Suicide Victims Research Articles

Characterising fire or burn-related fatalities in the USA using the National Violent Death Reporting System, 2003–2020

ObjectivesIntentional fire or burn-related deaths are rare in the USA compared with some countries, but do occur, and our knowledge of their epidemiology is limited. The objective of this study...

Firearm-related Hospitalizations and Newly Acquired Morbidities in Children and Adolescents: A Nationally Representative Study

BackgroundFirearm injury is the leading cause of pediatric death in the United States (US), but few investigations have focused on the healthcare cost and burden of hospitalized survivors. We aimed to delineate the landscape of pediatric firearm hospitalizations, with a focus on sociodemographic characteristics and on acquired morbidity among survivors. MethodsWe performed a retrospective cohort study of hospitalized children (<21 years old) with firearm injuries using the 2019 Kids’ Inpatient Database, representing 80% of pediatric hospitalizations nationally. ResultsThere were 5998 hospitalizations with 5592 hospital survivors, giving a US population-adjusted hospitalization rate of 9.7 per 100,000 subjects <21 years. Black subjects (37.9 per 100,000) were admitted at higher rates than other races and ethnicities (3.8–6.2 per 100,000). Non-survivors were overrepresented in White subjects who were disproportionately victims of suicide. There were 199 new invasive medical devices placed (3.3% of hospitalized subjects), including 194 in 5592 survivors (3.5% of survivors): 87 tracheostomies, 30 feeding tubes, and 77 both. Suicide attempt was overrepresented as a cause of injury in subjects needing new devices. Charges and length of stay were longer for subjects needing new devices. Total charges for all hospitalized subjects exceeded $1.05 billion for 2019, $136 million (13%) of which represented the 3.3% of admissions needing new devices. ConclusionsAmong pediatric firearm hospitalizations in 2019, Black children were overrepresented among assaults, and White children for suicide attempts. Suicide attempts were overrepresented among non-survivors, those requiring new devices, and contributed disproportionately to total hospital charges. Level of EvidenceLevel 3.

Student Suicide in India: An Analysis of Newspaper Articles(2019-2023).

Student suicide is one significant public health concern across the world, including India. In recent years, the surge in suicide cases has further worried mental health professionals and policymakers. The current study analysed the reported student suicide cases published in four leading Indian newspapers. Based on the analysis of newspaper reports published between 2019 and 2023, the study detected a total of 491 suicidal deaths of students. The result revealed that academic reasons (academic dissatisfaction, academic stress and academic failure), institutional reasons (bullying, caste discrimination, ragging, harassment and toxic institutional culture), mental health issues (depression, psychological stress and anxiety), financial crisis and online gaming are the most commonly reported reasons behind student suicides. The majority of suicide victims were within the age range of 16-21 years. The highest number of suicide cases are reported from Kota, a city often referred to as the coaching capital of India. The study highlights considering changes in the academic curriculum to make academic programs less stressful for students. More importantly, policies should ensure that the academic campuses are free from harassment, bullying or similar aggressive experiences. Furthermore, emphasising students' mental health should be the education system's biggest priority.

Air Rescue Missions for Suicide: A Retrospective Analysis of a 12-Year Period From a German Rescue Helicopter Base

