns of suicide varies significantly between from December to March 2013. Patients were non- Asian and Western countries as well as among different randomly selected; data collection was based on Asian countries. In Asia, the prevalence increases with obtained information through interview method. At the age; depression and alcoholism are predictors of beginning of the interview the patients were informed suicide at the western countries. about the goal of interview and privacy of names and Significant differences are seen in the rate of suicide this matter that the results will be published without among Asian countries; its sounds that geographic area mentioning any name. After stabilization in term of can have effects on suicide rates. physical and cognition statement the patients were The incidence of suicide increases with age in most interviewed by a psychologist for 20 minutes and a of Islamic countries and recent increase in the younger checklist containing demographic characteristics were age groups are observed in western countries is lower fulfilled. All proposed diagnostic issues by in Asian countries likewise in some Asian countries psychologist were re evaluated and corrected or suicidal rate in adolescents is lower than adults and the verified by a psychiatrist. Age, gender, marital, suicide problem is more remarkable in elderly educational and career statuses, number of suicidal compared with western countries (4). Suicidal rate is attempts, history of any psychiatric disorder, alcohol higher in men than women in Asian countries. Due to consumption were the items of checklist. The patients the fact that men use more lethal methods, successful who were not willing to participate in interview and suicidal rate is higher in this group. Availability of who could not participate for any reason were rough methods and tools can justify this reason. The excluded. low rate of suicide in Islamic countries can be linked to Statistical analysis software SPSS Version 11/5, and religious beliefs that prohibit alcohol consumption and Chi-square test was used to evaluate variables homicide and suicide as sins and that is why some suggested resolving manners for such these patients Results with acute stress decline impulsive actions like suicide Demographic characteristics of patients (include age, by reading Quran and invocation. In a study on social gender ,marriage state ,Job ,family environment, Past factors in Asian countries, environmental factors such medical history) and psychiatric history (depression, as unemployment, marital problems, stressful life psychosis, personality disorder, substance abuse) ,and events and living alone were associated with an suicide risk factor are respectively presented in tables increased risk of suicide. The relationship between 1,2,3 . immigration and suicide rate could be due to low economic status of this group in other countries. In a Table1: Demographic characteristics of patients who admitted in study in all immigrant groups in Sweden Asian medical toxicology centre due to suicidal attempt immigrants had higher rates of suicide than non- Demographic points Frequency Percent immigrant Asians (5). More than 45 10 5.1 Age In another study, 201 suicide victims including 41 Less than 45 188 94.9 female and 160 male who died during an episode of Male 65 32.8 Gender major depressive disorder were compared to 127 living Female 133 67.2 patients with the same disease (39 female and 88 male). Widowed or divorced 31 15.7 In this research impulsive aggression was higher in Marriage state Married 95 48 men (P < 0.05). They didn’t find any statistically Single 72 36.4 significant difference between cases and controls by Unemployed 143 72.2 Job gender in term of substance abuse, aggression and Employed 55 27.8 elevated hostility and cluster B disorders although Unstable 38 19.2 Family environment alcohol dependency was much more specific though Stable 160 80.8 less sensitive among depressed women (6). Chronic disease 17 8.6 Past medical history Approximately 90 % of patients who kill themselves Healthy 181 91.4 have a definitive psychiatric disorder include depression (60-70%), schizophrenia and substance abuse disorders and panic disorder (4). Because the most number of drug poisoning patients who admit in 248 Patient Saf Qual Improv, Vol. 3, No. 3, Sum 2015 Dadpour
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