Common Mode Of Suicide Research Articles

A STUDY OF PATIENTS PRESENTING WITH SUICIDAL ATTEMPT TO A TERTIARY CARE PSYCHIATRY DEPARTMENT DURING LOCKDOWN DUE TO COVID 19 PANDEMIC

Aim: To study cases presenting with suicidal attempt to Psychiatry set up of a tertiary care hospital to assess psychopathology and impact of the Covid pandemic, in precipitating suicidal attempts. Settings: Patients admitted with suicidality during lockdown in 2021,in department of Psychiatry of our tertiary care hospital. This hospital in urban Pune has a 30 bedded Psychiatry ward and outpatient psychiatry services. Methods And Material: Medical record-based study of the admitted patients in the stipulated period of time. Results: 71%(5) cases were new onset psychiatric illness with suicidal attempt precipitated due to various psychosocial, nancial or other unique factors secondary to pandemic situation or pre-morbid personality problems or interpersonal adjustment. Most common mode of suicide was consumption of easily available poisonous substance or medicines, followed by hanging. Conclusions: Vigilant suicidal ideation assessment, individual/family counselling would be important in management. Further larger studies are needed to assess harmful mental health effects of nationwide lockdown in the pandemic situation are necessary.

Management of Rodenticide Poisoning

Rodenticide ingestion, a common mode of suicide in Tamil Nadu and other states in southern and western parts of India, can lead to hepatotoxicity and death. Most rodenticide agents contain phosphorus, a potent toxin. The only definitive management in a patient who develops rodenticide induced acute liver failure is urgent liver transplantation. A study conducted across Tamil Nadu in 2019 documented that the majority (>99%) of rodenticide hepatotoxicity patients cannot access urgent liver transplantation. The current guidelines proposed by the Tamil Nadu chapter of the Indian Society of Gastroenterology are focused on improving survival in these patients, especially by nontransplant treatments. The indications for the use of plasma exchange, an emerging treatment which improves survival in acute liver failure, are described. In resource-constrained settings, it is preferable to avoid the use of sedative drugs, in rodenticide hepatotoxicity patients, who do not have encephalopathy. These management guidelines are specifically meant for use by doctors in primary health centers and in secondary hospitals who care for patients with rodenticide ingestion and hepatotoxicity. We hope these guidelines may also help inform health care policy in Tamil Nadu state to improve survival in patients with rodenticide hepatotoxicity by cost-effective interventions.

COVID-Related suicide during the second wave of COVID-19 pandemic in India: A tip of the iceberg of mental health problems.

The coronavirus disease (COVID-19) pandemic has influenced the entire world. There has been great surge of mental health problems after the pandemic has started. The second wave has almost exhausted the Indian Health care system. There has also been cases of suicide due to COVID-19 infection. The objective of study was to highlight various factors involved in COVID-19 related suicide (CRS) during second wave of COVID-19 pandemic in India. CRS reports on the websites of 10 popular newspapers and television news channels in North India and official government websites such as the Ministry of Health and Family Welfare were searched between February 1, 2020, and May 31, 2021. We also searched the Medline and Google Scholar databases for CRS reports from India using the terms "corona", "COVID-19", "SARS CoV 2", "India", and "suicide" in various combinations. A total of 62 articles were included for the study. Most common mode of suicide was hanging and most common site was the deceased's home. Fear of infecting family members was the most common cause of CRS during second wave of the ongoing pandemic in India. Many individuals lost their lives to suicide due to COVID-19 pandemic. The media report does not provide the exact picture of community suicide. Proper physician counselling at the time of providing treatment can help in reducing few CRS.

Pattern of Suicidal Deaths in Belagavi: Retrospective Study

A retrospective study was undertaken over a period of 3 years to find out pattern of suicidal deaths inBelagavi. Autopsied at BIMS Hospital, a referral District hospital catering to the needs of public within aradius of 150 km. Out of 2200 autopsies conducted, 670 were suicidal deaths.The commonest age group of victims were 21-40 yrs. Males predominated females in the ratio of 3:1.Maximum number of victims belonged to rural area. Majority of the victims were married. Common mode ofsuicide was poisoning. Maximum victims were brought dead. Maximum numbers of victims were farmers.Depression was the commonest cause for suicide.