ObjectiveTypical reasons for calling the rescue helicopter are medical emergencies, such as heart disease, trauma, and neurologic emergencies. However, there are also a small number of patients with attempted or completed suicide. The aim of this article was a general analysis and evaluation of the specific circumstances of emergencies related to suicide or attempted suicide in the prehospital environment involving the rescue helicopter (helicopter emergency medical services) Christoph 38 of the DRF Stiftung Luftrettung gAG based in Dresden, Germany. MethodsThe data of all emergency interventions performed by the helicopter emergency medical services in Dresden, Germany, between January 1, 2008, and December 31, 2020, were analyzed by examining the DIVI rescue protocols and electronic data (MEDAT and HEMSDER (Convexis, Germany)) with regard to suicide-related variables. The time, methods and information about the reason, sociodemographic data, and results of medical treatment were recorded and retrospectively analyzed. ResultsThere were a total of 17,754 emergencies during the study period. Of these, 277 cases (1.56%) were due to suicide. The average time for the emergency services to arrive at the scene of the emergency was 11.14 minutes. There were 52 patients with a completed suicide, 183 with a suicide attempt, and 42 patients with a suicide threat. Eleven were pronounced dead before or at the time of arrival of the emergency doctor. Of the 241 patients who were still alive when the emergency physician arrived, 101 were endotracheally intubated and mechanically ventilated, and 25 patients received cardiopulmonary resuscitation. In 19.57% of the patients, health problems were noted as the primary reason for attempted/completed suicide. In a further 12.68%, partnership problems or the loss of a partner were cited. The most common method used was an overdose (49.39%) followed by leaping from a great height (20%) and hanging (15.51%). Stab wounds and gunshot wounds were observed in 24% of the cases. The overall mortality rate was 18.77%. The method used, sex, and a suicide note were identified as possible influencing factors for the fatal outcome of a suicide. ConclusionThe number of suicide victims is low compared with the total number of 17,754 deployments. However, the mortality rate for these missions is quite high at 18%. Although some factors and circumstances could be identified in this study, many backgrounds and explanations are still missing. Therefore, this study shows a general need for more research in regard to better prevention as well as improved education and training of emergency response teams.

The forensic aspects of suicide and neurotrophin factors: a research study.

Introduction: Suicide represents a significant public health problem whose neurobiology is not yet fully understood. In many cases, suicidal behavior and psychiatric spectrum disorders are linked, in particular, to major depression. An emerging pathophysiological hypothesis underlines the role of neurotrophic factors, proteins involved in neurogenesis, in synaptic plasticity in response to stressors. Our research aims to evaluate the degree of expression of brain neurotrophic factor (BDNF) in brain areas involved in depressive disorder in suicidal subjects. Furthermore, we want to evaluate the expression of glial cell line-derived neurotrophic factor (GDNF) in suicidal subjects. Methods: We selected twenty confirmed cases of suicide among subjects with a clinical history of depressive pathology and possible psychopharmacological treatment, compared to ten controls of individuals who died of non-suicidal causes. For all selected cases and controls, immunohistochemical investigations were performed using a panel of antibodies against the BDNF and GDNF antigens on samples from the various brain areas. Results and discussion: The results show that BDNF was under-expressed in the cerebral parenchyma of subjects who died by suicide compared to controls, while there was an overexpression of GDNF in suicide victims, these data could be useful for a clinical application as potential markers for suicidal risk, to assess the severity of depression and development of specific pharmacological therapies for depression.

Youth Suicide in Nepal: A Growing Concern.

In Nepal, suicidal behaviour among adolescents is a growing concern, and the country has been in the grip of a major mental health disaster for many years. The issue must be addressed immediately, and there must be urgent and concerted action by state institutions, healthcare practitioners, and society. Official statistics show the increased rates of completed suicide, whereas those cases that attempted suicide and survived the event remain unaccounted for. The fortunate suicide victims, who were timely rescued, resuscitated, and survived; in the recent years as witnessed at a tertiary hospital in the western region of Nepal, depict a grim picture of suicidality among youths, particularly among teenagers and young adults. The authors recognize the urgent need to tackle and address the problem of youth suicide in the country. Keywords: Cultural factors; mental health crisis; Nepal; risk-taking behaviour; suicide prevention.

Association of Α-Klotho with regulation of Keap1/Nrf2/Interleukin-1 pathway and AMPA receptor trafficking in the brain of suicide victims.

