Iranian Journal of Medical Sciences

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Assessing the Risk Factors of Violent and Non-violent Suicide Attempt Methods: A Population-based Cross-sectional Study

Document Type : Original Article(s)

Authors

1 Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Epidemiology, School of Health, Management and Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Social Determinants of Health Research Center, Mashhad University of Medical Sciences Mashhad, Iran

Abstract

Background: Suicide is a serious global public health issue. It is the fourth-leading cause of death among young people between the ages of 15 and 29. Therefore, the present study was conducted to determine the important risk factors associated with violent and non-violent methods of committing suicide.
Methods: This research was a cross-sectional study that included all people who attempted suicide between 2019 and 2023 and were part of the population covered by Mashhad University of Medical Sciences (Mashhad, Iran). Predictive variables for suicide attempts included age, sex, education, marital status, occupation, place of residence, drug abuse, smoking, psychiatric diagnoses, and the intended outcome of violent and non-violent methods. Logistic regression analysis was used to model the relationship between selected risk factors and the response variable. The data were analyzed using STATA software version 14. P<0.05 was considered statistically significant.
Results: Among the 18,281 people, 53% were men. Men, those who had lost their wives, people who lived in suburban areas, and people who had self-employed jobs or were unemployed, had higher rates of attempted suicide using violent methods. The chance of using violent methods was found to be 64% lower in women than in men (OR=0.36, 95%CI=0.30-0.43) and 45% higher in single individuals than in married people (OR=1.45, 95%CI=1.20-1.75).
Conclusion: This study found that several factors influenced the choice of method for committing suicide. Men, those who had lost their wives, suburban inhabitants, those with insecure jobs or unemployment, and single people were more prone to use violent methods. Meanwhile, women, the elderly, and those with higher education levels showed a preference for non-violent methods.