Socio-Demographic Profile of Suicidal Cases Autopsied at Tertiary Care Centre in Uttarakhand: A Retrospective Study

Suicide is an imperative public health problem that needs social as well as medical attention. In India,134516 people committed suicide in 2018 and also there is an increase in the number of suicide cases inUttarakhand as well. The aim was to analyse the trend of suicidal deaths autopsied at our center concerningdifferent parameters like age, gender, method of suicide, reason for suicide, to know the demographic patternand its cause. The autopsy reports and inquest papers of suicidal cases autopsied at AIIMS Rishikesh wereincluded for evaluation. Out of total 19.49% of total autopsies were of suicidal deaths. Majority of thevictims were males (76.42%) compared to females (22.76%). The average age of victims was 35 years and76.4% belonged to the age group 14 to 43 years. The risk of suicide was more prevalent in urban population.Among the total victims, 39.83% were in jobs. Regarding the reason behind suicide, family dispute wasmost common. The most common mode of suicide was hanging followed by poisoning and drowning.Organophosphates was the most repeated poison consumed in suicides by poisoning. About 75% cases werecomplete suicides and couldn’t receive medical care. Majority of the cases belonged to Rishikesh policestation. The important aspects of suicides among young generation is peer pressure which can be fromfamily, institutional, or work etc. An effective strategy needs to be devised to combat the issue.

Role of magnetic resonance imaging in diagnosing neurological complications in intermediate syndrome of organophosphate poisoning

Organophosphate poisoning (OP) is a very common mode of suicide in rural and urban areas due to the wide availability of pesticides. The identification of OP and timely referral for appropriate supportive care can be lifesaving. Injury to the central nervous system is a serious entity in acute OP. Application of modern imaging techniques like diffusion weighted imaging increases the diagnostic rate of brain injury in the early period and can provide evidence for medical treatment. We present the imaging features in the intermediate syndrome of OP.

Epidemiology of attempted suicides in emergency of Mayo Hospital in 2004

Background: Suicide is one of the ten leading causes of death in the world, it ranks 8th leading cause in America and 4th as years of lost life. It accounts for more than 400,000 deaths annually. Different countries have different incidence rate and suicidal patterns, which are in accordance to their cultural, religious and social values. Suicide, a major global public health problem, is an under-studied and under researched subject in Pakistan, a conservative Islamic and developing country, with severe, legal, social and religious sanctions against it. Basic epidemiological data including national suicide rates are neither known nor reported to the World Health Organization. Despite this there is strong suggestive evidence that suicide not only occurs regularly but there has been an increase in the incidence over the last few years. Objective: The purpose of this study was to evaluate all the cases that presented in Mayo hospital Lahore from the duration 1st January 2004-31st December 2004, of attempted suicide. We wanted to find out what area they belonged to, which age group had an increased incidence, what was the male to female ratio, What method of suicide was adopted and during which season was the incidence the greatest. Materials and methods: All people who attempted suicide (medico-legal cases) from 1st January 2004 to 31st December 2004 were included in the study. Detailed information was provided by forensic department in Mayo Hospital, about age, sex, date of attempt and area they belonged to. Results: showed a male dominance, also the age group of 21-30 years showed the greatest frequency. Greater number of cases belonged to the urban area, the most common mode of suicide was by poisoning and contrary to international studies the greatest number of attempts was during the summer season. Conclusion: The results in our study show that attempted suicidal rate has rapidly increased since 1995. In 2004 almost 4/day of attempted suicide (medico-legal) cases presented in the emergency department of Ma yo hospital compared to less than 0.4/day in 1995. Our study also shows male dominance in number of attempted suicide. It also showed that in our population 21-30years had the highest number of attempts. . Our study also shows a greater number of attempts during summer months where as in the western countries a greater number is shown during spring and winter.

