Self-Harm (SH) is a major global public health problem under-researched in Pakistan due to religious and legal implications. This study aims to identify the characteristics and patterns among ...patients with SH and factors associated with the intent to die.
This retrospective descriptive study where SH cases presented to private tertiary care teaching hospital in Karachi, Pakistan, from January 2013 to December 2017 were extracted from HIMS records. Details related to demography, history, associated factors, access to methods used, and intent to die were collected on a structured proforma and analysed using STATA version 14. RESULTS: A total of 350 cases were analysed. More than half of the reported cases were in the age group 20-39 years. Though only one-fourth of the SH cases had a past psychiatric history, it was found to be significantly (P-value < 0.05) associated with intent to die. Notably, 81% of the cases do not have a history of SH. Drug overdose (61.6%) and insecticides (36.6%) were the two most common methods used. Depression was identified in nearly half of the cases. The most common reason for attempting SH was inter-personal relationship issues (54.3%).
This paper provides recent data on the characteristics and patterns associated with the intent to die of individuals who have self-harmed. In most cases of SH, past psychiatric history was not evident. Current psychiatric diagnosis and young adults were favoured in this study. The data from this study has limited representation for all demographic representation of SH cases from Pakistan as being from a single private hospital. There is a need for further research on SH in Pakistan.
There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 ...Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.
The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to ...effectively address their physical and mental health needs will be increasingly important.
We review the health and socioeconomic resources currently available for older people in South Asian countries, Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement.
We conducted a search of grey and published literature via Google Search, Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, Scopus and Web of Science. Data on population demographics, human resources, health funding and social protection for older people were extracted. Local informants were consulted to supplement and verify the data.
In the study countries, the number of health professionals with expertise in elderly care was largely unknown, with minimal postgraduate training programmes available in elderly medicine or psychiatry. Older adults are therefore cared for by general physicians, nurses and community health workers, all of whom are present in insufficient numbers per capita. Total average healthcare expenditure was 2.5-5.5% of GDP, with 48.1-72.0% of healthcare costs covered by out-of-pocket payments. Pakistan did not have a social pension; only India and Nepal offered financial assistance to people with dementia; and all countries had disproportionately low numbers of care elderly homes.
Inadequate healthcare funding, a shortage of healthcare professionals and insufficient government pension and social security schemes are significant barriers to achieving universal health coverage in LMICs. Governing bodies must expand training programmes for healthcare providers for older adults, alongside increasing social protection to improve access to those in need and to prevent catastrophic health expenditure.
In the winter of 2014, four terrorists attacked a school in Khyber Pakhtunkhwa (KPK), resulting in more than a hundred students' death. Twenty-two survivors (aged 10-18 years) with physical injuries ...were admitted to a private hospital in Karachi for further surgical and psychological interventions. The aim of this paper is to share a retrospective experiential account of a trauma management plan, based on the bio-psycho-socio-spiritual model for young survivors of terrorism. In biological management, children with hyper-arousal symptoms and sleep disturbances were started on Prazosin and those meeting criteria for Post-Traumatic Stress Disorders were started on Selective serotonin reuptake inhibitors. The Psychosocial interventions included individual therapy, physical therapy, family education, and music groups. Children and their families were also encouraged to draw on their religious support. At the time of discharge, these children were evaluated through clinical interview to assess for improvement. A massive decrease in their hyper-arousal symptoms was seen as evidenced by improvements in their sleeping patterns, mood and behaviour. Moreover, signs of psychosocial development based on the principles of Post Traumatic Growth were visible. Our main limitations were the short period of time and a lack of follow up opportunity. However, this framework provides a basis to establish trauma services at tertiary care hospitals in developing countries like Pakistan where access to overall health care is limited and specifically psychiatric care is lacking in health care institutes.
•Accepting suicide was positively associated with escape motives for suicide.•Escape motives were negatively related to post-suicidal well-being.•Communication motives for suicide were not associated ...with post-suicidal well-being.•Interdependent self-construal might be beneficial for post-suicidal well-being.•Others’ interpretation of suicidal act may be critical for post-suicidal well-being.
