DOCSLIB.ORG

Pattern of Suicide Attempts in Southern Nepal: a Multi-Centered

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pattern of Suicide Attempts in Southern Nepal: a Multi-Centered Pattern of Suicide Attempts in Southern RESEARCH Nepal: A Multi-Centered Retrospective Study Suresh Thapaliya*1, Anoop Krishna Gupta1, Suraj Tiwari2, Mohan Belbase, Shreya Paudyal2 1Department of Psychiatry,National Medical College, Birgunj, Parsa, Nepal 2 Department of Psychiatry, Lumbini Zonal Hospital,Rupandehi, Nepal Date of Submission : Feb 17, 2018 Received in Revised Form : March 02, 2018 Date of Acceptance : March 12, 2018 Date of Publishing : July 30, 2018 ABSTRACT Most of the attempts (87%) were triggered by Background: Suicide has become a major public psycho-social factors before the attempt, mainly health issue in low income underdeveloped interpersonal conflicts. countries like Nepal. In Nepal, suicide research based on General Hospital Psychiatry Unit Conclusions: The pattern shows predominance (GHPU) settings can be informative to explore of female gender, younger age group, a role of the trend in suicidal behaviors. In this study, we mental illness, impulsivity and psychosocial aimed to study the pattern of suicide attempts factors in suicide attempts. Future research in Southern Nepal by including retrospective should focus on these aspects to develop effective suicide attempt cases registered in the three prevention strategies. GHPU centers. Keywords: Psyco-social, Suicide, Southern Methods: The study included 116 survivors Nepal, Self Poisoning of suicide attempts registered over a period of six months (Jan, 2017 to July, 2017) at three *Corresponding Author: Dr. Suresh Thapaliya, centers in Southern region of Nepal. The cases Department of Psychiatry, NMC, Birgunj, Parsa, were referred from medical emergency or other Nepal, Email: [email protected] medical departments for psychiatric evaluation. They underwent evaluation by at least one INTRODUCTION consultant psychiatrist and received appropriate Suicide has become a serious public health interventions. problem globally contributing to around 800000 deaths every year. Data show that for each adult Results: Majority of the victims were female who died of suicide, there may have been more (68%), belonging to younger age group (90%) with than 20 others attempting suicide.1 The World one third in adolescent age group and homemakers Health Organization South-East Asia region had (32%) or students (31%) by occupation. The most age standardized suicide rate of 13.27 per 100000 common method of attempt was self poisoning population in 2015, more than the global average with pesticides (78.4%) followed by medication (10.67) and higher than other WHO regions.2 overdose (8.6%) and hanging (7.8%). Most of the attempts (82.7%) were impulsive in nature. Mental Nepal is a South Asian country located between illness was diagnosed in 60 % of the cases, mainly India and China with population of 28.5 million depressive disorder, and adjustment disorder. having multi-ethnic background and majority (86%) living in rural areas. It is geographically MED PHOENIX : An Official Journal of NMC, Birgunj, Nepal, Volume (3), Issue (1), July, 2018, 41-47 41 Thapaliya et al. divided into the northern Himalayas (Himal), OBJECTIVE the central hilly region (Pahad) and the southern This study aims to explore socio-demographic plain belt (Terai) and each region is inhabited characteristics, pattern of attempts, psychiatric by communities with distinct socio-cultural diagnosis, psychosocial and personality factors background. Despite the huge burden of mental among survivors of suicide attempts presenting illness and treatment gap, delivery of mental to General Hospital Psychiatry Unit (GHPU) health service in Nepal is facing several barriers settings located in the Southern region of like low prioritization and funding for mental Nepal. health by the government, poor public awareness, high stigma and unfavorable psychosocial factors METHODOLOGY leading to restricted treatment seeking by the Study design and setting: The study had affected people, limited number of mental health a retrospective design with data collection professionals, mostly practicing in the metropolis, based on review of clinical records of suicide availability of few trained community mental attempt surviviors evaluated at the department health workers and limited treatment options. 