Suicide attempts and suicides in Bolivia from 2007 to 2012: pesticides are the preferred method – females try but males commit suicide!
-
Erik Jørs
, Mette Christoffersen
Abstract
Background: Suicide attempts and suicides constitute a significant burden on communities and health systems, especially in low income countries. However, many low income countries lack epidemiological information on which to base future preventive strategies. This study reports on gender and age profiles as well as the likely background and means used for suicide attempts and suicides in Bolivia.
Method: This study presents 1124 cases from four different sources of information: (i) emergency ward data with suicide attempts by poisoning from the year 2007, (ii) psychiatric ward data including suicide attempts from July 2011 to July 2012, (iii) newspaper articles reporting attempted suicides and suicides from 2009 to 2011, and (iv) the National Statistics on Crime reporting suicides from the years 2010–2011. Data on age was stratified into three age groups: adolescents aged 10–19 years, young adults aged 20–29 years, and older adults aged above 29 years. Data from the hospital wards and Crime Statistics were pooled to compare characteristics of suicide attempts with suicides concerning age and gender. Data on age, gender, methods used, and reasons were analyzed using IBM SPSS version 21.
Results: Hospital data showed that more females (403/657, 61%) than males (254/657, 39%) attempted suicide, and females attempted suicide at a younger age than males (p<0.05). In contrast to this, more males (208/293, 70.5%) than females (85/293, 29.5%) committed suicide, and furthermore it was most prevalent among young adults aged 20–29 years of both genders, as observed from the Crime Statistics. The dominant method was pesticide poisoning varying from 400 out of 657 (70.5%) of the hospital poisoning cases to 65 out of 172 (37.8%) of the newspaper cases. Newspaper data showed a higher mortality rate (65/77, 85.1%) among those using violent methods such as hanging and jumping compared to non-violent methods (43/84, 50.9%) such as ingesting chemicals and drugs (p<0.05). The reasons were related to interpersonal problems, economic problems, depression, and unwanted pregnancies. Many cases of suicide seemed to be hidden due to cultural and religious reasons.
Conclusion: More females attempted suicide, whereas more males realized suicide. Suicide attempts were most numerous among adolescents in contrast to suicides being most prevalent in the older age groups. Self-poisoning with pesticides was the most popular method used. Access to potential suicide materials should be restricted and psychosocial interventions initiated to prevent suicides.
References
1. Bertolote JM, Fleischmann A. A global perspective in the epidemiology of suicide. Suicidologi 2002;7:6–8.Suche in Google Scholar
2. Hawton K, van Heeringen K. Suicide. Lancet 2009;373:1372–81.10.1016/S0140-6736(09)60372-XSuche in Google Scholar
3. Pritchar C, Hean S. Suicide and undetermined deaths among youths and young adults in Latin America: comparison with the 10 major developed countries – a source of hidden suicides. Crisis 2008;29:145–53.10.1027/0227-5910.29.3.145Suche in Google Scholar
4. Aaron R, Abraham J, Sulochana A, Jayaprakash M, Kuryan G, et al. Suicides in young people in southern India. Lancet 2004;363:1117–8.10.1016/S0140-6736(04)15896-0Suche in Google Scholar
5. Ahmed MK, Ginneken JV, Razzaque A, Alam N. Violent deaths among women of reproductive age in rural Bangla Desh. Soc Sci Med 2004;59:311–9.10.1016/j.socscimed.2004.01.020Suche in Google Scholar PubMed
6. Kumar V. Poisoning deaths in married women. J Clin Forensic Med 2004;11:2–5.10.1016/j.jcfm.2003.10.010Suche in Google Scholar PubMed
7. Vazquez-Machado A, Guarachi-Catari D. Epidemiologìa del intento suicida en el Hospital Madre Obrera, Llallagua, Bolivia. Rev Neuropsiquiatr 2010;73:39–44.10.20453/rnp.v73i2.1656Suche in Google Scholar
8. Turhan E, Inandi T, Aslan M, Zeren C. Epidemiology of attempted suicide in Hatay, Turkey. Neurosciences 2011;16: 347–52.Suche in Google Scholar
9. Senarathna L, Jayamanna SF, Kelly PJ, Dibley M, Dawson AH. Changing epidemiologic patterns of deliberate self poisoning in a rural district of Sri Lanka. BMC Public Health 2012;12:593.10.1186/1471-2458-12-593Suche in Google Scholar PubMed PubMed Central