Suicides and Factors Associated With Suicides-A Study in a Rural Setup of Pondicherry in South India

The aim of this study was to find out the suicide rate and possible factors associated with suicides in a rural area in Pondicherry. Information was collected regarding suicides within the last two years, using a pretested questionnaire by house to house survey in the study area which is a rural set up in the south Indian union territory of Pondicherry. We found that the annual average suicide rate in this village was 110.64/100,000 population which is very high compared to the national average. The majority of suicides were committed by married males (75%). Commonest age of suicide is 15-45 years (46.16%). The reasons found for suicide were family problems leading to stress 9(78.84%) and health problems 4(30.76%). The commonest mode of suicide was by hanging 6(46.15%) and least by burning 3(23.07%). Maximum suicide occurred in the month of November to December 4(36.36%). The findings imply the need for a holistic community based approach to tackle this complex issue of suicide.

Homeless and unclaimed persons' deaths in north India (Jan 2008–Nov 2012): A retrospective study

Homeless and unclaimed dead bodies are a social as well as legal stigma on a country's development index. In addition, homeless people are exposed to increased incidence of diseases, accidents and mortality. Lucknow city, a city situated in the heart of the great Gangetic plain in the northern region of India, is surrounded by rural towns and villages and has seen tremendous growth in the past few years; with this the problem of migrants and homelessness has also increased. This has resulted in a spectrum of problems relating to law and order, including frequent incidences of unclaimed dead bodies, both due to natural and unnatural causes. Few studies on this subject have been published in India. Observational retrospective study. Data was collected from the files of the Department of Forensic Medicine & Toxicology between 2008 and 2012. A total of 20877 autopsy cases were registered, out of which 3169 (15.17%) were unclaimed bodies. The majority of cases belonged to males (2218, 69.99%) as compared to females (951, 30.01%). Most unclaimed bodies were in the age group of 41-60 years (47.24%) and the least affected age group was 1-20 years (265, 8.36%). The most common manner of death was accident (1098, 34.64%), followed by suicide (1062, 33.51%), natural (927, 29.25%) and homicides (82, 2.59%). The most common cause of natural death in both males and females was chronic lung disease. Railway and road traffic accidents accounted for 516 (68.25%) accidental deaths in males, whereas in females they accounted for 301(88.01%). The most common mode of suicide among males was by poisoning (391, 48.81%), while poisoning (149, 57.08), hanging (78, 29.88%) and drowning (23, 8.81%) were the main modes of suicide in females reported in our study. Majority of the cases of deaths were reported during rainy season (2209, 69.70%). This autopsy-based study tries to highlight the picture of homeless deaths in Lucknow and the problems faced by the law enforcing authorities. More research is needed to identify the health-related problems of such people and possible contributory factors to mortality.

N-acetyl cysteine in aluminum phosphide poisoning: Myth or hope.

N-acetyl cysteine in aluminum phosphide poisoning: Myth or hope.

Patterns of suicide in Brunei Darussalam and comparison with neighbouring countries in South East Asia

A retrospective study of suicides in Brunei Darussalam (Brunei) over a 20 year period from 1991–2010 was conducted by analysing the post-mortem examination and external examination reports and other relevant records. The suicide rate in Brunei is very low (1.9 deaths per 100,000 per year). The majority of the victims were expatriates 82(66%) and hanging was the commonest mode of suicide both in expatriate and local population. The study showed that the suicide rate among the Bruneian Malays was the lowest (0.5 deaths per 100,000 per year) among the different nationalities. The study highlights the demographics and socio-economic background of the victims, methods used in committing suicide, suicide rates in different ethnic groups and predisposing factors. The results of this study would be of use for taking preventive measures to minimize the incidence of suicide.

