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Muhammad, S., Ahmad, R., Rajpoot, P. L., Tabassum, R., Khaskheli, M. S., Abbas, J., Sultana, R., Tabassum, S., & Kumar, N. (2024). Threads of Vulnerability: A Cross-sectional Study on Factors Associated with Suicide and Self-harm in Pakistan. Sudan Journal of Medical Sciences (SJMS), 19(2), 173–187. https://doi.org/10.18502/sjms.v19i2.13906
https://doi.org/10.18502/sjms.v19i2.13906
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Shaib Muhammad
Shaib Muhammad
Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
-
Rabbiya Ahmad
Rabbiya Ahmad
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia and Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
-
Pushp Lata Rajpoot
Pushp Lata Rajpoot
Department of Health Education and Promotion, College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
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Rafia Tabassum
Rafia Tabassum
Department of Anesthesiology, SICU & Pain Center, Peoples University of Medical and Health Sciences for Women, Shaheed Benazirabad, Pakistan
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Muhammad Saleh Khaskheli
Muhammad Saleh Khaskheli
Department of Anesthesiology, SICU & Pain Center, Peoples University of Medical and Health Sciences for Women, Shaheed Benazirabad, Pakistan
-
Jabbas Abbas
Jabbas Abbas
Institute of Pharmaceutical Sciences, People University of Medical and Health Sciences for Women, Shaheed Benazirabad, Pakistan
-
Razia Sultana
Razia Sultana
Institute of Pharmaceutical Sciences, People University of Medical and Health Sciences for Women, Shaheed Benazirabad, Pakistan
-
Shahida Tabassum
Shahida Tabassum
Department of Statistics, The Women University Multan, Pakistan
-
Narendar Kumar
Narendar Kumar
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, PulauPinang, Malaysia
Published Date
- Jun 28, 2024
Threads of Vulnerability: A Cross-sectional Study on Factors Associated with Suicide and Self-harm in Pakistan
Abstract
Background: Globally, over a million people commit suicide every year. Although suicide rates are more in high-income countries, many countries do not report suicide cases regularly to the World Health Organization (WHO). Therefore, this study aimed to determine the factors associated with suicide and self-harm in Pakistan.
Method: This cross-sectional study was conducted at Peoples Medical College Hospital (PMCH) in Shaheed Benazirabad, Sindh, Pakistan, from July to December 2019. A total of 131 cases of suicide/self-harm were included using a convenience sampling technique. Data were collected on a predesigned questionnaire consisting of 14 close-ended questions. A chi-square test was used to determine the association between different categorical variables.
Results: The majority of the subjects were males (53.4%), young adults aged between 16 and 30 years (69.5%), single (51.9%), and uneducated (57.3%). More than half (51.9%) of the subjects who attempted suicide or self-harm were unemployed. There was a significant association between education level (c2 =13.149, P = 0.001) and age groups (c2 = 15.554, P = 0.001) with health outcomes (suicide or self-harm) only. Moreover, gender (c2 = 20.776, P = 0.004), marital status (c2 = 69.047, P < 0.001), level of education (c2 = 63.144, P < 0.001), age groups (c2 = 69.848, P < 0.001), and employment status (c2 = 28.677, P = 0.012) were also associated with the reasons of suicide and self-harm.
Conclusion: Our study concluded that mostly single, unemployed males with low literacy and with marital and family issues are determined as factors associated with a high risk of self-harm and suicide.
Keywords:
suicide, self-harm, pesticide, black stone, Pakistan
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[4] Runnels, P. (2022). Benefits and drawbacks of universal suicide screening. Psychiatric Services, 74(1), 79. https://doi.org/10.1176/appi.ps.20220258
[5] Ketel, C., Hedges, J. P., Smith, J. P., Hopkins, L. W., Pfieffer, M. L., Kyle, E., Raman, R., & Pilon, B. (2021). Suicide detection and treatment in a nurse-led, interprofessional primary care practice: A 2-year report of quality data. The Nurse Practitioner, 46(4), 33–40. https://doi.org/10.1097/01.NPR.0000737208.68560.b8
[6] Haskell, B. (2021). Suicide assessment and follow-up care: Nursing skills and implications. American Nurse Journal, 16, 23.
