Risk factors for suicide in Bangladesh: case–control psychological autopsy study

Abstract

Background Suicide is an important, understudied public health problem in Bangladesh, where risk factors for suicide have not been investigated by case–control psychological autopsy study. Aims To identify the major risk factors for suicide in Dhaka, Bangladesh. Methods We designed a matched case–control psychological autopsy study. We conducted a semi-structured interview with the next-of-kin of 100 individuals who died by suicide and 100 living controls, matched for age, gender and area of residence. The study was conducted from July 2019 to July 2020. Results The odds ratios for the risk factors were 15.33 (95% CI, 4.76–49.30) for the presence of a psychiatric disorder, 17.75 (95% CI, 6.48–48.59) for life events, 65.28 (95% CI, 0.75–5644.48) for previous attempts and 12 (95% CI, 1.56–92.29) for sexual abuse. Conclusions The presence of a psychiatric disorder, immediate life events, previous suicidal attempts and sexual abuse were found as significant risk factors for suicide in Dhaka, Bangladesh.

Prevalence of Suicide Thoughts and Behaviours among Female Garment Workers Who Survived the Rana Plaza Collapse: An In-Depth Inquiry

“…An estimated 10,000 suicide deaths occur in Bangladesh every year [ 63 ], although the exact number is likely higher given data and reporting challenges. Reasons for these deaths have focused broadly on the psychiatric disorder, physical disability, traumatic life events, economic hardship along with age, literacy rate, and place of residence (urban/rural) [ 18 , 64 ]. However, the focus on suicide in LMIC is considerably lower than in high-income countries, which contributes to a predominantly Western view theorising how and why suicide occurs while simultaneously not acknowledging the different risk groups.…”

Study to Assess the Autopsy in Relation with Age and Gender in Tertiary Care Hospital of Hyderabad, Sindh, Pakistan

“…There are thousands of clinical investigations in clinical autopsy that supports the major post-mortem diagnosis yet there are diagnostic errors in 30% cases. 8 The significant inconsistency decreasing over the period of time, though 4-7% cases nearly touch the discrepancies. 9 In the modern practices the autopsy usually indicates the detailed examination, an autopsy needs the careful medical examiners and staff to expand the deal of efforts to identify the unattended death cases, sudden death cases, unexpected deaths cases, and deaths due to traumas.…”

Sexual violence and suicide in Bangladesh

“…The relatives of the deceased mentioned that 47% of the suicides were related to sexual and marital issues mentioned as extramarital love relationship (12%), premarital love relationship (12%), sexual abuse (9%), quarrel with spouse (6%), being refused to marry by the lover (6%), and forceful marriage (2%). 3 Another previous casecontrol study also identified a love relationship and a quarrel with the spouse as risk factors for suicide. 4 The findings indicate a close relationship of psychosexual events with the suicides in Bangladesh, perhaps a sociocultural influence.…”

“…Choice marriage was significantly found higher among suicides when compared to the age and sex‐matched living controls. The relatives of the deceased mentioned that 47% of the suicides were related to sexual and marital issues mentioned as extramarital love relationship (12%), premarital love relationship (12%), sexual abuse (9%), quarrel with spouse (6%), being refused to marry by the lover (6%), and forceful marriage (2%) 3 . Another previous case‐control study also identified a love relationship and a quarrel with the spouse as risk factors for suicide 4 …”

“…1,2 The first case-control psychological autopsy study in Bangladesh revealed mental disorders (OR = 15.33; CI = 4.76-49.30), life events (OR = 17.75; CI = 6.48-48.59), previous nonfatal attempts (OR = 65.28; CI = 0.75-5644.48), and sexual harassment (OR = 12; CI = 1.56-92.29) as the major risk factors for suicide in the country. 3 Among the suicides, 61% were found to have at least one psychiatric illness (depression 44%) and 91% had life events where 40% were closely related to sexual and marital issues such as breaking engagement (9%), quarrel with spouse (8%), sexual harassment (8%), an extramarital love relationship (7%), an extramarital relationship of spouse (5%), child marriage and marriage against the will (2%), and quarrel with the lover (1%). Choice marriage was significantly found higher among suicides when compared to the age and sex-matched living controls.…”