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Abstract
Suicide can be defined as intentional self-inflicted death. It is a serious cause of mortality worldwide. Suicide is considered as a psychiatric emergency and the awareness of the seriousness of suicide in our society should not be overlooked. It is a significant cause of death worldwide.It accounts for about 30,000 deaths annually in the USA and more than 5,000 deaths annually in South Africaand the prevalence of suicide in our society is on the increase. Etiological factors for suicide include social, psychological and physical factors. But suicide is multi-factorial in nature.
The risk factors for suicide include: demographic factors, psychiatric disorders, terminal or chronic medical conditions, and recurrent unresolved psychological stressors.
patients:
One hundred patients (54 males and 46 females) participated in the study, they were admitted in Psychiatry unit of Neurology and Psychiatry department of Assuit university Hospital (AUH).
Selection criteria of the patients:
-Inclusion Criteria:
1) Patients fulfill criteria for the diagnosis according to DSM-5 criteria (APA-2013).
2) Both sex are included in the study.
-Exclusion Criteria:
1) History of major neurological deficits or trauma.
2) Patients with chronic or serious medical condition that may affect cognition.
3) Patients who their relatives refuse to give informed consent.
Study design:
It is descriptive prospective study. The protocol and study design of this thesis were approved by local ethical committee in faculty of medicine, Assuit University. An informed consent was obtained from all the patients’ first degree relatives.
Aim of the study:
Clinical study of suicide including risk factors in psychiatric patients admitted in psychiatric unit of AssuitUniversity Hospital.
Methods:-
All patients were subjected to the following:-
1. Standard psychiatric interview which include: personal identification, history of present illness, family and past histories, mental state and neurological examination.
2. Diagnosis according to DSM-5 (APA, 2013).
3. Sheehan- SuicidilityTracking Scale (S-STS) (Sheehan et al, 2013).
4. Suicide Risk Assessment Scale: scale for impact of suicidality- management, assessment and planning of care (SIS-MAP) (Srivastava and Nelson, 2008).
5. Disability Rating Scale(DRS)(Rappaport et al.,1982).
Results showthat:
• Highly significant rate of MDD (major depressive disorder) among female patients than males.
• In patients with psychotic disorders, there was no gender predilection, but show higher scores in read and write, not working.
• In substance induced disorder, patients were males, primary educated, single, and manual workers.
• Significant statistical difference between pre Sheehan suicidality tracking scale and post Sheehan suicidality tracking scale scores of its different component indicating significant treatment outcome on suicidal behavior.
• Almost 35% of the patients did not have history of previous suicidal attempts, whereas 65% had attempted suicide.
• In regard nature of methods used in suicide, cut wrist (24%) was the most common violent method used, while drug over dose (18%)was the most common nonviolent method used.
• Frequency of suicidal attempts is more in MDD, bipolar disorders followed by schizophrenia.
• Significant severity of suicidal behavior in patients with psychotic disorders in comparison to patients with substance induced disorder or mood disorders as measured by pre Sheehan suicidalitytracking scale.
• Significant residual suicidal behavior after treatment in patient with psychotic disorders in comparison to patients with mood and substance induced disorders.
• Significant disability in patients with psychotic disorders in comparison to patients with mood and substance induced disorders.
• Significant more severity of suicidal behavior in patients with continuous illness in comparison to patients with episodic course of illness measured by pre Sheehan suicidality tracking scale.
• Significant poorer out come in patients with continuous course of illness in comparison to patients with episodic course of illness measured by post Sheehan suicidalitytracking scale.