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尼泊尔的自杀和自残行为:范围综述。

Suicide and self harm in Nepal: A scoping review.

机构信息

National Medical College, Parsa, Nepal.

Department of Psychiatry, Patan Academy of Health Sciences Kathmandu, Nepal.

出版信息

Asian J Psychiatr. 2018 Feb;32:20-26. doi: 10.1016/j.ajp.2017.11.018. Epub 2017 Dec 1.

Abstract

BACKGROUND

Suicide and self harm behavior has become a major public health issue in recent years in Nepal. This small south Asian country was ranked 7th by suicide rate globally by the 2014 World Health Organization report with an estimated 6,840 suicides annually, or 24.9 suicides per 100,000 people. We decided to explore the epidemiology of suicidal behaviour and self harm, modes of attempt, associated risk factors and trends in specific population.

METHODOLOGY

Two researchers independently reviewed 47 studies published in the US National Library of Medicine's PubMed electronic Database and Google Scholar till December 2016. Finally, twenty articles meeting the objective were included. This article summarizes findings on epidemiology of suicidal behavior, associated patterns, risk factors and trend in specific population in Nepal.

RESULTS

Most of the data available till date are hospital based and either cross-sectional or retrospective. Some of the studies have relied on mortality statistics whereas few have done community based screening. Some of the key findings include higher rate among women and younger age group, a rising trend among specific groups such as marginalized, migrant workers and disaster affected population. The studies also show role of mental illness, predominantly mood disorders and psycho-social factors such as interpersonal or marital conflicts and socio-economic issues in triggering suicide and self harm behavior.

CONCLUSION

Overall, the studies provide satisfactory information about the burden of suicide in Nepal. Some of the limitations include discrepancy in suicide reporting, lack of longitudinal follow up and qualitative studies and absence of studies on preventive aspects. Further, more research is warranted in this area not only at the assessment level but also at an intervention level. Several challenges such as poor distribution of mental health resources, social attitude towards mental illness and suicide in particular need to be addressed.

摘要

背景

近年来,自杀和自残行为已成为尼泊尔的一个主要公共卫生问题。这个南亚小国在 2014 年世界卫生组织的报告中,自杀率全球排名第 7,每年估计有 6840 人自杀,即每 10 万人中有 24.9 人自杀。我们决定探讨自杀行为和自残的流行病学、尝试的方式、相关的危险因素和特定人群的趋势。

方法

两名研究人员独立审查了美国国家医学图书馆 PubMed 电子数据库和 Google Scholar 截至 2016 年 12 月发表的 47 项研究。最终,有 20 篇符合目标的文章被纳入。本文总结了尼泊尔自杀行为的流行病学、相关模式、危险因素和特定人群趋势的研究结果。

结果

迄今为止,大多数数据都是基于医院的,要么是横断面的,要么是回顾性的。一些研究依赖于死亡率统计,而少数研究则进行了基于社区的筛查。一些主要发现包括女性和年轻人群体中的自杀率较高,边缘化、移民工人和受灾人口等特定群体的自杀率呈上升趋势。这些研究还表明,精神疾病、主要是情绪障碍以及人际或婚姻冲突和社会经济问题等心理社会因素在引发自杀和自残行为方面起着作用。

结论

总体而言,这些研究提供了关于尼泊尔自杀负担的令人满意的信息。一些局限性包括自杀报告的差异、缺乏纵向随访和定性研究以及缺乏预防方面的研究。此外,这一领域需要进一步研究,不仅在评估方面,而且在干预方面也是如此。还需要解决一些挑战,如心理健康资源分布不均、社会对精神疾病特别是自杀的态度等。

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