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Journal of Emergency Practice and Trauma
Volume 2, Issue 1, 2016, p. x-x Demographic status of married females with suicide
attempts referred to the emergency department of Sina
Hospital in Tabriz-Iran
Shiva Salmasi, Navideh Robai, Hanieh Ebrahimi Bakhtavar, Farzad Rahmani*, Farnaz Rahmani
Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Received: 27 Jan 2016
Accepted: 9 Apr 2016
Objective: According to the definition of World Health Organization (WHO), attempting
Published online: 6 May 2016
suicide is an act that a person intentionally and without others' interference shows an *Corresponding author: Farzad
abnormal behavior (such as harming themselves or eating a drug higher than treatment Rahmani MD, Emergency Medicine dose) and his objective is realizing his expected changes. The purpose of this study was Department, Sina Medical Research to investigate the demographic characteristics of married women with suicidal attempt and Training Hospital, Tabriz and a variety of methods used to suicide among them who referred to the emergency University of Medical Sciences, Tabriz, department of Sina hospital in Tabriz.
Iran. Tel: 00984135498322, Fax: Methods: In a cross-sectional study 472 married female patients with suicide attempt who
00984135412151, Email: [email protected] referred to the emergency department of Sina hospital in Tabriz in 2014 entered the study and relevant information was collected. Obtained information was analyzed using SPSS Competing interests: The authors
version 17.0.
declare that there are no conflict of interest.
Results: Findings showed that the most frequent method of suicide was drug use (99.8%).
A significant relationship was found between the type of drug used and seasons of the
Funding information: None.
year. The majority of the population (90.5%) lived in urban areas and based on statistical Citation: Salmasi S, Robai N, Ebrahimi
analyses, a significant relationship was found between residency and type of drug used.
Bakhtavar H, Rahmani F, Rahmani Conclusion: According to the results of this study it can be concluded that drug use is the
F. Demographic status of married most frequent method of suicide that is done with a higher frequency in summer. Thus, females with suicide attempts referred to the emergency department of rational prescription of drugs by physicians can be considered as one of the factors that Sina Hospital in Tabriz-Iran. Journal of can prevent suicide.
Emergency Practice and Trauma 2016; Keywords: Suicide, Married persons, Females, Emergency departments, Hospital
2(1): x-x. doi: 10.15171/jept.2016.05 family problems, hopelessness, depression, suicide his- The term suicide, originated from the Latin word "suici- tory and anxiety disorder affect committing suicide (7). dum" (kill himself), refers to a chain of thought and ac- The rate of those with self-harm referring to emergency tion that is converted from idea into action and makes units is increasing. From 1999 to 2004, intentional self- the person ends his life. Para suicide refers to an activity harm incidents have had a 20% increase, with the same and actions that lead to self-harm but not death. The rate percentage of hospitalization (8). In a 5-year study, about of suicide attempts has been 10-40 times more than suc- 412000 annual emergency visits have been reported for cessful suicide (1). According to the definition of World suicidal patients. A common cause of suicide or self-harm Health Organization (WHO), suicide attempt is an act in includes 68% poisoning and 20% intentional laceration which a person intentional y and without others' interfer- (9). According to statistics published by WHO, the high- ence shows an abnormal behavior (2). Suicide is consid- est suicide rate belonged to Hungary, Sri Lanka and Fin- ered as one of the top ten causes of death in the world. land, with 38.6, 35.8 and 29.8 in a hundred thousand of Thus, among three persons, one person considers suicide the population, respectively and the lowest rate belonged in his lifetime (3). In some studies, it was found that sui- to Mexico with 2.3 in a hundred thousand of the popula- cide with firearms and pesticides has replaced traditional methods of suicide (4). Women attempt more suicide Regarding the increased rate of suicide, the purpose of this compared with men while successful suicide is more com- study was to investigate the demographic characteristics mon among men (5,6).
of married women with suicidal attempts as well as deter- Salman et al concluded that several factors including mining the methods used and exploring the frequency of 2016 The Author(s). Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
drugs used for suicide among them in 2014.
and the agent of poisoning (P < 0.001).
Chi-square test was performed to determine the relation- ship between the seasons and used medicines for suicidal This cross-sectional study was conducted at the emergen- attempts (P < 0.001). Also, chi-square test was performed cy department of Sina hospital, a poisoning referral center, to determine the relationship between residency and in Tabriz in 2014 (11). Annual y about 3000 patients refer drugs used. In this regard, a significant relationship was to this center with poisoning and suicidal attempts. The found between these two variables (P < 0.001).