[7] De Leo, D., Goodfellow, B., Silverman, M., Berman, A., Mann, J., Arensman, E., Hawton, K., Phillips, M. R., Vijayakumar, L., Andriessen, K., Chavez-Hernandez, A. M., Heisel, M., & Kolves, K. (2021). International study of definitions of English-language terms for suicidal behaviours: A survey exploring preferred terminology. BMJ Open, 11(2), e043409. https://doi.org/10.1136/bmjopen-2020-043409
[8] Shekhani, S. S., Perveen, S., Hashmi, D. E., Akbar, K., Bachani, S., & Khan, M. M. (2018). Suicide and deliberate self-harm in Pakistan: A scoping review. BMC Psychiatry, 18(1), 44. https://doi.org/10.1186/s12888-017-1586-6
[9] Wasserman, D., Carli, V., Iosue, M., Javed, A., & Herrman, H. (2021). Suicide prevention in psychiatric patients. Asia-Pacific Psychiatry, 13(3), e12450. https://doi.org/10.1111/appy.12450
[10] Moitra, M., Santomauro, D., Degenhardt, L., Collins, P. Y., Whiteford, H., Vos, T., & Ferrari, A. (2021). Estimating the risk of suicide associated with mental disorders: A systematic review and meta-regression analysis. Journal of Psychiatric Research, 137, 242–249. https://doi.org/10.1016/j.jpsychires.2021.02.053
[11] Amitai, M., & Apter, A. (2012). Social aspects of suicidal behavior and prevention in early life: A review. International Journal of Environmental Research and Public Health, 9(3), 985–994. https://doi.org/10.3390/ijerph9030985
[12] Economic Advisor Wing MoF, Government of Pakistan. (2023). Pakistan Economic Survey 2022–23.
[13] Naveed, S., Tahir, S. M., Imran, N., Rafiq, B., Ayub, M., Haider, I. I., & Khan, M. M. (2023). Sociodemographic characteristics and patterns of suicide in Pakistan: An analysis of current trends. Community Mental Health Journal, 59(6), 1064–1070. https://doi.org/10.1007/s10597-022-01086-7
[14] World Health Organization. (2019). Suicide worldwide in 2019. Global Health Estimates.
[15] World Health Organization. (n.d.). Poisoning prevention and management 2020. World Health Organization. https://www.who.int/ipcs/poisons/en/
[16] Zahra, S. G., Elahi, M., Saleem, S., Noor, S., ur Rehman, M., Zubair, M., Ali, S., Ejaz, M. A., Faiz, M., Butt, S. B., Aziz, F., Salman, F., & Saeed, A. A. (2023). Causes of suicide in Pakistan. Journal of Society of Prevention, Advocacy and Research KEMU, 2(1). https://journalofspark.com/journal/index.php/JSpark/article/view/106
[17] Husain, M. O., Chaudhry, N., Kiran, T., Taylor, P., Tofique, S., Khaliq, A., Naureen, A., Shakoor, S., Bassett, P., Zafar, S. N., Chaudhry, I. B., & Husain, N. (2023). Antecedents, clinical and psychological characteristics of a large sample of individuals who have self-harmed recruited from primary care and hospital settings in Pakistan. BJPsych Open, 9(6), e216. https://doi.org/10.1192/bjo.2023.581
[18] Twayana, R., Pandey, R., Shrestha, S., Vaidya, N., Shrestha, H., & Subedi, N. (2019). Clinical correlation of the severity and outcomes of the organophosphorus compound poisoning cases admitted to Kathmandu University Hospital based on POP score and serum pseudocholinesterase level – A prospective observational study in Nepal. International Journal of Internal and Emergency Medicine, 2(1), 2.
[19] Akhtar, F., Ahmed, M., & Akhtar, M. N. (2021). Drinking, tap and canal water quality analysis for human consumption: A case study of Nawabshah city, Pakistan. Mehran University Research Journal Of Engineering & Technology., 40(2), 392–398. https://doi.org/10.22581/muet1982.2102.13
[20] Abaid, T., Anjum, H., Cheema, T. N., Khurram, A. R., & Ali, A. (2022). Analysis of poisoning cases at a tertiary care hospital in Bahawalpur. Pakistan Journal of Medical & Health Sciences, 16(05), 1470. https://doi.org/10.53350/pjmhs221651470
[21] Gummin, D. D., Mowry, J. B., Spyker, D. A., Brooks, D. E., Beuhler, M. C., Rivers, L. J., Hashem, H. A., & Ryan, M. L. (2019). 2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36th Annual Report. Clinical Toxicology (Philadelphia, PA), 57(12), 1220–1413. https://doi.org/10.1080/15563650.2019.1677022
[22] Khan, N., Pérez-Núñez, R., Shamim, N., Khan, U., Naseer, N., Feroze, A., Razzak, J., & Hyder, A. A. (2015). Intentional and unintentional poisoning in Pakistan: A pilot study using the Emergency Departments surveillance project. BMC Emergency Medicine, 15(Suppl 2), S2. https://doi.org/10.1186/1471-227X-15-S2-S2
[23] Durrani, A., Shahid, O., Sabir, A., & Faisal, M. (2017). Types of poisoning agents used in patients admitted to medical department of Holy Family Hospital, Rawalpindi (Pakistan) from 2011 to 2015. Asia Pacific Journal of Medical Toxicology, 6(2), 50–54.