Suicide is a significant public health challenge worldwide. Statistical data confirm a strong relationship between suicidal behavior and depressive disorders (DDs), but the molecular mechanisms of these diseases are still poorly understood. A growing body of research suggests that the Klotho-mediated pathway may be a novel intracellular target for the development of suicide-related disorders (including DDs). To verify this hypothesis, the link between α-Klotho levels, Nrf2-related inflammatory status (IL-1α, IL-1β, Keap1, NFκB p65), AMPA (GluA1, GluA2, p-S831-GluA1, p-S845-GluA1) receptor subunit trafficking and AMPK (AMPKα1/2; pT172-AMPKα1) signalling pathways in the brain of suicide victims as compared to controls were investigated. Commercially available enzyme-linked immunoassay (ELISA) and Western blot analysis were performed in the hippocampus (HP) and frontal cortex (FCx) of suicide victims and matched controls. Group differences were assessed using an unpaired Student's t-test. A statistically significant decrease in the level of α-Klotho (HP: p=0.001; FCx: p=0.012) with an increase in IL-1β (HP: p=0.0108) and IL-1α (FCx: p=0.009) concentrations were shown. These alterations were associated with increased Keap1 (FCx: p=0.023) and NF-κB-p65 (HP: p=0.039; FCx: p=0.013 nuclear fraction) protein levels. Furthermore, a significant reduction in p-S831-GluA1 (HP: p=0.029; FCx=0.002) and p-S845-GluA1 (HP: p=0.0012) proteins was observed. Similarly, the level of GluA2 (HP: p=0.011; FCx: p=0.002) and in p-T172-AMPKα1 (HP: p=0.0288; FCx: p=0.0338) protein were statistically decreased. Our findings demonstrate that a reduction in α-Klotho levels in brain structures related to mood disorders (HP, FCx) correlates with suicidal behavior. Moreover, our study provides novel insights into the molecular mechanisms underlying suicide-related disorders, highlighting the role of α-Klotho, Nrf2-related inflammatory status, AMPA receptor trafficking, and AMPK signaling pathways in the pathophysiology of suicidal behavior. These results may have implications for the development of targeted interventions for individuals at risk of suicide.

Этика психологической помощи в региональной службе «112» (на материале Волгоградской области)

In recent years, the Russian Federation has seen the institutionalization of various forms of providing emergency psy-chological assistance to the population; The Volgograd region is no exception. Thus, in January 2021, on the basis of the State Treasury Institution of the Volgograd Region under the Committee for Ensuring the Life Safety of the Population of the Volgograd Region, within the framework of the "Control and Communications Center", a unified psychological service for emergency operational calls was created to provide emergency psychological assistance and support to residents of the Volgograd Region "112". Assistance is provided in a distant format between applicants/consumers of psychological services and dispatcher psychologists (DP) of the institu-tion; it is available around the clock and does not require a SIM card or funds in the subscriber’s account. The work is carried out using and adapting modern psychological technologies of various directions to resolve the requests of applicants/consumers. A number of ethical problems in providing emergency psychological assistance and support to residents of the Volgograd region by aoperator-psychologist of the unified psychological service for emergency operational calls "112" (to applicants who are intoxicated, parasuicides and suicide victims, employees of the service itself, etc.) are highlighted. It is shown that the identified problems arise from the general problem field of bioethics (situations that are not clearly regulated in the legal field) and a conclusion is made about the expediency based on the agreed position of the organizers of emergency psychological assistance representing various departments, psychologists, law-yers, and specialists in the field of bioethics detailing the legal support for this institutionalized social practice. In principle, the above ethical problems arise from the general problem field of bioethics: situations that are not clearly regulated in the legal field. In this re-gard, it seems appropriate, based on the agreed position of the organizers of the implementation of emergency psychological assistance, psychologists, lawyers, and specialists in the field of bioethics representing various departments, to detail the legal support for this insti-tutionalized social practice.

Analysing Crime Scene Data, Medical Records and Forensic Information to Determine the Causes of Suicides.

