A predictor model for suicide attempt: Evidence from a population-based study

Background: There is an extreme need for planning to prevent suicide in developing countries. It is necessary to detect the risk factors of this problem and plan to control them. The aim of this study was to determine a predictive model for suicide attempt based on its risk factors in order to give information for planning therapeutic, preventive, and educational interventions in Karaj City. Methods: The setting was Karaj City, Tehran Province, Iran and the study design was cross-sectional. In this study, data were collected by using the World Health Organization (WHO) questionnaire of SUPRE-MISS study. The questionnaire included questions about demographic characteristics, personal and family history of suicide behaviors, use of psychotropic drugs, physical and mental disorders, and community stress. All parts of the questionnaire were filled out by interview. A total of 2300 individuals participated in this study having considered the 1.2 prevalence of suicide attempt in the pilot study, and with type one error rate of 5, the sample size was calculated as 2300. Results: About 65 of the participants were females. Most of the participants had high-school education (48) and 57.2 of them were married. Housewives included most of the occupation categories (46). The mean age of the suicide aftempters and nonattempters was 26 (±9) and 32 (±13) years, respectively. This difference was statistically significant. Younger age, female sex, history of mental disorders, lifelong use of tobacco and alcohol, and unemployment were the independent predictors of suicide attempt. Conclusion: Prevention of suicide is possible by understanding its risk factors and planning to control them

The prevalence of attempted suicides in proportion of referrals to emergency departments in Karaj, Iran

Introduction: The World Health Organization (WHO) has recognized suicidal behaviors as a serious public health problem in developed and developing countries. To increase the knowledge about suicidal behaviors, WHO has carried out the Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS) across eight countries. This paper presents data from the site in Karaj, Islamic Republic of Iran. Method: Karaj, with an urban population of 941,000, was selected as a catchment area. For the duration of the study all emergency departments (EDs) in the city were covered for 24 hours to identify suicide attempters who were presented the SUPRE-MISS questionnaire, consisting of comprehensive personal, family, social, somatic, and psychiatric variables. Results: During 10 months, 945 suicide attempters (the mean of referrals per month was 98) were referred to EDs (0.12 percent of the urban population in one year). Age, education, marriage, employment and occupational status, and the method of the suicide attempt had a significant correlation with the gender of the attempters (p < .001). Overall, 0.2 percent of the particpants died due to the suicide attempt. At the time of discharge, only 5.5 percent of the particpants were referred to psychiatric or consultation services. Conclusions: The comparison of the rate of suicidal behaviors generated from community and EDs studies gives an indication of the mental health services needed for particpants at risk of suicide. © 2008 M.E. Sharpe, Inc. All rights reserved

Community study of suicidal behaviors and risk factors among Iranian adults

The present study is part of the WHO/SUPRE-MISS conducted in Iran. The aim of the study was to determine the lifetime prevalence of suicide behaviors in a community sample of Iranian adults. Five hundred and four families were selected randomly according to electricity bills in Karaj, 45 km from the capital city, represented the catchment area for this investigation. The SUPRE-MISS questionnaires used in this study compromised a variety of aspects of suicidal behaviors. Lifetime prevalence rates for suicidal ideation, planning and attempts were 14, 6.6, and 4.1 respectively. Tobacco users and long-term mental and physical disabilities were significantly higher among subjects with a history of suicidal attempts. Younger ages, tobacco abuse, and long-term mental or physical disabilities could be considered risk factors for attempting suicide. © International Academy for Suicide Research

Suicide attempt and its relation to stressors and supportive systems: a study in Karaj city

Background: Psychosocial stressors and the quality of the support system are important factors in attempted suicide. This research has studied these stressors and the condition of the support system in suicide attempt cases in Karaj, Iran. Methods: This is a part of the Iranian section of the widest multisite study on suicide prevention (SUPRE-MISS) proposed and directed by the WHO in eight countries, including Iran. Here we present data obtained from 632 suicide attempters presenting in emergency centers over a period of ten months. Results: According to the time lapse from the stressor to the suicide attempt, proximal stressors are considered to be precipitating while distal stressors are considered to be perpetuating factors. Although, family conflicts were found to increase the risk of suicide one year after the conflict, conflicts with family (25%) and spouse (35%) were the most frequent stressors one month before the attempt, acting as proximal factors. Conflict with spouse was more prominent for people who had been married less than seven years. Conflict with family was the most important stressors for 15-25 year-old attempters. Though it is not clear which areas of conflict are more crucial in a suicide attempt, especially considering gender differences, educational and financial problems were more prominent one year before the suicide attempt. The support system was more crucial for female attempters: Although they received more practical support than males, females complained more of deficiencies in support. Conclusions: The roles of different psychological stressors in attempted suicide vary according to the time lapse from the stressor until the suicide. Family and marital conflicts can be precipitating and perpetuating factors, while educational and financial problems appear to be perpetuating factors. Family is considered to be an important support system for a great number of attempted suicide cases, especially since it offers practical support. Support systems are crucial in preventive programs for suicide, especially among women