This study focused on the well-being of the survivors of suicide attempts and the well-being of their interpersonal relationships after the attempt. The data came from a sample of 392 college students from 10 Muslim majority countries who reported having attempted suicide in the last 4 years. Suicide was conceptualized as a goal-directed behavior embedded in a sociocultural context and motivated by personal or interpersonal goals. We tested a process that linked culturally shaped self-construal to the postsuicidal personal and interpersonal well-being. We posited that this process would operate through the attitudes towards suicide, motives for suicide, the strength of the intention to die. Our model indicated that the acceptability of suicide was positively associated with escape motives, and this association was even stronger for the individuals with interdependent self-construals. Escape motives were negatively associated with postsuicidal personal and interpersonal well-being, but communication motives were not associated with these outcomes. We also found evidence that having an interdependent self-construal might be beneficial for postsuicidal personal and interpersonal well-being. Our results further suggested that the postsuicidal personal and interpersonal well-being of highly interdependent individuals may depend on the interpretation of their act of suicide by their close others.
The WHO
Eastern Mediterranean Region (EMR) consists of 22 countries including Afghanistan, Bahrain,
Djibouti, Egypt, Iraq, Islamic Republic of Iran, Jordan, Kuwait, Lebanon, Libya, Morocco,
Oman, ...Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic,
Tunisia, United Arab Emirates (UAE), and Yemen. According to Global Burden of Disease (GBD)
data, death from self-harm has increased by 100% between 1990 and 2015 in this region.
Although this increase is substantial, it appears trivial in comparison to the 1027% increase
in deaths due to war and legal interventions. This might partly explain why suicide
prevention does not have a high priority in these countries and why there are currently no
suicide prevention strategies in place. Despite the above, some important activities in the
area of suicide prevention have been carried out in the region. And while peace and stability
may take time to come to the region, it should not prevent suicide prevention programs from
being developed and implemented.
This systematic review aimed to help better to understand the epidemiology of suicidal behaviors among Eastern Mediterranean Region (EMR) countries. The PubMed, EMR medex, Scopus, PsychInfo, ISI, and ...IMEMR were searched with no language limitation for papers on the epidemiology of suicidal behaviors in the general population, published up to August 2013. A total of 13 articles were reviewed. The incidence (per 100.000) of committed suicide ranged from 0.55 to 5.4. The lifelong prevalence of attempted suicide, suicidal plan and thoughts were 0.72-4.2%, 6.2-6.7%, and 2.9-14.1%, respectively. The figures for suicide are higher than those officially reported. Suicide behaviors' statistics is susceptible to underestimation presumably due to the socio-cultural, religious and legal barriers, not to mention the lack of well-organized registries and methodologically sound community-based surveys.
Foreword Khan, Murad Moosa
Crisis : the journal of crisis intervention and suicide prevention,
03/2020, Volume:
41, Issue:
Supplement 1
Journal Article
Foreword Khan, Murad Moosa
Crisis : the journal of crisis intervention and suicide prevention,
01/2020, Volume:
41, Issue:
Suppl 1
Journal Article
Peer reviewed
This monograph is timely as the global priority of suicide prevention is highlighted by the United Nations Sustainable Development Goals (SDGs) for 2030, with a target of reducing premature mortality ...from noncommunicable diseases by one-third, with suicide mortality identified as an indicator for this target. The monograph is also highly relevant as it not only traces the major milestones and achievements in suicide prevention so far but also identifies key priority areas for the future. It takes a global perspective of suicide and suicide prevention, covering all the regions of the world. The authors are all based in their respective regions. Suicide may be a global problem, but solutions always have to be local. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: journal abstract)
There are no official data on suicide from Pakistan, a conservative South Asian Islamic country with traditionally low suicide rates. Both suicide and attempted suicide are illegal acts, as well as ...socially and religiously condemned, making research in this area difficult. Recent reports suggest an increase in suicide rates. In this study, police data from the Sindh province were examined to provide a unique picture of trends of suicide over 15 years (1985–1999). During this period there were 2,568 reported suicides (71% men, 39% women; ratio 1.8). The lowest number was 90 in 1987 and maximum was 360 in 1999. Poisoning by organophosphates was the most common method followed by hanging. This study, although limited in scope, provides evidence of an increase in suicide rates in Pakistan, from one data source. There is urgent need for further research on suicide in Pakistan; interventions for suicide prevention in the country can then be planned.
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