To analyse crime scene data, medical records, and forensic information to unveil insights into the causes and traits of suicides. Descriptive study. Place and Duration of the Study:Department of Family Medicine, Kayseri City Hospital, Kayseri, Turkiye, between January 2020 to December 2021. A suicide investigation team (doctor, social worker, psychologist) was created to study cases and conduct on-site psychological autopsies. Triggered by emergency calls, the team interviewed suicide victims' relatives using semi-structured questionnaires, gathering data on personal details, time, method, and potential motives. Medical records revealed psychiatric history and medication use, while national judicial systems were reviewed for legal records. A total of 158 fatal suicides were studied. Males accounted for 73.4%, females 26.6%. The leading cause was psychiatric illness (43%), chiefly depression (39%). Suicide peaked in the fall, especially in September, mainly at 23:00-23:59. Home was the common site (58.9%), and hanging was the primary method (44.3%). Prior hospitalisation for suicide attempts was 7.5%. Criminal records were held by 16.4% (26 individuals). The results support the idea that suicides have seasonal patterns and that there are temporal windows of increased risk for suicide. Suicide reasons, Suicide time, Psychological autopsy, Seasonal and temporal patterns.

Fictional faces of female suicide: Qualitative analysis of selected Russian-language texts of the school reader

IntroductionIsaiah Berlin’s (1948) exploration of the self-searching of Russian thinkers includes studies of the writers – Tolstoy and others (now – Russian-language texts of the school reader). These studies refute a widespread misconception about the relations between Russian writers and thinkers: namely, that in Russia literature and radical thought form two distinct traditions related only by mutual hostility. The works of Tolstoy, Dostoevsky, Karamzin, Leskov, Ostrovsky, and of minor novelists too, are penetrated with a sense of their own time, of this or that particular social and historical milieu and its ideological content, to an even higher degree than the ‘social’ novels of the west. The personal characteristics of suicide victims, heroines of Russian literature, along with the gender aspects, deserve attention in suicidal behavior (SP) focus.ObjectivesTo study personal characteristics of suicide victims, heroines of fiction.MethodsQualitative analysis of selected Russian-language texts of the school reader.ResultsAt the dawn of literature, we have seen fiery heroines and tremulous victims in the arms of death. Аs psychology approach was developed, and we get acquainted with the tragiс backstory. Psychotypes of suicides are exaggerated and overlapped. «Hysterical»: manipulative, frigid nymphomaniac (e.g., Anna Karenina). «Freedom-loving rebel» (i.e., Katerina reincarnations from A. Ostrovsky) in conditions of excessive regulation. «She-Devil, or Rebel Without a Cause». The obsession with death turns into a criminal and a victim (e.g., «Lady Macbeth of the Mtsensk» by N. Leskov, Turgenev’s Susanna or Klara Milich). The image of a vindictively furious («velvet and tiger claws») woman descends to the Victorian view of female self-will. «Mimosa» is a sensitive, dreamy person, unable to resist the hardships of life, dependent (dies with her beloved, objection). In suicide, the strength of weakness is the outcome of a humiliating life (e.g., Karamzin’s «Poor Liza», «A Gentle Creature» by F. Dostoevsky. The meaning of suicides is the following: a call (to compassion, salvation), a «cry for help», atonement for one’s (imaginary) – someone else’s (by proxy) guilt, and release from encumbrance.ConclusionsFiction and life are united by emotionally unstable characters and/or depression as markers of unsatisfactory resilience. The cultural diversity of gender patterns and interpretations of SP challenges the essentialist view that «femininity» and marriage are protective factors. SP patterns illustrate and complement the explanatory concepts of SP. The inner world of suicidal people is fascinating and contributes to the evidence-based optimism in the «patient-centric» crisis care model.Disclosure of InterestNone Declared

Transcranial Magnetic Stimulation and its Efficacy in Alleviating Depressive Symptoms in Patients with Suicidal Ideation

