Islam M S, Rashid M H, Islam M K, Rahman M M, Bashar M A, Alam M M, Abedin M F, Uddin M N
Dr Md Shahedul Islam, Associate Professor, Department of Psychiatry, Cumilla Medical College, Cumilla (CuMC), Bangladesh; E-mail:
Mymensingh Med J. 2020 Apr;29(2):392-398.
Suicide is one of the important cause of death worldwide. The precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour are not well understood. A descriptive cross sectional study was carried out in the department of Psychiatry, Cumilla Medical College, Cumilla, Bangladesh. All cases were selected from patients attending at Cumilla Medical College hospital and Private Hospitals in Cumilla City from April 2017 to September 2018. We found out the association between childhood adversities and suicidal behaviour over the life course and delineated the types of suicidal behavior. Total 120 cases were included in the study. Respondents provided socio-demographic and diagnostic information, childhood adversities as well as an account of suicide-related thoughts and behaviours. A participation rate was 77.5% female. Of 120 suicidal behavior participants physical abuse was 2.5%, sexual abuse was 16.67%, parental death was 5%, parental divorce was 2.5%, other parental loss was 4.17%, family violence was 5%, physical illness was 1.67%, financial adversity was 3.33% and composite adversity was 59.16%. Among childhood adversities participants suicidal ideation was 70%, suicidal plans was 15.83%, suicidal attempts was 45%, ideators only proceeded to plans was 22.5%, ideation to attempt was 63.33%, planned attempts was 10.83% and impulsive attempts was 52.5%. Among suicidal behavior participant's psychiatric disorders were 65%. Where neurotic disorders were 17%, psychotic disorders were 13%, personality disorders were 44% and others disorder was 26%. Most of the suicidal behavior patients were female 77.5% and age group of 18-24 years. Childhood sexual abuse emerged as a particularly robust risk factor for suicide attempts in younger participants. Childhood physical and sexual abuse emerged as risk factors for the emergence and persistence of suicidal behaviour, especially in adolescence. Two or more childhood adversities were associated with a three fold higher risk of lifetime suicide attempts. Childhood adversities are main risk factors for the onset and persistence of suicidal behaviour. The risks being are the greatest in childhood, adolescence and early adult. A longitudinal follow-up study is required to give a more reliable in Bangladesh.
自杀是全球重要的死因之一。童年逆境作为自杀行为发生和持续的风险因素，其确切影响尚未得到充分理解。在孟加拉国库米拉市库米拉医学院精神病学系开展了一项描述性横断面研究。所有病例均选自2017年4月至2018年9月在库米拉医学院医院和库米拉市私立医院就诊的患者。我们查明了童年逆境与一生中自杀行为之间的关联，并明确了自杀行为的类型。该研究共纳入120例病例。受访者提供了社会人口学和诊断信息、童年逆境以及与自杀相关的想法和行为描述。参与率为女性77.5%。在120名自杀行为参与者中，身体虐待占2.5%，性虐待占16.67%，父母死亡占5%，父母离异占2.5%，其他父母离世占4.17%，家庭暴力占5%，身体疾病占1.67%，经济困境占3.33%，复合逆境占59.16%。在童年逆境参与者中，自杀意念占70%，自杀计划占15.83%，自杀未遂占45%，仅有意念者发展为计划者占22.5%，从意念到未遂占63.33%，有计划的未遂占10.83%，冲动性未遂占52.5%。在自杀行为参与者中，精神障碍占65%。其中神经症占17%，精神病占13%，人格障碍占44%，其他障碍占26%。大多数自杀行为患者为女性，占77.5%，年龄在18 - 24岁之间。童年性虐待是年轻参与者自杀未遂的一个特别显著的风险因素。童年身体和性虐待是自杀行为发生和持续的风险因素，尤其是在青春期。两种或更多童年逆境与一生中自杀未遂风险高三倍相关。童年逆境是自杀行为发生和持续的主要风险因素。这些风险在童年、青春期和成年早期最大。在孟加拉国需要进行纵向随访研究以给出更可靠的结果。