3,4 of Psychiatry in three GHPU centres situated in the Southern belt of Nepal. Data collection Amidst growing coverage in the media, suicide was done from two private teaching hospitals has been considered as the silent or the hidden associated with medical colleges, located at epidemic.5 However, Nepal still lacks national level Kohalpur (Banke district) in Mid-Western Nepal suicide surveillance and prevention programs. and Birganj (Parsa district) in Central Nepal. This has led to confusion regarding actual rate of The third centre was a GHPU of a Governement suicide and restricted efforts for development of Zonal hospital located in Butwal (Rupandehi feasible suicide prevention strategies.6 district) of Western Nepal. Each centre had a Psychiatry department with at least one full time A scoping review of literature on self harm and practising consultant psychiatrist. suicide behavior in Nepal found that the victims were predominantly females, belonging to Eligibility criteria: The study sites were chosen younger age group with prominent role of mental purposively. illness and psychosocial stressors.7 Following inclusion criteria were used to screen the medical records of registered suicide attempt cases. In Nepal, General Hospital Psychiatry Unit 1. Identified as suicide attempt cases by medical (GHPU) settings play vital role in delivery of emergency/other departments and referred to mental health services. Individuals with suicide the department of psychiatry for evaluation st st attempts are brought to medical emergency for between 1 January, 2017 to 31 July,2017 management, stabilized by medical or surgical 2. Complete psychiatric evaluation done by at least one psychiatrist with collateral departments and referred to Psychiatry department information from the close family members for detail evaluation during admission or discharge. 3. Registered as suicide attempt/deliberate self Hence, suicide research based on GHPU settings harm after psychiatric evaluation can be informative to explore the trends in suicidal behaviors. Most of the past studies on suicide Following cases were excluded from the study. attempts in Nepal have done data collection in . Patients who were medically unstable (e.g. in a single GHPU setting, especially in teaching altered sensorium) causing difficulty in detail hospital located either in the capital, big peripheral psychiatric evaulation; cities or hilly region of the country. There is scarcity . Absence of reliable informants during of data from the Southern region of Nepal which is evaluation; inhabited by population with an entirely different . Diagnosed as accidental cases; ethnic and socio-cultural background from rest of . Death during the hospital stay due to medical Nepal. Hence, it is important to understand the complications pattern of suicide attempts in this population of Nepal to outline specific prevention strategies. 42 MED PHOENIX : An Official Journal of NMC, Birgunj, Nepal, Volume (3), Issue (1), July, 2018, 41-47 Pattern of Suicide Attempts Study procedure: The clinical registers in the Table 1 : Socio-demographic profiles of self department of Psychiatry in the three centers harm/suicide attempters in Southern Nepal Number of were retrospectively screened for registered Socio-demographic variables subjects (%) suicide attempt cases during six months period Gender st st (1 January,2017 to 31 July,2017). The data Male 37 (31.9) regarding socio-demographic characteristics of Female 79 (68.1) Age group category (years) the individuals, details of the attempts, psychiatric Early adolescence (<14) 8(6.9) diagnosis, psychosocial stressors and personality Late adolescence (14 to 19) 31(26.7) factors were extracted from the records. The Young adulthood (20-35) 64(55.2) Middle/Late adulthood (36-59) 10(8.6) individuals had undergone standard clinical Geriatric age group (>60) 3(2.6) evaluation by at lease one qualified psychiatrist Ethnicity in each centre. The evaluation included recording Upper caste hill region 36(31) Upper caste plain region 20(17.2) of the socio-demographic characteristics, detail Indigenous hill region 6(5.2) interview with the victims lasting at least one hour Indigenous plain region 35(30.2) with Psychiatric history taking and Mental Status Disadvantaged/ religious/ethnic minority 19(16.4) Marital status Examination (MSE) and collateral information Married 69(59.5) from the close family members along with Single 47(40.6) review of the available medical