IntroductionSuicide is a global public health issue. According to the latest available data from the National Institute of Statistics, 4,003 people died by suicide in 2021, reaching a new historical high. Approximately 90% of suicide victims suffer from one or more severe psychiatric disorders, and there is a documented 20-fold higher risk of suicide in individuals with affective disorders compared to healthy subjects (Abdelnaim et al., 2020). Repetitive transcranial magnetic stimulation (rTMS) has been established as an effective alternative or complementary treatment option for patients with depressive disorders, but little is known about its effects on suicide risk.ObjectivesTo assess the efficacy of rTMS in reducing depressive symptoms in patients with suicidal ideation and behaviors.MethodsPopulation and Methods: A retrospective analysis was conducted on a sample of 28 psychiatric patients (23 females; mean age 49.36 ± 16.23) with suicidal ideation identified by item 3 (suicidality) of the Hamilton Depression Rating Scale (HDRS), who were treated with rTMS. All patients received a minimum of 30 sessions, consisting of the application of a high-frequency (&gt;10Hz) or intermittent theta burst stimulation (TBS) over the left dorsolateral prefrontal cortex (DLPFC) at an intensity of 120% of the resting motor threshold (RMT), and repeated low-frequency pulses (1Hz) or continuous TBS over the right DLPFC with an intensity of 110% of the RMT.ResultsResults: The results show a statistically significant improvement in depressive symptoms following rTMS intervention (p &lt; 0.001). Furthermore, remission was observed in 46% of the sample (HDRS &lt; 8).ConclusionsDiscussion: In line with recent studies (Abdelnaim et al., 2020; Hines et al., 2022) and systematic reviews (Cui et al., 2022; Bozzay et al., 2020) on suicidal ideation in the context of psychiatric disorders, the findings of this study demonstrated that rTMS achieved satisfactory results in reducing depressive symptoms and suicidal ideation.Conclusions: This clinical study indicates preliminary promise for the prevention of suicidal acts and underscores the need for more detailed and specific research on rTMS in the field of suicide.Keywords: rTMS, neuromodulation, depression, suicide.Disclosure of InterestNone Declared

Fatal Police Shootings of Victims with Mental Health Crises: A Descriptive Analysis of Data from the 2014-2015 National Violent Death Reporting System.

One in five fatal police shooting victims may have been experiencing a mental health crisis (MHC) at the time of their death [1]. We use data on fatal police shootings from the National Violent Death Reporting System (2014-2015) to (a) identify incidents where the victim is reported to have experienced an MHC at the time of their death, (b) describe the characteristics of these incidents, and (c) compare the characteristics of MHC to fatal police shootings where the victim was not experiencing an MHC at the time of their death. We systematically coded 633 fatal police shootings from 27 states. Descriptive statistics characterized fatal police shootings, including victim characteristics; their mental health status; and contextual information regarding the police encounter (e.g., reason for police call). Overall, 203 of 633 fatal police encounters (32%) involved victims who showed signs of an MHC at the time of their death. Victims were predominantly white, male, and in possession of a firearm. In 3 of 4 cases, the MHC manifested as suicidal ideation despite any relevant documented history among most victims. Among half of suicidal victims, suicidal ideation was expressed verbally and in-person to a family member/intimate partner who subsequently called the police. Dispatch was aware of the MHC in 1 of 4 of total police calls. Overall, fatal police encounters involving those experiencing an MHC accounted for 1 in 3 of our caseloads. Approximately, 3 of 4 mental health calls involved a suicidal person who mainly expressed intent to a loved one in-person.

