Suicidal behavior by burns among women in two bordering provinces in Iran
R. Alaghehbandan,1 N.A. Dinn,2 E. Rastegar Lari,3 and A. Rastegar Lari4,5,∗
Abstract
The objective of the study was to describe epidemiologic features of suicidal behavior by burns among women in two bordering provinces in Iran. A prospective hospital-based study of all suicidal behaviors by burns among women was carried out in the Iranian provinces of Khorasan (which borders Afghanistan) and Ilam (which borders Iraq) in 2006. These two provinces suffered from war and economic instability with high rates of poverty and unemployment. Data were obtained from patients, family members, and/or significant others through interviews during the course of hospitalization. Of 181 hospitalized patients, 130 (71.8%) were female, representing a hospital separation rate of 5.4 per 100,000 person-year (P-Y). The rate of suicidal behavior involving burns among the rural population was higher than that in the urban population (6.3 vs. 4.7 per 100,000 P-Y, P = 0.09). The median age of the patients was 23 years old, with a mean (±SD) of 27.9 (±14.3) years old. Approximately 68.5% of women were married. Quarrels with "a family member, spouse, a relative, or a friend" (marital plus other conflicts) was identified as the most common precipitating factor (88.5%) in attempting suicide. More than one third of women were abused (physically and/or verbally) by family members (i.e. spouse, father-in-law). Case fatality rate in this study was 52.3% (68/130). Suicide by burns is still a socio-epidemiological problem in Iran, particularly among young, married women in rural areas. Social and economic conditions, as well as violence against women, play a major role in the high rate of suicide by burns. The findings of this study highlight the need for the implementation of a well-organized approach to reduce the rate of suicide by burns among the most vulnerable populations in Iran.
Keywords: burn; epidemiology; suicide; woman.
A prospective population-based study of suicidal behavior by burns in the province of Ilam, Iran
Reza Alaghehbandan1, Abdolaziz Rastegar Lari, Mohammad-Taghi Joghataei, Azar Islami, Abbas Motavalian
1 Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
Abstract
Objective:
The aim of this study was to examine epidemiologic characteristics of suicidal behavior by burns requiring hospitalization in the province of Ilam, Iran.
Methods:
A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Ilam, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or significant others through interviews during the course of hospitalization.
Results:
A total of 51 patients with suicidal behavior by burns requiring hospitalization were identified during the study period, representing an overall incidence rate of 12.5 per 100,000 person-years (P-Y) (95% confidence interval [CI]: 9.1-16.0 per 100,000 P-Y). Women had a higher rate of suicidal behavior by burns than men (18.0 vs. 7.2 per 100,000 P-Y) (P < 0.001). The age-specific rate of suicidal behavior by burns peaked at age group 20-29 years (19.3 per 100,000 P-Y). The rate of suicidal behavior by burns was slightly higher among married persons than single persons, although not statistically significant (13.5 vs. 9.8 per 100,000 P-Y) (P = 0.25). The rate of suicidal behavior by burns among the rural population was significantly higher than the urban population (17.9 vs. 9.3 per 100,000 P-Y) (P = 0.02). The most frequent precipitating factor for suicidal behavior was marital conflicts.
Conclusions:
The high rate of suicidal behavior by burns among young, married women in Ilam is an alarming social tragedy. Despite substantial efforts toward improving health and human rights, persistent conditions allow violence against women in Iran and these women continue to turn to the desperate remedy of self-burning. Findings of this study highlight the need for the implementation of a well-organized approach to reduce the incidence of suicide by burns.
Keywords
Suicide; Burns; Epidemiology; Ilam; Iran
The role of marital status, literacy, and urbanity in suicidal behavior by burns in the province of Khorasan, Iran
Reza Alaghehbandan1, Abdolaziz Rastegar Lari, Mohammad-Taghi Joghataei, Azar Islami
1 Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
Abstract
A prospective study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Khorasan, Iran, from March 21, 2005 to March 20, 2006, to examine marital status, urbanity and literacy among these patients. Data were obtained through interviews during the course of hospitalization. A total of 130 patients with suicidal behavior by burns were identified (incidence rate of 2.9 per 100,000). Females had a higher rate of suicidal behavior by burns than males (4.2 vs. 1.6 per 100,000, P < 0.001). The rate of suicidal behavior by burns was higher among single persons than married persons (4.3 vs. 3.5 per 100,000). The rate of suicidal behavior by burns among the rural population was slightly higher than the urban population (3.2 vs. 2.7 per 100,000). The high rate of suicidal behavior by burns among young, married women in Khorasan is a social tragedy.
Suicidal behavior by burns in the province of Fars, Iran
Abdolaziz Rastegar Lari1, Reza Alaghehbandan, Mohammad-Reza Panjeshahin, Mohammad-Taghi Joghataei
1Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. lari@iums.ac.ir
Abstract
Background: While suicide by burns is a relatively uncommon form of suicide in developed countries, it is one of the most common methods of suicide in the Middle East region including Iran.
Aims: To describe epidemiologic characteristics of suicidal behaviors by burns in the province of Fars, Iran.
Methods: A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Fars, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or significant others through interviews during the course of hospitalization.