records. After Occupation Students 36(31.03) clinical evaulation, the inviduals were diagnosed Homemakers 37(31.9) based on ICD-10 classification of mental and Self-employed 24(20.7) behavioral disorders criteria. They were either Agriculture 6(5.2) Manual laborer 10(8.62) admitted or advised follow up in outpatient basis Unemployed/Retired 3(2.6) depending upon severity of the attempt, risk of further attempts and their psychiatric diagnosis. Details of the attempt: The details about suicide All of them received appropriate pharmacological attempts have been mentioned in Table 2. Self and psychological interventions depending upon poisoning with pesticides was the most attempt their clinical diagnosis. method (78.4%), mainly with organophosphates. Some individuals (8.6%) had attempted to RESULTS overdose
Load more

Recommended publications
  • Suicide in South Asia
    SUICIDE IN SOUTH ASIA: A SCOPING REVIEW OF PUBLISHED AND UNPUBLISHED LITERATURE FINAL REPORT OCT 15, 2013 HEALTHNET TPO i RESEARCH TEAM Mark Jordans, PhD Research and Development, HealthNet TPO, the Netherlands Center for Global Mental Health, King’s College London, UK Anne Kaufman, BA Research and Development, HealthNet TPO, the Netherlands Natassia Brenman, BA Research and Development, HealthNet TPO, the Netherlands Ramesh Adhikari, MA, MPhil Transcultural Psychosocial Organization (TPO), Nepal Nagendra Luitel, MA Transcultural Psychosocial Organization (TPO), Nepal Wietse Tol, PhD Bloomberg School of Public Health, Johns Hopkins University, USA Ivan Komproe, PhD Research and Development, HealthNet TPO, the Netherlands Faculty of Social and Behavioral Sciences, Utrecht University, the Netherlands i ACKNOWLEDGEMENTS Special thanks to the members of our Research Advisory Group, Dr. Arzu Deuba, Dr. Murad Khan, Professor Atif Rahman and Dr. Athula Sumathipala, for their support and review of the search protocol, and to our National Consultants, Dr. Hamdard Naqibullah (Afghanistan), Dr. Nafisa Huq (Bangladesh), Ms. Mona Sharma (India), Dr. Jamil Ahmed (Pakistan), and Dr. Tom Widger (Sri Lanka), for their valuable local knowledge, and for leaving no stone unturned in identifying in-country documents on suicide. We also acknowledge the comments on the search protocol and draft report received from DFID’s South Asia Research Hub and in particular from the external peer reviewers, Daniela Fuhr (London School of Hygiene and Tropical Medicine), and Joanna Teuton (NHS Scotland). We thank Inge Vollebregt (HealthNet TPO) for her support in improving the presentation of the report. This research was done with financial support from DFID’s South Asia Research Hub, for which we are thankful.
    [Show full text]
  • Suicidal Behaviour in Bangladesh: a Scoping Literature Review and a Proposed Public Health Prevention Model
    Open Journal of Social Sciences, 2017, 5, 254-282 http://www.scirp.org/journal/jss ISSN Online: 2327-5960 ISSN Print: 2327-5952 Suicidal Behaviour in Bangladesh: A Scoping Literature Review and a Proposed Public Health Prevention Model Afroze Shahnaz, Christopher Bagley*, Padam Simkhada, Sadia Kadri Public Health Institute, Liverpool John Moores University, Liverpool, UK How to cite this paper: Shahnaz, A., Bag- Abstract ley, C., Simkhada, P. and Kadri, S. (2017) Suicidal Behaviour in Bangladesh: A Scop- The objectives of this review are to explore through a scoping analysis of pub- ing Literature Review and a Proposed Pub- lished literature, the prevalence of suicidal ideation, attempts and suicide, and lic Health Prevention Model. Open Journal the correlates and presumed causes of such behaviours in Bangladesh, in or- of Social Sciences, 5, 254-282. https://doi.org/10.4236/jss.2017.57016 der to develop a model of public health research and prevention. This type of review aims to contextualise existing knowledge, set it within a practice and Received: June 2, 2017 policy context, and make recommendations for health care service delivery Accepted: July 16, 2017 and evaluation. The evidence indicates an unusual pattern of completed sui- Published: July 19, 2017 cide rates, those most at risk being younger women. The rate in adolescent Copyright © 2017 by authors and girls is exceptionally high by international standards, and appears to reflect Scientific Research Publishing Inc. poverty, the low status of women, violence directed against girls and women, This work is licensed under the Creative and forced marriages of young, teenage girls.
