Suicide in children and adolescents: a Tunisian perspective from 2009 to 2015

Abstract

This study presents the characteristics of child and adolescent suicides which occurred in Kairouan, Tunisia. Data were collected from autopsy records of the Forensic Department of the University Hospital Ibn El Jazzar of Kairouan. General characteristics of suicides among children and adolescents (under the age of 18) between 2009 and 2015 were retrospectively reviewed. A total of 49 cases, with a female predominance (61.2%) and a mean age of 15.4 ± 2.1, were registered. Most of the victims were from rural areas (93.1%). In most cases, suicide occurred in the victim's home or the surrounding area (73.4%). The identified precipitating factors were family problems in 55.1%, and school issues in 12.2%. The most common suicide method was hanging (69.38%) for both genders, followed by self-immolation for males and poisoning for females, the majority using pesticides. This study offers useful information to understand the risk factors in Tunisian child and adolescent suicides and provides a basis for the development of urgently needed preventive strategies.

Patterns of Unnatural Deaths Among Children and Adolescents: Autopsy Study (2011-2018)

“…Self-immolation remains an uncommon means of suicide in the Western literature, [40][41][42] unlike the Tunisian data. 33,[43][44][45] This mode of suicide has, in fact, acquired a heroic dimension since the heavy media coverage of Mohamed Bouazizi's suicidal act on January 14, 2011. The spark of revolution (the Jasmine Revolution) was initially ignited on 17 December 2010, when he set himself on fire in front of Sidi Bouzid's municipality building, to protest his humiliation at the hands of a female police officer who confiscated his fruit and vegetable car.…”

“…13 The idea of suicide among children and young adolescents can be indeed nurtured through 3 sources: discussions with older children, the media, and the suicide of a member of their entourage. 33,46 The fact that the 6 suicidal acts occurring in the school were all by self-immolation (among many other means of suicide) suggests that this act is a means of transmitting messages and calling for help concerning inner suffering, school being the place where children learn about their rights and self-expressing. 47 In our study, homicides accounted for 5.3% of all violent deaths in children, which is comparable to some studies in the literature.…”

“…32 Similarly, a Tunisian study on child suicide carried out in the center of the country revealed a female predominance accounting for 61.2% (n = 30/49, sex ratio female to male at 1.6:1). 33 This was mainly explained by a comparative study between suicides among Turkish and American youths, 34 by female social characteristics such as lack of social support, high rates of domestic violence, and early marriage often forced against the wishes of the female. A statistically significant association between suicide and type of living area (rural areas) and the low-income level was found in our series, highlighting the impact of poverty on suicidal behaviors.…”

Environmental factors and daily suicides: a time series analysis

“…Suicide is an act of self-harm with fatal consequences. 1,2 It is a rising global health problem and is responsible for 50% of all violent deaths. 3 The World Health Organization (WHO) estimates that the annual number of suicides worldwide exceeds the combined total of deaths due to homicide and war, despite under-reporting in most countries.…”

Profil épidémiologique et clinique des tentatives de suicide chez l'enfant et l'adolescent en Tunisie en post révolution

“…En Tunisie, les données récentes ont montré une augmentation de l'incidence du suicide après la révolution de 2011, avec un profil différent en comparaison avec la période antérieure à 2011 [2]. La proportion des jeunes de moins de 19 ans décédés par suicide en 2015 représentaient 13,4% des cas selon les statistiques du Ministère de la Santé; et dans une étude menée dans une région du centre de la Tunisie, une augmentation de la mortalité par suicide chez les mineurs a été objectivée entre 2009 et 2015 [3, 4]. Quant aux tentatives de suicide (TS), ce sont des comportements préoccupants par le risque de morbidité et le risque de récidive qu'elles représentent, un tiers des jeunes décédées par suicide avaient des antécédents de TS et de ce fait elles constituent un facteur de risque majeur d'évolution fatale [5].…”