Pregnancy-Associated Firearm Mortality in the U.S., 2008–2019

IntroductionThis study analyzed the contribution of firearms to pregnancy-associated mortality from homicide and suicide. MethodsThis was a retrospective cohort study using the CDC's National Violent Death Reporting System from 2008 – 2019. Women aged 15-44 years who died by suicide (intentional self-harm) and homicide where a firearm was involved were included. Persons without known pregnancy status were excluded. Pregnancy-associated deaths were defined as those that occurred during pregnancy or within 1 year of pregnancy (early and late postpartum). Sociodemographic characteristics, social, and circumstantial differences were compared in pregnancy-associated and non-pregnant deaths. Data analysis was conducted in 2022 – 2023. ResultsA total of 1,803 homicide and 1,929 suicide deaths from firearms were included. Twenty-two percent (n=388) and 11% (n=212) of firearm homicides and suicides respectively, were pregnancy-associated. Victims of pregnancy associated homicide were predominantly Black (54.8%), single (76%), and had high school diploma or equivalent degree (41.2%). Victims of pregnancy-associated suicide were predominantly White (80.5%). Among pregnancy-associated homicides and suicides, deaths occurred more frequently during pregnancy (63.4% and 40.3%). Compared to non-pregnancy associated homicides, pregnancy-associated homicides more frequently occurred in the victim's home (51.5% vs 46.7%, p=0.02) and was related to ongoing conflict or violence between a current or former partner (61.6% vs 51.9%, p < 0.001). Compared to non-pregnancy-associated suicide, pregnancy-associated suicides more frequently occurred in those who experienced intimate partner violence within a month of death (4.2% vs 1.3%, p=0.005). ConclusionsWhile there are differences in demographic characteristics between victims, interpersonal violence is associated with both pregnancy-associated homicides and suicides where a firearm was involved.

15-Year Suicide Trends Using Media Reporting Methodology from the Tricity Region of Chandigarh: A Brief Analysis

Introduction: Suicide has become a societal crisis owing to the recent increasing trends globally. Of the total suicide deaths globally, two-thirds occur in the developing countries including India. The available data on suicide in India reflect a rate of 11% (according to the National Crime Records Bureau 2013) with the highest rates in older adult males and an increasing trend of suicide deaths in younger age groups. Much of the literature is from the southern part of India with a relatively sparse data from North India. Aim and Methodology: The aim was to examine the 15-year (2004-2019) trend of suicide (age and gender distribution, methods used, and reasons) in an urban city in North India. Information was collected from the leading newspapers (English, Hindi, and Punjabi) of the area. Duplication of information was avoided, and statistical analysis was done using SPSS version 20. Results: Fluctuations in the total number of suicide cases over the 15-year period were observed with nearly 63% of people committing suicide being younger than 30 years of age, of whom 53% were male. More females in the younger age group and more males in the older age group were suicide victims. Of all the methods used, hanging was the most common (70%), followed by consuming poisonous substance, jumping from height, shooting self, and stabbing in the descending order. A ceiling fan was used for hanging by 32% of victims who hanged themselves, of whom 65% were male. Among the cited reasons, stress/depression was experienced by 19% of victims. Discussion and Conclusion: The trends with respect to age distribution, gender, and method used that is reported in the current study are in line with the trends reported globally. The preventive measures, especially using technological advances in designing fans not suitable for tying noose around it, can be explored.

Histological Changes in Adrenal Glands in Suicidal and Sudden Death Cases: A Postmortem Study.

Introduction Various studies have linked suicidal behavior, stress, affective disorders, and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis resulting from chronic stress. Chronic stress has been shown to cause enlargement of the adrenal glands, altering their function and potentially leading to suicidal behaviors in individuals with depression. This study aimed to compare the histological changes in the adrenal glands of individuals who died by suicide with those who experienced sudden death. Suicide victims are exposed to chronic stress, while individuals with sudden deaths face acute stress related to the act of dying. Methods This analytical study, approved by the Institutional Ethics Committee (IEC), was conducted in the Department of Forensic Medicine and Toxicology at Gandhi Medical College, Bhopal. The study included 100 confirmed cases of suicide, irrespective of gender, aged 15-60 years, with notable autopsy findings, relevant history, no signs of decomposition, and varying survival periods (including immediate deaths within 24 hours). Additionally, 20 controls were selected, involving individuals who died suddenly from causes other than suicide within 24 hours of the incident. Informed consent was obtained using a prescribed proforma from relatives and the police. Histological examination slides of the adrenals were prepared and analyzed. Data were collected and statistically analyzed using GraphPad software and Epi Info 7. Results Capsular hemorrhage was observed in 98% of suicide cases and 40% of controls. Nodulation was present in 48% of suicidal cases and 20% of controls. Zonal extension of zona fasciculata was specific to chronic stress in suicidal cases. In 25% of suicidal cases, a prominent extension of the medulla was noted. Irregular thinning of zona glomerulosa with shrunken cells and increased nuclear density in 88% of cases were considered specific to chronic stress conditions and suicide, not observed in controls. Lipid depletion was observed in all suicidal cases, with diffuse depletion in 47% and focal depletion in 53% of cases. In contrast, 45% of those exposed to the acute stress of dying showed focal depletion, with none exhibiting diffuse depletion. Suicidal cases displayed dilated prominent sinusoids in all three zones and the adrenal medulla (98-99%), absent in controls. Adrenal hemorrhage and necrosis were specific to chronic stress conditions, with 7%, 8%, 32%, and 16% of cases showing hemorrhage in all three zones and adrenal medulla, respectively, and none in controls. Conclusion Histological changes observed in acute stress conditions included focal lipid depletion, capsular hemorrhage, nodular hyperplasia, and hemorrhage and necrosis with edema. However, the proportion and severity of these changes were lower than those observed in the suicidal group, suggesting that these findings may be considered non-specific for differentiating between acute and chronic stress.