    [Show full text]
  • A Comparison Between the Age Patterns and Rates of Suicide in the Islamic Republic of Iran and Australia
    Report EMHJ – Vol. 26 No. 6 – 2020 A comparison between the age patterns and rates of suicide in the Islamic Republic of Iran and Australia John Snowdon,1 Seyed Mehdi Saberi2 and Ehsan Moazen-Zadeh3,4 1Sydney Medical School and Concord Hospital, Sydney, Australia (Correspondence to: John Snowdon: [email protected]). 2Legal Medicine Research Centre, Legal Medicine Organization, Tehran, Islamic Republic of Iran. 3Psychiatric Research Centre, Roozbeh Hospital and Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 4Institute of Mental Health, Department of Psychiatry, University of British Colum- bia, Vancouver, Canada. Abstract Background: When planning interventions aimed at preventing suicide, it is important to consider how socioeconomic and cultural factors may affect suicide rates. There has been variability in the accuracy of recording suicide deaths, lead- ing to varying levels of underestimation. Social, cultural and religious elements affect whether deaths resulting from suicide are reported as such and those responsible for reporting a death may avoid providing information that would suggest the death was due to suicide. Aims: The aim of this study was to document Iranian suicide patterns in 2006–2010 and 2011–2015, compare them with those in a “Western” country (Australia) and explore whether differences point to factors that affect suicide rates. Methods: Data were obtained from Iranian and Australian national statistics offices. Results: Peak Iranian male suicide rates were in young adulthood. There was a modest increase between the 2 quinquen- nials studied. Australian male rates were much higher, with age peaks in middle age and very late life. From age 30, the female rate was twice as high in Australia, graphs of the age patterns being relatively flat in both countries.
    [Show full text]
  • High Rates of Suicide and Violence in the Lives of Girls and Young Women in Bangladesh: Issues for Feminist Intervention
    social sciences $€ £ ¥ Article High Rates of Suicide and Violence in the Lives of Girls and Young Women in Bangladesh: Issues for Feminist Intervention Christopher Adam Bagley *, Afroze Shahnaz and Padam Simkhada Public Health Institute, Liverpool John Moores University, Liverpool L32ET, UK; [email protected] (A.S.); [email protected] (P.S.) * Correspondence: [email protected] or [email protected]; Tel.: +44-1625-477060 Received: 6 September 2017; Accepted: 3 November 2017; Published: 14 November 2017 Abstract: Deaths by suicide in Bangladesh have an atypical sex ratio, with higher rates in females than in males—a characteristic shared with several countries in Southern Asia. Reasons for this are explored in this paper. An examination of the social structure of Bangladesh suggests that girls and women are subjected to higher rates of sexual and physical violence compared with males, especially in rural and urban slum areas. This violence is often linked to the enforced marriage of young girls to older men. A systematic review of 24 studies on suicide and suicidal behaviors in Bangladesh has shown that suicide death rates are exceptionally high in younger women, at a rate of about 20 per 100,000, more than twice the rate in males aged less than 49. In girls aged 15 to 17, the estimated suicide rate is 14 per 100,000, 50% higher than in males. Because of problems in obtaining systematic data on deaths by suicide, these rates are likely to be underestimates. Extreme poverty and lack of education have been recorded as factors in deaths by suicide, although there are methodological problems in reaching such conclusions.
    [Show full text]
  • Perception of Suicide Among Higher Secondary Level Students
    Int.J.Adv.Microbiol.Health.Res.2018; 2(2):17-22 International Journal of Advanced Microbiology and Health Research ISSN: 2457-077X. Volume 2, Issue 2 (June 2018), PP. 17-22 Available online at www.ijamhr.com Original Research Article Perception of Suicide among Higher Secondary Level Students Nira Neupane1, Sanjay Kumar Sah2, Anupama Pradhan (Thaiba)3, Anjana Adhikari4, Sabita Shah5 Lecturer1&3, Assistant Professor2, Student4, Assistant Lecturer5 1Department of Psychiatric Nursing, Sanjeevani College of Medical Sciences, Butwal, Nepal. 2Department of Anatomy, Universal College of Medical Sciences, Bhairahawa, Nepal. 3&5Department of Obstetrics and Gynecology, Sanjeevani College of Medical Sciences, Butwal, Nepal. 44th Year B.Sc. Nursing Student, Sanjeevani College of Medical Sciences, Butwal, Nepal. Article Info ABSTRACT Background: A descriptive study entitled "Perception of Suicide among Higher Secondary Level Students" was carried out to find out the perception of suicide among 130 students of Received 15th May, 2018 New Life Higher Secondary School, Bardaghat Makar-4, Nawalparasi, Nepal. Materials Revised 18th May, 2018 and Methods: Non probability purposive sampling technique with self-administered Accepted 21st May, 2018 structured questionnaire was used to collect the data and analyzed with the help of Published online 5th June, 2018 descriptive statistics. The study findings revealed that all the respondents were between the age group of 15-19 years. Results: Out of 130 respondents, most of them (34.6%) belong to Keywords 18 years age group. Most of the respondents were female (61.5%) and majority of the Perception respondents (86.6%) followed Hindu religion. Likewise most of the respondents (66.9%) were strongly disagreed with the statement “Suicide is act of intentionally causing one’s Suicide death” whereas (1.5%) respondent neutrally to this statement.