[24] Tanweer, S., Saeed, M., Zaidi, S., & Aslam, W. (2018). Clinical profile and outcome of paraphenylene diamine poisoning. Journal of the College of Physicians and Surgeons—Pakistan, 28(5), 374–377. https://doi.org/10.29271/jcpsp.2018.05.374
[25] Khurram, M., Mahmood, N., & Ikram, N. (2010). Unintentional poisoning: Experience at a medical unit. Journal of Rawalpindi Medical College, 14(1).
[26] Mamun, M. A., & Ullah, I. (2020). COVID-19 suicides in Pakistan, dying off not COVID-19 fear but poverty? The forthcoming economic challenges for a developing country. Brain, Behavior, and Immunity, 87, 163–166. https://doi.org/10.1016/j.bbi.2020.05.028
[27] Muhammad, S., Qureshi, Y., Tabassum, R., Khaskheli, M. S., Kumar, N., Abbas, J., Kumari, G., Sultana, R., Ahmer, A., & Jamali, J. (2020). Safety and awareness of healthcare workers during the COVID-19 outbreak; A cross-sectional study. Journal of Pharmaceutical Research International, 32(38), 30–38.
[28] Batool, H. (2019). A sociological study into apparently consensual but actually forced marriages in Pakistan [PJSBS]. Pakistan Journal of Social and Behavioral Sciences, 1(1), 60–71.
[29] Husain, M. O., Umer, M., Taylor, P., Chaudhry, N., Kiran, T., Ansari, S., Chaudhry, I. B., & Husain, N. (2019). Demographic and psychosocial characteristics of self-harm: The Pakistan perspective. Psychiatry Research, 279, 201–206. https://doi.org/10.1016/j.psychres.2019.02.070
[30] Khadem Rezaiyan, M., & Afshari, R. (2017). Epidemiology of poisoning in northeast of Iran (2004–2013). International Journal of Medical Toxicology and Forensic Medicine, 7, 54–58.
[31] Veen, S., Moorten, R., & Durani, W. (2018). Marriage decision-making: A family affair-Insight into marriage decision-making processes and social norms around child marriage in Larkana and Shikarpur in Sindh and Lodhran and Muzaffargarh in Punjab. Oxfam.
[32] Arafat, S. M. Y., Menon, V., Khan, M. A. S., Htay, M. N. N., Singh, R., Biyyala, D., Krishnamoorthy, Y., & Mynampally, K. (2023). Marital status and suicidal behavior in South Asia: A systematic review and meta-analysis. Health Science Reports, 6(12), e1781. https://doi.org/10.1002/hsr2.1781
[33] Bhatt, M., Perera, S., Zielinski, L., Eisen, R. B., Yeung, S., El-Sheikh, W., DeJesus, J., Rangarajan, S., Sholer, H., Iordan, E., Mackie, P., Islam, S., Dehghan, M., Thabane, L., & Samaan, Z. (2018). Profile of suicide attempts and risk factors among psychiatric patients: A case-control study. PLoS One, 13(2), e0192998. https://doi.org/10.1371/journal.pone.0192998
[34] Khan, M. M., Mahmud, S., Karim, M. S., Zaman, M., & Prince, M. (2008). Case-control study of suicide in Karachi, Pakistan. The British Journal of Psychiatry, 193(5), 402–405. https://doi.org/10.1192/bjp.bp.107.042069
[35] Imtiaz, F., Ali, M., & Ali, L. (2015). Prevalence of chemical poisoning for suicidal attempts in Karachi, Pakistan. Emergency Medicine (Los Angeles, Calif.), 5(247), 1–3.
[36] Rehman, A., Jingdong, L., & Hussain, I. (2015). The province-wise literacy rate in Pakistan and its impact on the economy. Pacific Science Review B. Humanities and Social Sciences, 1(3), 140–144.
[37] Rashid, K., & Mukhtar, S. (2012). Education in Pakistan: Problems and their solutions. International Journal of Academic Research in Business & Social Sciences, 2(11), 332.
[38] Fallahi-Khoshknab, M., Amirian, Z., Maddah, S. S. B., Khankeh, H. R., & Dalvandi, A. (2023). Instability of emotional relationships and suicide among youth: A qualitative study. BMC Psychiatry, 23(1), 50. https://doi.org/10.1186/s12888-023-04534-0
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