A Study among Chemical Suicidal Victims: Situation Analysis

Background: Suicide by poisoning is the act of intentionally killing oneself by using various chemical substances and it is the most common and widely used method in developing countries like Bangladesh. Objective: The objectives of this study were to find out the socio-demographic characteristics and possible reasons among the chemical suicidal victims. Materials and method: This was a descriptive type of cross-sectional study, held in the Morgue of department of Forensic Medicine of Dhaka Medical College (DMC), Dhaka, Bangladesh, from July 2016 to June 2018. Victims were selected purposively according to the availability in the morgue of Dhaka MedicalCollege. Data were collected from the relatives of the victims and the verbal consent of the doctors who performed autopsy at DMC morgue. Results: A total of 50 victims of suicide using chemical substances as revealed by autopsy findings from the DMC morgue were enlisted in this study. Victims of suicide not using chemicals were excluded from this study. Half (50.0%) of the suicidal deaths by poisoning cases were aged 20 or below. Majority (66.0%) of the victims was male. Organophosphorus compound was found in 58.0% cases, followed by diazepam (8.0%) and barbiturates (4.0%), after receiving chemical analysis report. Conclusion: Pesticides are the most commonly used suicidal agent particularly in low and middle-income countries like ours. So, social awareness regarding this issue is very much needed. Delta Med Col J. Jan 2021;9(1):23-27

Suicide attempts and depression associated factors among the male child sexual abuse survivors in Bangladesh

In Bangladesh, male child sexual assault is seldom ever reported. Due to cultural standards, sexual assault survivors often refrain from talking about their experiences. Depression therefore overtakes them. Their mental health declines and their chance of committing suicide rises. The goal of this study was to explore depression and suicide attempts among Bangladeshi male child sexual assault survivors. An online survey was conducted, and data was collected using the Patient Health Questionnaire (PHQ-9) and one suicide attempt item. Descriptive analysis, Pearson chi-square test, and a binary logistic regression model were fit to analyze the data. A total of 61 participants participated. All the participants were depressed, with 67.21 % having severe depression. 21.31 % of the survivors attempted suicide at least once. Disclosure rates were relatively low, with only 14.75 % of participants reporting affirmative disclosure, Furthermore, a significant proportion of participants experienced repetitive abuse (73.77 %), and the prevalence of physical abuse was also notable, with 78.69 % reporting such experiences. To safeguard children and adolescents, parents as well as government stakeholders must be aware of male child sexual abuse. Public discourse regarding the subject is recommended. To stave off suicide and safeguard victims, experts advise seeking professional assistance.

The Relationship Between Bullying and Risk of Suicide Among Adolescents During the COVID-19 Pandemic in Indonesia.