Keywords

References
  1. World Health O. Suicide in the world: global health estimates. Geneva: World Health Organization, 2019.
  2. Lubbert M, Bahlmann L, Sobanski T, Schulz A, Kastner UW, Walter M, et al. Investigating the Clinical Profile of Suicide Attempters Who Used a Violent Suicidal Means. J Clin Med. 2022;11. doi: 10.3390/jcm11237170. PubMed PMID: 36498743; PubMed Central PMCID: PMCPMC9735514.
  3. Mojahedi M, Esmaeili A, Mahdizadeh K, Nakhaei MH, Salehiniya H, Sahranavard S. Trends of suicide attempts and factors related to completed suicide during the years 2014-2019 in South Khorasan province, Iran. Asian J Psychiatr. 2021;65:102825. doi: 10.1016/j.ajp.2021.102825. PubMed PMID: 34562752.
  4. Asadiyun M, Daliri S. Suicide Attempt and Suicide Death in Iran: A Systematic Review and Meta-Analysis Study. Iran J Psychiatry. 2023;18:191-212. doi: 10.18502/ijps.v18i2.12370. PubMed PMID: 37383956; PubMed Central PMCID: PMCPMC10293692.
  5. Beckman K, Mittendorfer-Rutz E, Waern M, Larsson H, Runeson B, Dahlin M. Method of self-harm in adolescents and young adults and risk of subsequent suicide. J Child Psychol Psychiatry. 2018;59:948-56. doi: 10.1111/jcpp.12883. PubMed PMID: 29504652.
  6. Glenn JJ, Werntz AJ, Slama SJ, Steinman SA, Teachman BA, Nock MK. Suicide and self-injury-related implicit cognition: A large-scale examination and replication. J Abnorm Psychol. 2017;126:199-211. doi: 10.1037/abn0000230. PubMed PMID: 27991808; PubMed Central PMCID: PMCPMC5305619.
  7. Houtsma C, Butterworth SE, Anestis MD. Firearm suicide: pathways to risk and methods of prevention. Curr Opin Psychol. 2018;22:7-11. doi: 10.1016/j.copsyc.2017.07.002. PubMed PMID: 30122279.
  8. Sher L. Resilience as a focus of suicide research and prevention. Acta Psychiatr Scand. 2019;140:169-80. doi: 10.1111/acps.13059. PubMed PMID: 31150102.
  9. Isaac V, Wu CY, McLachlan CS, Lee MB. Associations between health-related self-efficacy and suicidality. BMC Psychiatry. 2018;18:126. doi: 10.1186/s12888-018-1705-z. PubMed PMID: 29747578; PubMed Central PMCID: PMCPMC5946427.
  10. Small LA, Godoy SM, Lau C, Franke T. Gender-Based Violence and Suicide Among Gender-Diverse Populations in the United States. Arch Suicide Res. 2024;28:107-22. doi: 10.1080/13811118.2022.2136023. PubMed PMID: 36353845.
  11. Persons JE, Hefti MM, Nashelsky MB. Epidemiology of suicide in an Iowa cohort. Public Health. 2019;177:128-34. doi: 10.1016/j.puhe.2019.08.005. PubMed PMID: 31563700; PubMed Central PMCID: PMCPMC7025775.
  12. Turecki G, Brent DA, Gunnell D, O’Connor RC, Oquendo MA, Pirkis J, et al. Suicide and suicide risk. Nat Rev Dis Primers. 2019;5:74. doi: 10.1038/s41572-019-0121-0. PubMed PMID: 31649257.
  13. Klonsky ED, Qiu T, Saffer BY. Recent advances in differentiating suicide attempters from suicide ideators. Curr Opin Psychiatry. 2017;30:15-20. doi: 10.1097/YCO.0000000000000294. PubMed PMID: 27798483.
  14. Stewart JG, Shields GS, Esposito EC, Cosby EA, Allen NB, Slavich GM, et al. Life Stress and Suicide in Adolescents. J Abnorm Child Psychol. 2019;47:1707-22. doi: 10.1007/s10802-019-00534-5. PubMed PMID: 31028559; PubMed Central PMCID: PMCPMC6717522.
  15. Zhou L, Wang G, Jia C, Ma Z. Being left-behind, mental disorder, and elderly suicide in rural China: a case-control psychological autopsy study. Psychol Med. 2019;49:458-64. doi: 10.1017/S003329171800106X. PubMed PMID: 29692283; PubMed Central PMCID: PMCPMC6331683.
  16. Quillerou B, Bouchard JP. Epidemiology of suicide and suicide attempts. Rev Infirm. 2021;70:20-1. doi: 10.1016/j.revinf.2021.02.007. PubMed PMID: 33832723.
  17. Stavrianakos K, Kontaxakis V, Moussas G, Paplos K, Papaslanis T, Havaki-Kontaxaki B, et al. Attempted suicide during the financial crisis in Athens. Psychiatriki. 2014;25:104-10. PubMed PMID: 25035179.
  18. Farmani A, Rahimianbougar M, Mohammadi Y, Faramarzi H, Khodarahimi S, Nahaboo S. Psychological, Structural, Social and Economic Determinants of Suicide Attempt: Risk Assessment and Decision Making Strategies. Omega (Westport). 2023;86:1144-66. doi: 10.1177/00302228211003462. PubMed PMID: 33736538.