    [Show full text]
  • Suicide and Deliberate Self-Harm Among Women in Nepal: a Scoping Review
    Suicide and deliberate Self-Harm Among Women in Nepal: A Scoping Review Sarina Pradhan Kasaju ( [email protected] ) Maastricht University School for Public Health and Primary Care: Universiteit Maastricht Care and Public Health Research Institute https://orcid.org/0000-0002-0093-5047 Johanna Krumeich Maastricht University Faculty of Health Medicine and Life Sciences: Universiteit Maastricht Faculty of Health Medicine and Life Sciences Marc Van der Putten Thammasat University Faculty of Public Health https://orcid.org/0000-0003-0591-4541 Research article Keywords: Suicide, Deliberate self-harm, Women, Asia, Nepal, Public Health Posted Date: March 17th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-321446/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/15 Abstract Background: Suicide is a growing public health problem globally. Suicide accounts for 70% of violent deaths among women in low and middle income countries. In Nepal suicide is the single leading cause of death among women of reproductive age. The aim of this scoping review is to explore and understand the various contexts related to vulnerability of Nepalese woman towards suicide and deliberate self-harm. Methods: A scoping review based on Arksey and O’Malley’s methodological framework including a combination of peer- reviewed publications and grey literature was conducted. The National Library of Medicine’s PubMed and Google Scholar search engines were used during July 2019 applying a Boolean search strategy. Results: Suicide incidence was found to be higher among younger age group and married women, with poisoning as the most common means of suicide.
    [Show full text]
  • Suicide in Asia: Opportunities and Challenges
    Epidemiologic Reviews Vol. 34, 2012 ª The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. DOI: 10.1093/epirev/mxr025 All rights reserved. For permissions, please e-mail: [email protected]. Advance Access publication: December 7, 2011 Suicide in Asia: Opportunities and Challenges Ying-Yeh Chen, Kevin Chien-Chang Wu, Saman Yousuf, and Paul S. F. Yip* * Correspondence to Dr. Paul S. F. Yip, Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China (e-mail: [email protected]). Downloaded from https://academic.oup.com/epirev/article/34/1/129/498617 by guest on 29 September 2021 Accepted for publication September 8, 2011. Asian countries account for approximately 60% of the world’s suicides, but there is a great mismatch in the region between the scale of the problem and the resources available to tackle it. Despite certain commonalities, the continent itself is culturally, economically, and socially diverse. This paper reviews current epidemiologic patterns of suicide, including suicide trends, sociodemographic factors, urban/rural living, suicide methods, sociocultural religious influences, and risk and protective factors in Asia, as well as their implications. The observed epidemiologic distributions of suicides reflect complex interplays among the traditional value/culture system, rapid economic transitions under market globalization, availability/desirability of suicide methods, and sociocultural permission/ prohibitions regarding suicides. In general, compared with Western countries, Asian countries still have a higher average suicide rate, lower male-to-female suicide gender ratio, and higher elderly-to-general-population suicide ratios. The role of mental illness in suicide is not as important as that in Western countries.
