The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors

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Abstract

The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15–17 and 4.04 times among 18–24 olds compared to 25–64 years old. Married adolescents were 22 times more likely to commit suicide compared to never-married people. Compared to Chandpur/Comilla district, the risk of suicide was significantly higher in Narshingdi. Students had significantly lower risk of non-fatal suicidal behavior compared to skilled laborers. The risk of non-fatal suicidal behavior was lower in Sherpur compared to Chandpur/Comilla. Among adolescents, unskilled laborers were 16 times more likely to attempt suicide than students. The common methods for fatal and non-fatal suicidal behaviors were hanging and poisoning. Suicide is a major public health problem in Bangladesh that needs to be addressed with targeted interventions.

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Most cited references 46

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The impact of physical, psychological, and sexual intimate male partner violence on women's mental health: depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide.

Enrique A. Picó, Daniel M. Linares, Nuria Navarro … (2006)

This study aimed to determine the impact of lifetime physical, psychological, and sexual intimate male partner violence (IPV) on the mental health of women, after controlling for the contribution of lifetime victimization. The comorbidity of depressive symptoms and posttraumatic stress disorder (PTSD) and their relation to state anxiety and suicide were also assessed. Physically/psychologically (n = 75) and psychologically abused women (n = 55) were compared with nonabused control women (n = 52). Information about sociodemographic characteristics, lifetime victimization, and mental health status (depressive and state anxiety symptoms, PTSD, and suicide) was obtained through face-to-face structured interviews. Women exposed to physical/psychological and psychological IPV had a higher incidence and severity of depressive and anxiety symptoms, PTSD, and thoughts of suicide than control women, with no differences between the two abused groups. The concomitance of sexual violence was associated with a higher severity of depressive symptoms in both abused groups and a higher incidence of suicide attempts in the physically/psychologically abused group. The incidence of PTSD alone was very rare, and depressive symptoms were either alone or comorbid with PTSD. The severity of state anxiety was higher in abused women with depressive symptoms or comorbidity, as was the incidence of suicidal thoughts in the physically/psychologically abused group. Lifetime victimization was not a predictor of the deterioration of mental health in this study. These findings indicate that psychological IPV is as detrimental as physical IPV, with the exception of effects on suicidality, which emphasizes that psychological IPV should be considered a major type of violence by all professionals involved.

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The gender gap in suicide and premature death or: why are men so vulnerable?

A. Christina Møller (2003)

Suicide and premature death due to coronary heart disease, violence, accidents, drug or alcohol abuse are strikingly male phenomena, particularly in the young and middle-aged groups. Rates of offending behaviour, conduct disorders, suicide and depression are even rising, and give evidence to a high gender-related vulnerability of young men. In explaining this vulnerability, the gender perspective offers an analytical tool to integrate structural and cultural factors. It is shown that traditional masculinity is a key risk factor for male vulnerability promoting maladaptive coping strategies such as emotional unexpressiveness, reluctance to seek help, or alcohol abuse. This basic male disposition is shown to increase psychosocial stress due to different societal conditions: to changes in male gender-role, to postmodern individualism and to rapid social change in Eastern Europe and Russia. Relying on empirical data and theoretical explanations, a gender model of male vulnerability is proposed. It is concluded that the gender gap in suicide and premature death can most likely be explained by perceived reduction in social role opportunities leading to social exclusion.

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The impact of pesticide regulations on suicide in Sri Lanka.

Thilini Fernando, M Hewagama, W Priyangika … (2007)

Between 1950 and 1995 suicide rates in Sri Lanka increased 8-fold to a peak of 47 per 100,000 in 1995. By 2005, rates had halved. We investigated whether Sri Lanka's regulatory controls on the import and sale of pesticides that are particularly toxic to humans were responsible for these changes in the incidence of suicide. Ecological analysis using graphical and descriptive approaches to identify time trends in suicide and risk factors for suicide in Sri Lanka, 1975-2005. Restrictions on the import and sales of WHO Class I toxicity pesticides in 1995 and endosulfan in 1998, coincided with reductions in suicide in both men and women of all ages. 19,769 fewer suicides occurred in 1996-2005 as compared with 1986-95. Secular trends in unemployment, alcohol misuse, divorce, pesticide use and the years associated with Sri Lanka's Civil war did not appear to be associated with these declines. These data indicate that in countries where pesticides are commonly used in acts of self-poisoning, import controls on the most toxic pesticides may have a favourable impact on suicide. In Asia, there are an estimated 300,000 deaths from pesticide self-poisoning annually. National and international policies restricting the sale of pesticides that are most toxic to humans may have a major impact on suicides in the region.

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Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 09 September 2017

Publication date (Print): September 2017

Volume: 14

Issue: 9

Electronic Location Identifier: 1032

Affiliations

[1 ]International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh; irteja.islam@ 123456icddrb.org (M.I.I.); emdad@ 123456icddrb.org (D.M.E.H.); shams@ 123456icddrb.org (S.E.A.)

[2 ]Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA 21205, USA; oalonge1@ 123456jhu.edu (O.A.); swadhwa2@ 123456jhu.edu (S.W.)

[3 ]Center for Injury Prevention and Research, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh; kamran_baset@ 123456yahoo.co.uk (M.K.U.B.); mashreky@ 123456ciprb.org (S.R.M.)

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[* ]Correspondence: shumona@ 123456icddrb.org

Author information

Dewan Md Emdadul Hoque https://orcid.org/0000-0001-8219-9196

Saidur Rahman Mashreky https://orcid.org/0000-0001-7892-798X

Article

Publisher ID: ijerph-14-01032

DOI: 10.3390/ijerph14091032

PMC ID: 5615569

PubMed ID: 28891939

SO-VID: 53eeea98-8bfe-486d-924a-e3572901804b

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors

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Most cited references 46

The impact of physical, psychological, and sexual intimate male partner violence on women's mental health: depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide.

The gender gap in suicide and premature death or: why are men so vulnerable?

The impact of pesticide regulations on suicide in Sri Lanka.

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