sample size was 460 patients by using Morgan table with confidence coefficient of 99% and α = 0.05. Inclusion cri- teria encompassed female married patients with suicidal Suicide is an important public health problem and in some attempts (drug overdose), eating caustic substances or countries it is the eighth leading cause of death in adults. herbal poisons, self-immolation, self-harm or attempting Suicide is rooted in complex behavioral, biological, social, for hanging and confessions to commit suicide. Exclusion psychological problems and their mutual effects, but the criteria included a history of mental disease, conscious- necessary information in this regard is limited (12). Social ness disorder, unable to speak, single patients, and refrain- changes that may be associated with suicide can include ing from signing the consent form. The questionnaire in- lack of family stability, marital problems, poverty and un- cluded patients' characteristics, the type of drug used and employment. Studies have shown that the causes of suicide the method for suicidal attempts. Sampling was done by are different and can be divided into three areas of mental convenient method. The questionnaire variables were pa- diseases, social and physical problems (13). A number of tients' characteristics including age, residence, education studies show that those who commit suicide have five con- level and occupation. The questionnaire also included the siderable features: major problems with the spouse, the type of medicine used and the method done for suicide. presence of a new person in the life (second spouse), the After admission and doing routine diagnostic and thera- presence of a disease in a family member, the presence of peutic measures, patients were provided with necessary a severe physical disease, and emotional failure (14). Stud- explanations regarding the objectives of the study. An ies conducted in the last two decades in Iran show that informed consent was obtained and questionnaires were suicide and committing it, especial y among adolescents For statistical analysis of obtained data, SPSS software ver- Table 1. Frequency of poisoning agents in patients
sion 17.0 was used. Descriptive statistical methods (mean ± SD), frequency and percentage were applied as appro- priate. In order to compare qualitative data, chi-square test was used. In all cases, P < 0.05 was considered significant.
The population consisted of 472 patients. The mean ± SD of patients' age was 29.40 ± 9.00. In terms of residence, 90.5% of patients (n = 427) lived in urban areas and 9.5% (n = 45) lived in rural areas. Regarding employment status, 85.6% of patients (n = 404) were housewives, 6.8% (n = 32) were self-employed, 4.9% (n = 23) were employees, and 2.8% (n = 13) were university students. Concerning edu- cation level, 4.2% (n = 20) were illiterate, 45.8% (n = 216) Aluminum phosphide were under diploma, 26.9% (n = 127) had diploma, and 23.1% (n = 109) had university education. The frequency of used agents for suicide and self-harm was investigated. Table 2. Distribution of poisoning agent in different seasons
Table 1 shows the frequency and percentage of agents used Number (%)
Poisoning agent
Number (%)
by patients.
Table 2 shows the frequency of suicide based on the sea- sons and the most used drugs in the seasons. As seen in Table 2, benzodiazepines, acetaminophen and multidrugs were common poisoning agents. Three common poison- ing agents among urban population included benzodiaz- epines (n = 116, 27.2%), acetaminophen (n = 111, 26%), and multi drugs (n = 90, 21.1%). On the other hand, three common poisoning agents among rural population in- cluded organophosphorus (n = 12, 26.7%), multidrugs (n = 9, 20%) and acetaminophen (n = 7, 15.6%). A signifi- cant relationship was found between patients' residence Journal of Emergency Practice and Trauma, 2016, 2(1), x-x and young people, has been increasing in most provinces. sampling in limited hours (8 am-4 pm). Also another limi- For example, in Ilam province, suicide rate increased from tation of our study is its descriptive nature and lack of a 2 persons per hundred thousand in 1989 to 63 persons per control group in the study.
100 000 in 1994 (15). The most important study conduct- ed on suicide in Iran was a multicenter suicide preven- tion (SUPRE-MISS, SUicide PREvention-Multisite Inter- According to the results of our study, we recommend ra- vention Study on Suicidal Behaviours) program that was tional medicine prescription by physicians and with ap- carried out by WHO in eight countries. According to this propriate number. Otherwise, there will be some possibil- study, some risk factors for suicidal attempt were financial, ity of medicine abuse by patients.
educational, occupational problems and the presence of a prolonged physical disease. Some other facilitating factors were problems with the family and spouse (16).
Authors are grateful to all the health-providing personnel Rafiei et al showed that 60% of those committing suicide of the emergency department of Sina hospital and patients were female and 89% of the cause of committing suicide who participated in the study. This article was written was the family violence (12). In a study by Khodabandeh based on a dataset of MD thesis, registered in Tabriz Uni- et al regarding factors associated with committing sui- versity of Medical Sciences.
cide in adults and elderly, it was found that the causes of committing suicide were problem with the spouse, family problems, financial problems, physical or mental disease, All authors read and approved the manuscript. SS, HEB, addiction and/or the spouse violence (10). The results of and NR performed the data collection, writing, critical re- the study of Memari et al showed that a clear relationship vision and drafting of the manuscript. FR and FR under- was found between violence in the family and committing took the major parts of the study design and performed the suicide among married women (14). The main cause of statistical analysis, data analysis and data interpretation.
committing self-immolation among women in the study of Amirmoradi et al was the presence of violence in the family (17). Suicide risk factors identified by Nazarza- The study was approved by the Ethics Committee of deh et al were family problems (30%), marital problems Tabriz University of Medical Sciences with No. 7478 in (26%), education failure (5%), and economic problems 2013. Participation was voluntary and the confidentiality of the information gathered during the study guaranteed. In this study, the majority of women committing suicide were housewives and had diploma degree. The frequency of patients committing suicide in urban population was 1. Colucciello AS. Suicide. In: Marx JA, ed. Rosen's more than rural population. This is due to the fact that Emergency Medicine: Concepts and Clinical ractice. 8th medical centers are located in the center of the province ed. Philadelphia: Mosby; 2014. p. 1492-500.
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