Epidemiological survey of intentional poisoning suicide during 1993-2013 in Ilam Province, Iran

Abstract

BackgroundSuicide is an important social tragic phenomenon which occurs by different tools or methods in different communities. Considering deliberate poisoning as a common and important method in Ilam province for suicide, the present study was launched to epidemiologically assess committing suicide in Ilam province, Iran, based on intentional poisoning.MethodsBy a retrospective study, all the recorded data associated with intentional poisoning suicide in Ilam Province during 1993–2013 were analyzed. All the demographic variables and the suicides’ outcomes were analyzed using the Chi-Square test, and the univariate and multivariate logistic regression models.ResultsTotally, 6794 cases of suicide (annual incidence rate of 87.28/ 100, 000) associated with poisoning were evaluated. The incidence rate of suicide attempts was 84.63/ 100, 000 (94.51 in female and 74.98 in male) and the incidence rate of completed suicide was 2.17/ 100, 000 (1.94 in female and 2.40 in male). Also, the highest rates of attempted and completed suicide (annual incidence rate of 172.42 and 4.14, respectively) were attributed to the age group of 15–24 year.ConclusionFemales had a greater tendency to commit suicide by poisoning, and the lower level of education, the age group of 15–24 years and single individuals were more associated with suicide using poisonings. The incidence of attempted suicide in females and completed suicide in males was higher in this method. Considering the high rate of suicide by poisoning, further attention and supervision on the sale and reserve of drugs and poisons is necessary.Meanwhile, it seems that due to momentary emotions during the pubertal stage, the risk of committing suicide is increased especially among unemployed individuals; therefore, performing an extensive psychotherapy intervention is needed in the societies with younger populations.

Profile of cases suspected of attempted suicide by exogenous intoxication

“…In the study conducted in Ilam province in Western Iran, the highest incidence rate and suicide attempts were observed between 15 and 24 years. [9] A study in the city of Taubaté-SP identified that there was a predominance of incomplete grade 2, this for the individual exposed to suicide attempt. Some medical records did not have the information in question, being represented by the item "not applicable" (15.5%).…”

“…Educational level, therefore, can be considered as a deterrent against suicide. [9] A study of suicide attempts by exogenous intoxication in Ceará, Brazil [10] found that it was higher among women (55%), followed by 45% among men. In the present study, however, the highest number of suicide attempts was among men.…”

“…A retrospective review paper found that 28.7% of patients were referred to psychiatric institutions. [9] A study in the city of Newcastle, Australia, [16] found that, after assessing patients for the risk of suicide, 27.6% were not referred for admission to a psychiatric service, 45.3% did not receive a psychiatric evaluation and 29.2% of the individuals were referred for psychiatric hospitalization. In this respect, from the official databases, it is reiterated that there is a 61.3% probability of underreporting in cases of attempted suicide, thus suggesting the importance of better professional evaluation and recording of information.…”

Being at the center of attention: Iranian women's experience after suicide attempts

“…In the process of data collection, numerous efforts were made for purposes of consistency to recruit women who had attempted various suicide methods, but four cases who used the self‐immolation method died after 1 month due to the severity of the injury, one case of attempted hanging was transferred to prison for criminal activity, and one case of rice‐tablet (aluminum phosphide) poisoning lost her ability to speak. Ultimately, all interviews were conducted with seven cases of suicide attempts by drug ingestion, which is the most common method of suicide attempt in Iran . Women who were willing to participate in the study entered into the research if the following criteria were met: being hospitalized due to a suicide attempt as a nonfatal, self‐directed, potentially injurious behavior with intent to die; aged 18 to 45 years old; able to speak in Farsi or Kurdish; and having no history of cognitive disorders such as schizophrenia that could disrupt the interview process .…”

“…However, there is no published evidence available to explain the reasons why self‐immolation is chosen more frequently than other methods for suicide. Although self‐immolation is the most common method for achieving suicide in Iran, drug ingestion was the most common method used for those surviving a suicide attempt …”