Although adolescents appear less vulnerable to coronavirus disease (COVID-19), the side effects of this pandemic can still be devastating. Bullying and suicidality are significant global issues with detrimental effects on young people, particularly during school closure. This study aimed to identify the relationship between bullying and suicide risk among adolescents in Indonesia during the COVID- 19 pandemic. A cross-sectional study was conducted on adolescents aged 14-18 years in May 2020 in Bandung, Indonesia, using a webbased closed survey. The Adolescent Peer Relations Instrument and the Suicide Behavior Questionnaire-Revised were used to measure bullying and risk of suicide. Multinomial logistic regression analysis was performed. This study included 268 participants in 2020 and 175 participants in 2019. In 2020, the prevalence of perpetrators and victims of bullying combined was 74.6%. Meanwhile, in 2019, the prevalence of perpetrators and victims of bullying combined was 82.9%. Risk of suicide increased from 26.1% in 2019 (before the COVID-19 pandemic) to 36.5% in 2020 (during the first wave of the COVID-19 pandemic). The risk of perpetrators and suicide victims was higher than that of perpetrators and victims alone (odds ratio [OR]=4.0, 95% confidence interval [CI]=1.5-6.6 vs. OR=1.3, 95% CI=1.0-2.9 and OR=1.6, 95% CI=1.1-2.8, respectively). Bullying can enhance the likelihood of suicide among adolescents in Indonesia, and the risk was highest for the combination of victims and perpetrators. It is very important to provide early risk prediction for youths with bullying behavior and improve the knowledge and understanding of families and schools regarding the negative effects of bullying behavior.

Suicide victims and alcohol-related consumption in Brazil: An observational study and a narrative review of the literature.

Deaths due to external causes, mainly suicide, are a severe public health problem in Brazil. Evidence shows that the tendency to impulsive behavior is exacerbated after alcohol consumption. The relationship between alcohol and suicide is poorly described in the medical literature. The study aims to analyze the relationship between victims' blood alcohol levels and suicides in some municipalities in Greater São Paulo, Brazil. We reviewed the data from the medical records of 805 necropsies performed at the Medical Legal Institute of Sao Paulo in Franco da Rocha, Brazil, from 2001 to 2017. The manner of death was established based on the result of police inquiry. Deaths due to suicide (n=41) were selected for the study. Descriptive statistics and Student t-test was applied when appropriate. The variables studied were sex, age, suicide mechanism, and blood alcohol level (BAC). In all cases we could not determine how much time the deceased consumed alcohol before suicide. Of the individuals analyzed, 85.36% were male, and 14.64% were female. The most prevalent age range for males was between 18 and 23 (19.5%). For females, it was between 12 and 23 years (33.2%). Most suicides (48.78%) were due to hanging, followed by self-poisoning (22.08%) and firearms (17.1%). 38 victims (92.68%) presented a positive BAC, over 0.3 mg/dl. The higher levels were in the group of suicide by hanging (2.3 mg/ml). Thus, alcohol intoxication is common among suicide victims, and it can contribute to the fatal outcome as a risk factor. Further studies are necessary for a better comprehension of the effect of alcohol on suicide victims.

Suicide Death and Post-suicide Cultural Practices in Southwest Nigeria: Implications for Suicide Reporting

Indeed, the underreporting of suicides and misclassification of causes of death has been acknowledged as a serious global concern among scholars and policymakers, especially in low and middle-income countries (LMIC). While studies have identified the criminal status of suicide as a factor responsible for the low reporting of suicide cases in Nigeria, religious and sociocultural underpinnings of suicide reporting have been ignored. This study, therefore, explores the social interpretations and cultural practices involved in handling suicide cases in 30 selected communities in southwest Nigeria. This is to unravel how these practices impact suicide reporting in the selected region. Purposive sampling was used to reach out to 90 traditional rulers, religious priests, and opinion leaders in the selected communities. The narratives of the study participants revealed that suicide is socially perceived as an abominable way to die, a revolt against one’s destiny, and a protest against the gods. Communities are in awe of the spiritual import of suicide deaths, which often informs the harsh treatment of bodies of suicide victims and secondary victimization of bereaved families, with implications for suicide reporting. The study suggests aligning cultural practices with the formal methods of handling suicide.