  19. Bostwick JM, Pabbati C, Geske JR, McKean AJ. Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew. Am J Psychiatry. 2016;173:1094-100. doi: 10.1176/appi.ajp.2016.15070854. PubMed PMID: 27523496; PubMed Central PMCID: PMCPMC5510596.
  20. Stenbacka M, Jokinen J. Violent and non-violent methods of attempted and completed suicide in Swedish young men: the role of early risk factors. BMC Psychiatry. 2015;15:196. doi: 10.1186/s12888-015-0570-2. PubMed PMID: 26271258; PubMed Central PMCID: PMCPMC4536779.
  21. Zhu RT, Ma ZY, Jia CX, Zhou L. Completed Suicide With Violent and Non-violent Methods by the Elderly in Rural China: A Psychological Autopsy Study. Front Psychiatry. 2021;12:624398. doi: 10.3389/fpsyt.2021.624398. PubMed PMID: 34211408; PubMed Central PMCID: PMCPMC8239144.
  22. Rakhshani T, Abbasi T, Kamyab A, Jeihooni AK. Suicide attempts and related factors in patients referred to Gachsaran Hospital, Iran. Heliyon. 2022;8:e10804. doi: 10.1016/j.heliyon.2022.e10804. PubMed PMID: 36217456; PubMed Central PMCID: PMCPMC9547215.
  23. Chen J, Lui ID, Hsu YC, Yip PSF. Patterns in suicide by marital status in Hong Kong, 2002-2020: Is marriage still a protective factor against suicide? J Affect Disord. 2024;346:31-9. doi: 10.1016/j.jad.2023.10.100. PubMed PMID: 37866734.
  24. Khademi N, Zangeneh A, Ziapour A, Saeidi S, Teimouri R, Yenneti K, et al. Exploring the epidemiology of suicide attempts: Risk modeling in Kermanshah-Iran. Front Public Health. 2022;10:924907. doi: 10.3389/fpubh.2022.924907. PubMed PMID: 36081477; PubMed Central PMCID: PMCPMC9445249.
  25. Kim B, Ahn JH, Cha B, Chung YC, Ha TH, Hong Jeong S, et al. Characteristics of methods of suicide attempts in Korea: Korea National Suicide Survey (KNSS). J Affect Disord. 2015;188:218-25. doi: 10.1016/j.jad.2015.08.050. PubMed PMID: 26368946.
  26. Ramamurthy P, Thilakan P. Geographical and Temporal Variation of Suicide in India, 2006-2015: An Investigation of Factors Associated with Suicide Risk Difference across States/Union Territories. Indian J Psychol Med. 2019;41:160-6. doi: 10.4103/IJPSYM.IJPSYM_569_17. PubMed PMID: 30983665; PubMed Central PMCID: PMCPMC6436417.
  27. Xu X, Zhang J, Zhou Q, Sun L. Gender Characteristics in Methods of Chinese Rural Young Suicides. Int J Ment Health Addict. 2021;19:438-46. doi: 10.1007/s11469-019-00078-1. PubMed PMID: 34149330; PubMed Central PMCID: PMCPMC8209688.
  28. Gomez SH, Overholser J, McGovern C, Silva C, Stockmeier CA. The role of premeditation in suicide: Identifying factors associated with increased planning among suicide decedents. J Clin Psychol. 2023;79:2768-80. doi: 10.1002/jclp.23577. PubMed PMID: 37539866; PubMed Central PMCID: PMCPMC10838361.
  29. Darvishi N, Farhadi M, Azmi-Naei B, Poorolajal J. The role of problem-solving skills in the prevention of suicidal behaviors: A systematic review and meta-analysis. PLoS One. 2023;18:e0293620. doi: 10.1371/journal.pone.0293620. PubMed PMID: 37906576; PubMed Central PMCID: PMCPMC10617726.
  30. Ahmady S, Shahbazi S. Impact of social problem-solving training on critical thinking and decision making of nursing students. BMC Nurs. 2020;19:94. doi: 10.1186/s12912-020-00487-x. PubMed PMID: 33041659; PubMed Central PMCID: PMCPMC7542695.
  31. Kaufman JA, Salas-Hernandez LK, Komro KA, Livingston MD. Effects of increased minimum wages by unemployment rate on suicide in the USA. J Epidemiol Community Health. 2020;74:219-24. doi: 10.1136/jech-2019-212981. PubMed PMID: 31911542; PubMed Central PMCID: PMCPMC7549077.
  32. Gertner AK, Rotter JS, Shafer PR. Association Between State Minimum Wages and Suicide Rates in the U.S. Am J Prev Med. 2019;56:648-54. doi: 10.1016/j.amepre.2018.12.008. PubMed PMID: 30905484.
  33. Gravagnuolo R, Tambuzzi S, Gentile G, Boracchi M, Crippa F, Madeddu F, et al. Is It Correct to Consider Caustic Ingestion as a Nonviolent Method of Suicide? A Retrospective Analysis and Psychological Considerations. Int J Environ Res Public Health. 2023;20. doi: 10.3390/ijerph20136270. PubMed PMID: 37444118; PubMed Central PMCID: PMCPMC10341094.
Iranian Journal of Medical Sciences
Volume 49, Issue 12
December 2024
Pages 761-768
Files
History
  • Received: 10 November 2023
  • Revised: 10 December 2023
  • Accepted: 05 January 2024
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