    [Show full text]
  • Validation of the Patient Health Questionnaire (PHQ-9) and Cultural Concepts of Distress in Nepal Brandon A
    Kohrt et al. BMC Psychiatry (2016) 16:58 DOI 10.1186/s12888-016-0768-y RESEARCH ARTICLE Open Access Detection of depression in low resource settings: validation of the Patient Health Questionnaire (PHQ-9) and cultural concepts of distress in Nepal Brandon A. Kohrt1,2, Nagendra P. Luitel1* , Prakash Acharya1 and Mark J. D. Jordans1,3,4 Abstract Background: Despite recognition of the burden of disease due to mood disorders in low- and middle-income countries, there is a lack of consensus on best practices for detecting depression. Self-report screening tools, such as the Patient Health Questionnaire (PHQ-9), require modification for low literacy populations and to assure cultural and clinical validity. An alternative approach is to employ idioms of distress that are locally salient, but these are not synonymous with psychiatric categories. Therefore, our objectives were to evaluate the validity of the PHQ-9, assess the added value of using idioms of distress, and develop an algorithm for depression detection in primary care. Methods: We conducted a transcultural translation of the PHQ-9 in Nepal using qualitative methods to achieve semantic, content, technical, and criterion equivalence. Researchers administered the Nepali PHQ-9 to randomly selected patients in a rural primary health care center. Trained psychosocial counselors administered a validated Nepali depression module of the Composite International Diagnostic Interview (CIDI) to validate the Nepali PHQ-9. Patients were also assessed for local idioms of distress including heart-mind problems (Nepali, manko samasya). Results: Among125primarycarepatients,17(14%)werepositiveforamajordepressiveepisodeintheprior2 weeks based on CIDI administration. With a Nepali PHQ-9 cutoff ≥ 10: sensitivity = 0.94, specificity = 0.80, positive predictive value (PPV) =0.42, negative predictive value (NPV) =0.99, positive likelihood ratio = 4.62, and negative likelihood ratio = 0.07.
    [Show full text]
  • Suicide and Self Harm in Nepal
    Asian Journal of Psychiatry 32 (2018) 20–26 Contents lists available at ScienceDirect Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp Suicide and self harm in Nepal: A scoping review T ⁎ Suresh Thapaliyaa, , Pawan Sharmab, Kapil Upadhyayac,d a National Medical College, Parsa, Nepal b Department of Psychiatry, Patan Academy of Health Sciences Kathmandu, Nepal c The Centre for Mental Health and Counselling (CMC), Nepal d Kathmandu Model Hospital, Kathmandu, Nepal ARTICLE INFO ABSTRACT Keywords: Background: Suicide and self harm behavior has become a major public health issue in recent years in Nepal. Mental Health Nepal This small south Asian country was ranked 7th by suicide rate globally by the 2014 World Health Organization Suicide report with an estimated 6,840 suicides annually, or 24.9 suicides per 100,000 people. We decided to explore the Self harm epidemiology of suicidal behaviour and self harm, modes of attempt, associated risk factors and trends in specific Asia population. Nepal Methodology: Two researchers independently reviewed 47 studies published in the US National Library of Suicide prevention Suicide research Medicine's PubMed electronic Database and Google Scholar till December 2016. Finally, twenty articles meeting Prevention strategies the objective were included. This article summarizes findings on epidemiology of suicidal behavior, associated patterns, risk factors and trend in specific population in Nepal. Results: Most of the data available till date are hospital based and either cross-sectional or retrospective. Some of the studies have relied on mortality statistics whereas few have done community based screening. Some of the key findings include higher rate among women and younger age group, a rising trend among specific groups such as marginalized, migrant workers and disaster affected population.
    [Show full text]
  • The Encyclopedia of Suicide, 2Nd Revised Edition (Facts on File
    THE ENCYCLOPEDIA OF SUICIDE Second Edition THE ENCYCLOPEDIA OF SUICIDE Second Edition Glen Evans Norman L. Farberow, Ph.D. Kennedy Associates Foreword by Alan L. Berman, Ph.D. Executive Director, American Association of Suicidology The Encyclopedia of Suicide, Second Edition Copyright © 2003 by Margaret M. Evans All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, elec- tronic or mechanical, including photocopying, recording, or by any information storage or retrieval sys- tems, without permission in writing from the publisher. For information contact: Facts On File, Inc. 132 West 31st Street New York NY 10001 Library of Congress Cataloging-in-Publication Data Evans, Glen The encyclopedia of suicide / Glen Evans, Norman L. Farberow.—2nd ed. p. cm. Includes bibliographical references and index. ISBN 0-8160-4525-9 1. Suicide—Dictionaries. 2. Suicide—United States—Dictionaries. 3. Suicide—United States—Statistics. 4. Suicide victims—Services for—United States—Directories. 5. Suicide victims—Services for— Canada—Directories. I. Farberow, Norman L. II. Title. III. Series. HV6545 .E87 2003 362.28'03—dc21 2002027166 Facts On File books are available at special discounts when purchased in bulk quantities for businesses, associations, institutions, or sales promotions. Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755. You can find Facts On File on the World Wide Web at http://www.factsonfile.com Text and cover design by Cathy Rincon Printed in the United States of America VB FOF 10 9 8 7 6 5 4 3 2 1 This book is printed on acid-free paper.