10. Rajapakse T, Griffiths K, Christensen H. Characteristics of non-fatal self-poisoning in Sri Lanka: a systematic review. BMC Public Health 2013;13:331.10.1186/1471-2458-13-331Suche in Google Scholar PubMed PubMed Central
11. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health 2007;7:357.10.1186/1471-2458-7-357Suche in Google Scholar PubMed PubMed Central
12. Ajdacic-Gross V, Weiss MG, Ring M, Hepp U, Bopp M, et al. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bull World Health Organ 2008;86:726–32.10.2471/BLT.07.043489Suche in Google Scholar
13. De Silva VA, Senanayake SM, Dias P, Hanwella R. From pesticides to medicinal drugs: time series analyses of methods of suicide attempt in Sri Lanka. Bull World Health Organ 2012;90:40–6.10.2471/BLT.11.091785Suche in Google Scholar PubMed PubMed Central
14. Denning DG, Conwell Y, King D, Cox C. Method choice, intent, and gender in completed suicide. Suicide Life Threaten Behav 2000;30:282–8.Suche in Google Scholar
15. Palacio C, Garcia J, Diago J, Zapata C, Lopez G, et al. Identification of suicide risk factors in Medellin, Colombia: a case-control study of psychological autopsy in a developing country. Arch Suicide Res 2007;11:297–308.10.1080/13811110600894223Suche in Google Scholar PubMed
16. Konradsen F, van der Hoek W, Peiris P. Reaching for the bottle of pesticide – a cry for help. Self-inflicted poisonings in Sri Lanka. Soc Sci Med 2006;62:1710–9.10.1016/j.socscimed.2005.08.020Suche in Google Scholar PubMed
17. Gururaj G, Isaac MK, Subbakrishna DK, Ranjani R. Risk factors for completed suicides: a case-control study from Bangalore, India. Inj Control Saf Promot 2004;11:183–91.10.1080/156609704/233/289706Suche in Google Scholar PubMed
18. Dearden KA, De La Cruz N, Crookston BS, Novilla MLB, Clark M. Adolescents at risk: depression, low academic performance, violence and alcohol increase Bolivian teenagers’ risk of attempted suicide. Int Electr J Health Educ 2005;8:104–19.Suche in Google Scholar
19. Sawalha AF. Deliberate self-poisoning: a study from Nablus. Int J Adolesc Med Health 1012;24:373–7.10.1515/ijamh.2012.054Suche in Google Scholar PubMed
20. Wasserman D, Cheng Q, Jiang G. Global suicide rates among young people aged 15–19. World Psychiatr 2005;4:114–20.Suche in Google Scholar
21. Conner KR, Phillips MR, Meldrum S, Knox KL, Zhang Y, et al. Low-planned suicides in China. Psychol Med 2005;35:1197–204.10.1017/S003329170500454XSuche in Google Scholar PubMed
22. Eddleston M, Karunaratne A, Weerakoon M, Kumarasinghe S, Rajapakshe M, et al. Choice of poison for intentional self-poisoning in rural Sri Lanka. Clin Toxicol 2006;44:283–6.10.1080/15563650600584444Suche in Google Scholar PubMed PubMed Central
23. Shu-Seng C, Tsung-Hsueh L, Eddleston M, Konradsen F, Sterne JA, et al. The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis. BMC Publ Health 2012;12:260.10.1186/1471-2458-12-260Suche in Google Scholar PubMed PubMed Central
24. Shu-Seng C, Tsung-Hsueh L, Eddleston M, Konradsen F, Sterne JAC, et al. Factors associated with the decline in suicide by pesticide poisoning in Taiwan: a time trend analysis 1987–2010. Clin Toxicol 2012;50:471–80.10.3109/15563650.2012.688835Suche in Google Scholar PubMed
25. Jørs E, Morant RC, Concarco GC, Huici O, Lander F, et al. Occupational pesticide poisonings among farmers in Bolivia: a cross-sectional study. Environ Health 2006;5:10.10.1186/1476-069X-5-10Suche in Google Scholar PubMed PubMed Central
26. DeFeo KL. Pesticide retailers exposure to pesticides in La Paz, Bolivia. Master thesis, Rollins School of Public Health, Emory University, Atlanta, GA, 2009.Suche in Google Scholar
27. Phillips MR, Yang G, Zhang Y, Wang L, Ji H, et al. Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet 2002;30:1728–36.10.1016/S0140-6736(02)11681-3Suche in Google Scholar
28. Gunnell D, Fernando R, Hewagama M, Priyangika WDD, Konradsen F, et al. The impact of pesticide regulations on suicide in Sri Lanka. Int J Epidemiol 2007;36:1235–42.10.1093/ije/dym164Suche in Google Scholar
29. Eddleston M, Lakshman K, Buckley N, Fernando R, Hutchinson G, et al. Pesticide poisoning in the developing world – a minimum pesticides list. Lancet 2002;360:1163–7.10.1016/S0140-6736(02)11204-9Suche in Google Scholar