Retrospective Study of Suicide Among Children and Young Adults

Introduction: The prevalence of suicide has been increasing globally in all age groups. There is dearth of literature on suicide among younger patients from developing country. The objective of this study was to find out the prevalence and cause of suicide as well as to identify the vulnerable groups of children and young adults to suicide. Materials and Methods: This is a retrospective observational study. Data was collected from the Police Head Quarters in Kathmandu and included all completed suicide cases of less than twenty one years of age from January 2005 to December 2009. Results: There were a total of 2172 documented cases of completed suicide in the age group between 4 to 21 years. The majority were female and belonged to the adolescent age group. The incidence of suicide showed an increasing trend within the five years of the study. A monthly breakdown of the cases revealed that the incidence of suicide was lowest in January and February and peaked from April to October. Hanging was the most common mode of suicide followed by poisoning and drowning. The reason for suicide could be ascertained only among 25.5 % of cases. Domestic violence (35%), mental illness (24%), failure in academic achievement (15.8%) and end of a romantic relationship (8.7%) were found to be common causes of committing suicide. Of the 87 cases found who committed suicide because of academic failure 46.6% were at a grade ten level. Conclusions: Suicide in children and young adults in Nepal appears to be a concealed but serious problem requiring immediate attention and systematic efforts. DOI: http://dx.doi.org/10.3126/jnps.v33i2.7512 J Nepal Paediatr Soc. 2013; 33(2):110-116

Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

Suicide an Emerging Public Health Problem: Evidence from Rural Haryana, India

Analysis of annual mortality data for year 2002-2009 of twenty eight villages in Ballabgarh block of rural Haryana was carried out to calculate suicide rates per 100,000 population. In addition, informal discussions were carried out amongst health providers to understand their perceptions regarding suicides. In a period of 8 years, out of total 4552 deaths, 163 (3.5%) deaths were attributed to suicides giving a suicide rate of 24.4/100,000 population (95% CI 24.1- 24.7). Mean years of productive life lost for males and females were estimated to be 44.4 (SD 1.1) years and 39.9 (SD 1.4) years respectively. Poisoning (41.1%) was the most common mode of suicide followed by hanging (36.8%) and burns (14.7%). Health workers also perceived suicide as major problem in the community and marital conflict was identified as major cause for suicides. There is need to address the complex issue of suicide by public- health approach at the community level.

Suicidal hanging: Fatalities in Istanbul Retrospective analysis of 761 autopsy cases

We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine during the five-year period between 1998 and 2002 to document the characteristics of fatalities resulting from hanging which is the commonest mode of suicide in Istanbul. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. Seven hundred sixty one hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, cause of death, internal findings in neck organs, other traumatic findings suggesting the use of another method for suicide, toxicological findings and microscopic findings in delayed death cases. In 364 of these cases suspension was complete and in 397 incomplete. Five hundred thirty seven of those (70.56%) were male and 224 (29.44%) were female. The preponderance of male cases in our autopsy population was also detected in suicidal hanging cases. There was no case aged lower 10 and the number of the cases in the age group of cases aged over 80 was the lowest ( n = 3, 0.4%). In 634 of cases, the place of hanging was the subject’s own house, most victims selected rope (652 cases) for the ligature with the rest using sheet, belt, cable and necktie. There were traumatic findings showing attempts of suicide other than hanging in 24 cases (tentative marks in 22 cases and non-fatal burning in 2). In 23 of cases, there were bruises of different ages. In these cases females constituted the majority suggesting violence against women that is a social problem in various cultural subgroups of our country. This violence may have played a role in the decision of suicide. Superficial bruises were detected in 56 cases and were attributed to the trauma. Fractures in neck organs were detected in 446 of cases. In fracture-determined cases, fracture in hyoid bone was seen in 177, in thyroid cartilage in 163, in both hyoid and thyroid in 106. Vertebral fracture was detected in six cases and fractures both in hyoid, thyroid and vertebra was found in four cases. Hyperemic lines around the ligature were prominent in 620 of the cases and soft tissue ecchymoses in all cases. In 305 of the cases (40.07%) diagnosis was based only on the soft tissue hemorrhage.

Acute copper toxicity following copper glycinate injection

We present a patient who developed multi-organ failure due to severe copper toxicity following attempted suicide by s.c. injection of copper glycinate. Acute copper toxicity is rare in the developed world, although it occurs more frequently in developing world countries, where it is a common mode of suicide. Acute toxicity usually results from oral ingestion and there are several local and systemic effects. Specific management can be difficult as there is little evidence regarding the efficacy of chelating agents in acute toxicity.

