Methods of deliberate self-harm in Pakistan

Khan, Murad Moosa; Reza, Hashim

doi:10.1192/pb.20.6.367

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…This study also highlights that mortality is high and main reason is prescription drugs. The case fatality rate of 6.6% found in this study falls on the higher side of the 2.5 to 11% case fatality rates reported by other hospitals in Pakistan [ 10 - 14 , 22 - 24 ]. These findings also fall on the higher side of case fatality rates seen in neighboring countries like Sri Lanka (3.2%) and India (11%) [ 25 , 26 ].…”

Section: Discussioncontrasting

confidence: 70%

“…Such findings highlight a large amount of uncertainty and could be due to changes in the epidemiology of poisoning, regional differences and even changes to the case definition itself. Poisons most commonly employed in Pakistan are organophosphates (found in insecticides) followed by tranquilizers and narcotics [ 10 - 14 ]. Among medical drugs, benzodiazepines accounted for 60% of the cases but are also featured in almost all cases of multiple drug overdoses [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Poisons most commonly employed in Pakistan are organophosphates (found in insecticides) followed by tranquilizers and narcotics [ 10 - 14 ]. Among medical drugs, benzodiazepines accounted for 60% of the cases but are also featured in almost all cases of multiple drug overdoses [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

et al. 2015

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BackgroundAcute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments.MethodsThe data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire.ResultsAcute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died.ConclusionPoisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem.

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Section: Discussioncontrasting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

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Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

et al. 2015

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“…Overdose of benzodiazepine and ingestion of organophosphorus, accounting for more than two-thirds of the total cases in this study, is comparable with earlier studies from Pakistan (5,24). Regarding the use of organophosphate overdose, our study is in consort with other studies conducted in China and India (25)(26)(27).…”

Section: Discussionsupporting

confidence: 92%

Characteristics of Individuals with Self-Harm: A Retrospective Descriptive Study from Karachi, Pakistan

Tharani

Farooq

Ali

et al. 2021

Preprint

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Background: Self-Harm (SH) is a major global public health problem which is under-researched in Pakistan. A prior act of self-harm is one of the strongest predictors of future suicide.Method: This retrospective descriptive study describes the characteristics of SH cases (n=350) that presented to a tertiary care teaching hospital in Karachi, Pakistan, from January 2013 to December 2017. 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: It was found that self-harm acts were twice as more common in females than in males. More than half of the reported cases were in the age group 20-39 years. Drug overdose and use of insecticides were the two most common methods used in both genders. Depression was identified in nearly half of the reported SH cases. Intention to die was found to be 3 times greater among patients with psychiatric illness as compared to those with no history of psychiatric illness. Conclusion: This study suggests that limiting access to lethal means, regulating over-the-counter sale of medications, and safe storage of pesticides can possibly serve as effective measures to minimize self-harm incidences. Moreover, integration of suicide assessment and prevention programmes for the general population is also suggested.

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“…: 50% Suicide: drugs, poisons, sharp instruments DSH: drugs, poisons, sharp instruments Suicide: 8% DSH: 1% Noor et al (1988) [ 58 ] Retrospective case series (1984–1987) Multan, Punjab Unnatural deaths 20 out of 112 N/A N/A Poisoning N/A Jamil et al (1990) [ 59 ] Retrospective case series (1976–1985) Karachi, Sindh Unnatural deaths 1330 out of 1900 N/A N/A Poisoning N/A Javed et al (1996) [ 24 ] Cross-sectional (1992) Lahore, Punjab Suicidal ideation 27 out of 60 0.66: 1 N/A N/A N/A Khan et al (1996) [ 60 ] Retrospective case series (1989–1992) Karachi, Sindh DSH 314 0.69:1 <30 yrs. : 71% Poisoning, hanging, wrist slashing 31% affective disorder 6% schizophrenia Khan et al (1996) [ 25 ] Retrospective case series (1989–1993) Karachi, Sindh DSH 382 0.69:1 <30 yrs. : 69% Poisoning N/A Waseem et al (1997) [ 61 ] Prospective case series (1996) Lahore, Punjab Suicide 20 1.85: 1 N/A Poisoning N/A Khan et al (1998) [ 39 ] Retrospective case series (1989–1994) Karachi, Sindh DSH 447 0.69:1 <30 yrs.…”

Section: Resultsmentioning

confidence: 99%

Suicide and deliberate self-harm in Pakistan: a scoping review

et al. 2018

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BackgroundSuicide is a major global public health problem with more than 800,000 incidents worldwide annually. Seventy-five percent of the global suicides occur in low and middle-income countries (LMICs). Pakistan is a LMIC where information on suicidal behavior is limited. The aim of the review is to map available literature on determinants, risk factors and other variables of suicidal behavior in Pakistan.MethodThis study was based on Arksey and O’Malley’s methodological framework of scoping review, combining peer reviewed publications with grey literature. Ten databases including Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Trials Register (CRG), Cumulative Index to Nursing and Allied Health (CINAHL), National Library of Medicine Gateway (NLMG), ExcerptaMedica (EMBASE), National Library of Medicine’s MEDLINE (PUBMED), PSYCHINFO, Social Science Citation Index and Science Citation Index (SCI) and Pakmedinet.com were searched from the beginning of their time frames until December 2016 using a combination of key terms. The inclusion criteria included studies of various study designs covering different aspects of suicidal behavior in English language.ResultsSix hundred and twenty three articles were initially retrieved from all ten databases. Two independent reviewers screened the titles and abstracts for relevance. One hundred and eighteen articles were read in full, out of which 11 were excluded because they did not fit the eligibility criteria. One hundred and ten articles, including two student theses and one report, were included in the final review. Most studies were descriptive in nature, with only three that used a case-control design. Majority of the studies were from urban areas, and addressed determinants rather than risk factors. Gender differences and age were predominantly reported, with more males committing suicide. Suicidal behavior was more common among individuals younger than 30 years of age. The three most common methods for suicides were hanging, poisoning and use of firearms. Mental illness as a risk factor for suicides was mentioned in only three studies.ConclusionsThis review is the first attempt to synthesize available literature on suicidal behavior in Pakistan. The evidence is limited, and calls for more robust analytical research designs, along with a focus on risk factors.

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Methods of deliberate self-harm in Pakistan

Cited by 12 publications

References 6 publications

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

Characteristics of Individuals with Self-Harm: A Retrospective Descriptive Study from Karachi, Pakistan

Suicide and deliberate self-harm in Pakistan: a scoping review

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