    [Show full text]
  • Wearable Digital Sensors to Identify Risks of Postpartum Depression
    JMIR RESEARCH PROTOCOLS Poudyal et al Protocol Wearable Digital Sensors to Identify Risks of Postpartum Depression and Personalize Psychological Treatment for Adolescent Mothers: Protocol for a Mixed Methods Exploratory Study in Rural Nepal Anubhuti Poudyal1*, MPH; Alastair van Heerden2,3, PhD; Ashley Hagaman4,5, MPH, PhD; Sujen Man Maharjan6, MA; Prabin Byanjankar6, MSc; Prasansa Subba7, MPhil; Brandon A Kohrt1*, MD, PhD 1Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine and Health Sciences, Washington, DC, United States 2Human and Social Development, Human Sciences Research Council, Pietermaritzburg, South Africa 3Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa 4Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States 5Center for Methods in Implementation and Prevention Science, Yale University, New Haven, CT, United States 6Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal 7United Mission to Nepal, Kathmandu, Nepal *these authors contributed equally Corresponding Author: Brandon A Kohrt, MD, PhD Division of Global Mental Health Department of Psychiatry and Behavioral Sciences George Washington School of Medicine and Health Sciences 2120 L Street, Suite 600 Washington, DC, 20037 United States Phone: 1 (202) 741 2888 Email: [email protected] Related Article: This is a corrected version. See correction statement in: https://www.researchprotocols.org/2019/10/e16837 Abstract Background: There is a high prevalence of untreated postpartum depression among adolescent mothers with the greatest gap in services in low- and middle-income countries. Recent studies have demonstrated the potential of nonspecialists to provide mental health services for postpartum depression in these low-resource settings.
    [Show full text]
  • Social Determinants of Suicidal Ideation Among Adolescents in Rural Bangladesh
    Social Determinants of Suicidal Ideation among Adolescents in Rural Bangladesh Afroza Begum Main supervisor: Gloria Macassa, Professor Co-supervisors: Joaquim Soares, Professor, AKM Fazlur Rahman, Professor, Eija Viitasara, Associate Professor, Hamid Reza Khankeh Professor Faculty of Human Sciences Thesis for Licentiate degree in Health Sciences Mid Sweden University Sundsvall, 2021-02-26 Akademisk avhandling som med tillstånd av Mittuniversitetet i Sundsvall framläggs till offentlig granskning för avläggande av filosofie licentiatexamen fredagen den 26 februari 2021, klockan 10:00 via Zoom, Mittuniversitetet, Sundsvall. Seminariet kommer att hållas på engelska. Social Determinants of Suicidal Ideation among Adolescents in Rural Bangladesh © Afroza Begum, 2021-02-26 Printed by Mid Sweden University, Sundsvall ISSN: 1652-8948 ISBN: 978-91-88947-90-1 Faculty of Human Sciences Mid Sweden University, SE-851 70 Sundsvall Phone: +46 (0)10 142 80 00 Mid Sweden University Licentiate Thesis Number 177 To my beloved parents To my beloved daughters, Tasneem and Tashfia To my beloved husband And To my beloved brother Acknowledgement I feel deeply indebted to Almighty Allah and a great many people whose inspiration and support enabled me to complete my thesis. In particular, I would like to thank my main supervisor Professor Gloria Macassa, for her invaluable guidance, encouragement, academic inspiration and generous help. From the inception of this thesis to its completion, she has contributed so much to my studies. She was always there for me whenever I needed assistance and suggestions throughout my writing. I gained not only the knowledge, but the rigorous scientific approach and spirit of dedication to the work that needed to be done.
    [Show full text]