Periligature injuries in hanging

Hanging is a common mode of suicide while ligature strangulation is a common way of homicide. Ligature marks (patterned abrasion caused by ligature material) can be of great significance to the forensic pathologist in determining the cause and manner of death. Ligature material usually produces a prominent mark over the bight area, which is opposite to the knot and an inverted ‘V’ pattern at the site of the knot. Apart from ligature mark, sometimes findings such as rope burns & nail marks may be seen around the ligature mark and can be termed as ‘periligature injuries’. Nail marks over the neck are usually suggestive of throttling. But they can also be self inflicted by the victim while trying to extricate himself/herself from the strangling grip of hanging or ligature strangulation. Such injuries, when present may mislead the forensic pathologist in drawing conclusion as to whether it is due to hanging or manual strangulation. Rope burn is caused by friction of rope against skin leading to blister formation. Thus it is an antemortem feature. We present two cases of hanging with periligature injuries.

Clinicoradiological observation in three patients with suicidal hanging

Study design: A hospital-based clinical, radiological and neurophysiological study. Objectives: Hanging is a common mode of suicide in India, but there is paucity of MRI and neurophysiological findings in the context of clinical and neurological changes. We report the clinical, neurophysiological and MRI studies of three females who attempted suicide by hanging. Methods: All three patients who attempted hanging underwent detailed clinical, electroencephalographic, motor, somatosensory and brainstem-evoked potential and magnetic resonance imaging studies. Patients were clinically followed up for 6 months. Results: Their ages were 21, 26 and 35 years. They developed altered sensorium, decorticate posturing and had a wide variety of movement disorders. Patient no. 1 had the most severe illness and recovered by the seventh month while the others recovered earlier. MRI revealed hyperintense signal changes in the globus pallidus, caudate nucleus and thalamus in all patients and in the midbrain in one patient. Electroencephalography showed nonspecific slowing. Somatosensory, motor and brainstem-evoked potential studies were normal. Conclusion: Hanging leads to hypoxic brain damage resulting in signal changes mainly in the basal ganglia and thalamus and may be associated with transient movement disorders.

Under-reporting of suicide in South Yorkshire (West): a retrospective study of suicide and open verdicts returned by HM Coroner, 1992–1997

A retrospective study was performed using information obtained from HM Coroner for South Yorkshire (West) over the period 1992–1997. All inquests which received a suicide or open verdict were reviewed to investigate the regional suicide statistics and the actual number of cases. Particular attention was paid to the age, sex, mental health and mode of death. There were 295 deaths believed to be suicidal in nature. Of these only 79% had suicide verdicts given and these comprise the official statistics. Of the open verdicts, many were suggestive of suicide but the circumstances were insufficient for the Coroner to be satisfied beyond reasonable doubt of the victims intention to kill themselves. Males and females had the same proportion of verdicts (80 and 76% respectively). Hanging was the commonest mode of suicide, (sex ratio 4.06 male: 1 female) and received a high percentage of suicide verdicts (81.5%). Self-poisoning was second but received suicide verdicts in only 66.3% of cases, whilst carbon-monoxide poisoning had a 98.1% rate of suicide verdict. Of the 295 cases, 202 decedents (88.5%) had a history of mental illness. Depression accounted for 153 cases (75.7%). Twelve decedents had psychotic illness (4%), one-half dying by jumping from a height. Official national data may under-report the annual suicide rate by over 20%. Deaths from poisoning by solid or liquid and jumping from a height appear particularly difficult to establish as suicide in coronial practice, with one-third of cases declared an open verdict.

Suicides and pesticides in Sri Lanka.

Sri Lanka has one of the highest rates of suicide in the world (29 per 100,000 population in 1980). Suicides are especially frequent among young adults, both male and female. Compared to the US, the suicide rate for males ages 15 to 24 years in Sri Lanka is nearly four times greater; the female rate nearly 13 times greater. The most common mode of suicide is ingestion of liquid pesticides.