30. Konradsen F. Acute pesticide poisoning – a global public health problem. Dan Med Bull 2007;54:58–9.Suche in Google Scholar
31. Bertolote JM, Fleischmann A, De Leo D, Bolhari J, Botega N, et al. Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey. Psychol Med 2005;35:1457–65.10.1017/S0033291705005404Suche in Google Scholar PubMed
32. Jørs E. Acute pesticide poisonings among small-scale farmers in La Paz County, Bolivia. Copenhagen, Denmark: University of Copenhagen, 2004.Suche in Google Scholar
© 2014 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Editorial
- Healthy eating and physical activity
- Reviews
- A comprehensive review of mental health gatekeeper-trainings for adolescents and young adults
- A conceptual framework for early adolescence: a platform for research
- Original Articles
- Body image satisfaction and self-esteem in Thai female adolescents: the moderating role of self-compassion
- Iranian university students’ perceived reproductive health needs
- An exploration of adolescent nonsuicidal self-injury and religious coping
- Adolescents’ view of health concept and its risk factors: a literature review
- Suicide attempts and suicides in Bolivia from 2007 to 2012: pesticides are the preferred method – females try but males commit suicide!
- Predictive factors and psychosocial effects of Internet addictive behaviors in Cypriot adolescents
- Nutrition, lifestyle factors, and mental health in adolescents and young adults living in Austria
- University students’ point of views to facilitators and barriers to sexual and reproductive health services
- The context of alcohol consumption among adolescents and their families
- Determinants of condom use at sexual debut among young Vietnamese
- Associations between sleep disturbance and suicidal ideation in adolescents admitted to an inpatient psychiatric unit
- Body size preferences among young women in five Arab countries: a cross-cultural study
- Drug knowledge of expatriate adolescents in the United Arab Emirates and their attitudes towards self-medication
- Perspectives of clinical medical directors in child and adolescent psychiatry: diagnostic and treatment needs of migrant families
- Factors associated with physical inactivity among female and male rural adolescents in Borneo – a cross-sectional study
- Book Review
- Brainstorm: The Power and Purpose of the Teenage Brain by Daniel J. Siegel M.D
Artikel in diesem Heft
- Frontmatter
- Editorial
- Healthy eating and physical activity
- Reviews
- A comprehensive review of mental health gatekeeper-trainings for adolescents and young adults
- A conceptual framework for early adolescence: a platform for research
- Original Articles
- Body image satisfaction and self-esteem in Thai female adolescents: the moderating role of self-compassion
- Iranian university students’ perceived reproductive health needs
- An exploration of adolescent nonsuicidal self-injury and religious coping
- Adolescents’ view of health concept and its risk factors: a literature review
- Suicide attempts and suicides in Bolivia from 2007 to 2012: pesticides are the preferred method – females try but males commit suicide!
- Predictive factors and psychosocial effects of Internet addictive behaviors in Cypriot adolescents
- Nutrition, lifestyle factors, and mental health in adolescents and young adults living in Austria
- University students’ point of views to facilitators and barriers to sexual and reproductive health services
- The context of alcohol consumption among adolescents and their families
- Determinants of condom use at sexual debut among young Vietnamese
- Associations between sleep disturbance and suicidal ideation in adolescents admitted to an inpatient psychiatric unit
- Body size preferences among young women in five Arab countries: a cross-cultural study
- Drug knowledge of expatriate adolescents in the United Arab Emirates and their attitudes towards self-medication
- Perspectives of clinical medical directors in child and adolescent psychiatry: diagnostic and treatment needs of migrant families
- Factors associated with physical inactivity among female and male rural adolescents in Borneo – a cross-sectional study
- Book Review
- Brainstorm: The Power and Purpose of the Teenage Brain by Daniel J. Siegel M.D