Results: A total of 125 patients with suicidal behavior by burns requiring hospitalization were identified during the study period, representing an overall incidence rate of 4.3 per 100,000 (95% Confidence Interval [CI]: 3.6-5.1). Females (6.2 per 100,000) had a higher rate of suicidal behavior by burns than males (2.4 per 100,000; p < .001). The age-specific rate of suicidal behavior by burns peaked at age 20-29 years (10.1 per 100,000). The rate of suicidal behavior by burns was higher among single (7.2 per 100,000) vs. married persons (4.2 per 100,000; p = 0.03). Single males aged 20-39 years and young married women aged 15-29 years were at greatest risk of suicidal behavior by burns. The most common precipitating factor (74.4%) for suicidal behavior was a quarrel with a family member, a relative, and/or a friend.
Conclusions: The high rate of suicidal behavior by burns among young/married women in Fars is of concern. Social, cultural, and economic factors may contribute to suicidal behavior and need to be addressed through education, support, and commitment.
Epidemiology of suicide by burns in the province of Isfahan, Iran
Abdolaziz Rastegar Lari1, Mohammad Taghi Joghataei, Yasaman Rezaei Adli, Yashar Aliabadi Zadeh, Reza Alaghehbandan
1Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract
The aim of the study was to determine epidemiologic features and factors associated with suicidal behaviors by burns requiring hospitalization in the province of Isfahan, Iran. A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Isfahan, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or friends through interviews during the course of hospitalization. A total of 89 patients ages 13 to 62 years with suicidal behaviors by burns were identified during the study period, representing an overall incidence rate of 2.9 per 100,000 persons-year (P-Y; 95% confidence interval 2.3-3.5 per 100,000 P-Y). Females (4.7 per 100,000 P-Y) had a higher rate of suicidal behavior by burns than males (1.2 per 100,000 P-Y; P < .001). The age-specific rate of suicidal behavior by burns peaked at age group 20 to 29 years (6.3 per 100,000 P-Y). Among the population aged 15 to 29 years, married women had a higher rate of suicidal behavior by burns (9.3 per 100,000 P-Y) than single women (6.6 per 100,000 P-Y). The highest rate of suicidal behavior by burns was found among the unemployed population (17.7 per 100,000 P-Y). The most frequent precipitating factor for suicidal behavior was a quarrel with a family member, relative, and/or friend (61.8%). Depression and anxiety disorders were the most frequent psychiatric comorbidities associated with suicidal behaviors. Mortality rate caused by suicidal behavior by burns was 1.4 per 100,000 P-Y. A high rate of suicidal behavior among young and mostly married women in the province of Isfahan is a tragedy and great concern. Social, cultural, and economical factors may contribute to suicidal behavior in Isfahan, and they need to be addressed through education, support, and commitment. Findings of this study can be used for implementation of a preventive program(s) to reduce the incidence of suicide among high risk groups.
Epidemiological study of self-inflicted burns in Tehran, Iran
Abdolaziz Rastegar Lari1, Reza Alaghehbandan
1 Department of Microbiology, Iran University of Medical Sciences, Tehran, Iran.
Abstract
Self-inflicted burns have been considered a serious mental health problem throughout the world and especially in economically developing countries. The aim of this study was to identify the epidemiologic features and current etiological factors of suicide by burning in Tehran, Iran, to develop effective prevention programs. Over a period of 2 years from March 1997 to March 1999, of the 1,236 patients aged 14 years and older who were admitted to Tohid Burn Center in Tehran, Iran, 110 (8.9%) had attempted suicide by self-immolation. The median age was 25 years (range: 14-68 years) and the median extent of the burns was 71% TBSA (range: 20-100%). Forty-eight patients had a previous psychiatric diagnosis (43.6%). Depression was the most common psychiatric diagnosis by history. The method most commonly used was a flame with the addition of a flammable liquid (frequently kerosene). Also, most of the patients (70%) were of a low socioeconomic class. Overall, self-inflicted burns should be considered an increasing mental health problem in our society. Therefore, it is necessary to implement prevention programs and strategies to reduce the incidence rate of this problem.
Analysis of 1089 burn patients in province of Kurdistan, Iran
Bahram Groohi1, Reza Alaghehbandan, Abdolaziz Rastegar Lari
1Department of Microbiology, Iran University of Medical Sciences, P.O. Box 14515-717, Tehran, Iran.
Abstract
Burn injuries still produce a significant morbidity and mortality in Iran. This study was carried out to analyze the epidemiology, mortality, and current etiological factors of 1089 burn patients in the province of Kurdistan in the west of Iran during the 6 years from 21 March 1994 to 20 March 2000. There were two burn centers in Kurdistan, serving 1.4 million people in an area of 28,000 km(2). The incidence rate of burn hospitalization was 13.5 per 100,000 person-years. The median age was 18 years with 58% of the patients under 20 years. The median Body Surface Area (BSA) burned was 40%. Incidence rate of burns for females was 18 per 100,000 person-years and 9.1 per 100,000 person-years for males (P((2))<0.000001). Also there was a statistically significant association between mortality rate and age groups/gender/BBS (P((2))<0.000001). Flame was the most common type of burn (694/1089, 63.7%). There was also a significant correlation between the age groups and types of burn (P((2))<0.000001). Ninety-one percent (991/1089) of the burns were unintentional (12.3 per 100,000 person-years), while suicide attempts by burning for the population aged 13 and older accounted for 12.7% (98/771) (2 per 100,000 person-years). The mortality rate was 4.5 per 100,000 person-years. The study results provide a valuable baseline by which to assess future efforts directed toward the prevention of burn injuries in Kurdistan.