The Underlying Reasons of Suicide Attempts among Arab Population in the Holy-Land—Nazareth: View and Overview

Abstract

Suicide is one of the leading causes of death in many western countries, but in eastern countries this phenomenon was until recently extremely rare. Our study, performed during 2005-2012 comes to shed lights on the prevalence and the underlying reasons of the notable increase of suicide attempts in the conservative and religious Arab community of Nazareth, Israel. Extensive interviews, sociodemographic information, suicide risk factors in addition to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnoses were used in current retrospective study of 772 suicide attempters in the emergency room at the Nazareth Hospital. Statistical analysis using SPSS version 17, Pearson χ2 analysis and percentage distribution were used for the statistical analysis. We considered the differences to be significant at the level of p < 0.05. Three fold frequency of suicide attempts were observed among females (77%) compared to males (23%), (P = 0.0001). During the year 2009 the suicide attempts prevalence was the highest 118 (15.3%) and during 2005 it was the lowest 77 (10%). 76.5% of the attempters arrived to the emergency room within 1 - 6 hours. A single suicide attempt was observed among 60% of males compared to 70.5% among females [OR = 0.846 (CI: 0.742 - 0.966)] additionally, more than one suicide attempt was notified among 40% of males whereas 29.5% among females [OR = 1.367 (CI: 1.099 - 1.701), (P = 0.007)]. Psychiatric patients (59.3%) performed more than one suicide attempt compared to normal subjects (21.5%), [OR = 2.76; CI: 2.276 - 3.354, P-value = 0.0001]. Drugs was preferred for suicide attempts in both genders (87.7%), especially among females compared to males (90.6% vs. 78.8% respectively), [OR = 0.869; CI: 0.801 - 0.942, P = 0.001]. 38 of males (21.3%) committed suicide attempts by causing accidents and self harm compared to 56 females (9.4%); [OR = 2.261; CI: 1.552 - 3.294, (P = 0.0001)]. 40 psychiatric patients (18.7%) chose this method compared to 54 non-psychiatric patients (9.7%), [OR = 1.925; CI: 1.32 - 2.806, P-value = 0.001]. The underlying causes of suicide were as follows: 50% social causes, 26% adjustment reactions and 24% psychiatric diseases. Conclusion: Being the first unique study to shed lights on the increasing phenomenon of suicide in the Arab community, our findings unveiled a tragic transition in the rate of suicide attempts in a supposedly conservative and religious community. Even though the rate of suicide attempts is lower than other communities it should not divert focus away from efforts to develop effective strategies to prevent suicide attempts, especially among females.

Share and Cite:

Haj, E. , Hag, E. , Hanna, R. , Kamal, F. , Bishara, B. and Abdalla, B. (2014) The Underlying Reasons of Suicide Attempts among Arab Population in the Holy-Land—Nazareth: View and Overview. Journal of Behavioral and Brain Science, 4, 190-200. doi: 10.4236/jbbs.2014.44021.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Coleman, J.S. and Coleman, J.S. (1994) Foundations of Social Theory. Harvard University Press, Cambridge.
[2] Marsella, A. and Yamada, A. (2000) Culture and Mental Health: An Introduction and Overview of Foundations, Concepts, and Issues. In: Cuellar, I. and Paniagua, F., Eds., Handbook of Multicultural Mental Health, Academic Press, San Diego, 3-24.
http://dx.doi.org/10.1016/B978-012199370-2/50002-X
[3] Goldston, D.B., Molock, S.D., Whitbeck, L.B., et al. (2008) Cultural Considerations in Adolescent Suicide Prevention and Psychosocial Treatment NIHPA. American Psychologist, 63, 14-31.
[4] Minois, G. (1999) History of Suicide: Voluntary Death in Western Culture. Johns Hopkins University Press, Baltimore.
[5] Spirito, A. and Esposito-Smythers, C. (2006) Attempted and Completed Suicide in Adolescence. Annual Review of Clinical Psychology, 2, 237-266.
http://dx.doi.org/10.1146/annurev.clinpsy.2.022305.095323
[6] Barclay, D.J. (1965) Durkheim’s One Cause of Suicide. American Sociological Review, 30, 875-886.
http://dx.doi.org/10.2307/2090966
[7] Windfuhr, K. and Kapur, N. (2011) International Perspectives on the Epidemiology and Aetiology of Suicide and Self-Harm. In: O’Connor, R., Platt, S. and Gordon, J., Eds., The International Handbook of Suicide Prevention. Wiley Blackwell, West Sussex, 27-57.
[8] O’Carroll, P., Berman, A., Maris, R., Moscicki, E., Tanney, B. and Silverman, M. (1996) Beyond the Tower of Babel: A Nomenclature for Suicidology. Suicide and Life-Threatening Behavior, 26, 237-252.
[9] Mehlum, L. (2001) Suicidal Behaviour and Personality Disorder. Current Opinion in Psychiatry, 14, 131-135.
http://dx.doi.org/10.1097/00001504-200103000-00006
[10] Everson, S.A., Goldberg, D.E., Kaplan, G.A., Cohen, R.D., Pukkala, E., Tuomilehto, J. and Salonen, J.T. (1996) Hopelessness and Risk of Mortality and Incidence of Myocardial Infarction and Cancer. Psychosomatic Medicine, 58, 113-121.
[11] Beck, A.T. (1967) Depression: Clinical, Experimental, and Theoretical Aspects. University of Pennsylvania Press, Philadelphia.
[12] Kessler, R.C., Chiu, W.T., Demler, O. and Walters, E.E. (2005) Prevalence, Severity, and Comorbidity of Twelve-Month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617-627.
http://dx.doi.org/10.1001/archpsyc.62.6.617
[13] Dombrovski, A.Y., Siegle, G.J., Szanto, K., Clark, L., Reynolds, C.F. and Aizenstein, H. (2012) The Temptation of Suicide: Striatal Gray Matter, Discounting of Delayed Rewards, and Suicide Attempts in Late-Life Depression. Psychological Medicine, 42, 1203-1215.
http://dx.doi.org/10.1017/S0033291711002133
[14] Moscicki, E.K. (2001) Epidemiology of Completed and Attempted Suicide: Toward a Framework for Prevention. Clinical Neuroscience Research, 1, 310-323.
http://dx.doi.org/10.1016/S1566-2772(01)00032-9
[15] Conwell, Y. and Brent, D. (1995) Suicide and Aging. Patterns of Psychiatric Diagnosis. International Psychogeriatrics, 7, 149-164.
http://dx.doi.org/10.1017/S1041610295001943
[16] Mann, J.J., Oquendo, M., Underwood, M.D. and Arango, V. (1999) The Neurobiology of Suicide Risk: A Review for the Clinician. Journal of Clinical Psychiatry, 60, 7-11.
[17] Niederkrotenthaler, T., Voracek, M. and Herberth, A. (2010) Role of Media Reports in Completed and Prevented Suicide: Werther v. Papageno Effects. British Journal of Psychiatry, 197, 234-243.
[18] Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (2010) Web-Based Injury Statistics Query and Reporting System (WISQARS).
www.cdc.gov/injury/wisqars/index.html
[19] Milligan, K. (2013) Cognitive Distortions as a Mediator between Early Maladaptive Schema and Hopelessness. PCOM Psychology Dissertations, Paper 256.
http://digitalcommons.pcom.edu/psychology_dissertations/256.
[20] Mann, J.J., Apter, A., Bertolote, J., et al. (2005) Suicide Prevention Strategies. JAMA, 294, 2064-2074.
http://dx.doi.org/10.1001/jama.294.16.2064
[21] Karch, D.L., Logan, J., McDaniel, D., Parks, S. and Patel, N. (2012) Surveillance for Violent Deaths—National Violent Death Reporting System, 16 States, 2009. MMWR Surveillance Summary, 61, 1-43.
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6106a1.htm?s_cid=ss6106a1_e#tab6
[22] Crosby, A.E., Han, B., Ortega, L.A., Parks, S.E. and Gfoerer, J. (2011) Suicidal Thoughts and Behaviors among Adults Aged ≥18 Years—United States, 2008-2009. MMWR Surveillance Summaries, 60, 1-22.
www.cdc.gov/mmwr/preview/mmwrhtml/ss6013a1.htm?s_cid=ss6013a1
[23] Wagman, B.I., Ireland, M. and Resnick, M.D. (2001) Adolescent Suicide Attempts: Risks and Protectors. Pediatrics, 107, 485-493.
http://dx.doi.org/10.1542/peds.107.3.485
[24] Appelbaum, P.S. (1993) Legal Liability and Managed Care. American Psychologist, 48, 251-257.
http://dx.doi.org/10.1037/0003-066X.48.3.251
[25] Mills, P.D., King, L.A., Watts, B.V. and Hemphill, R.R. (2013) Inpatient Suicide on Mental Health Units in Veterans Affairs (VA) Hospitals: Avoiding Environmental Hazards. General Hospital Psychiatry, 35, 528-536.
http://dx.doi.org/10.1016/j.genhosppsych.2013.03.021
[26] Fakhr, el Islam, M. (2000) Social Psychiatry and the Impact of Religion. In: Okasha, A. and Maj, M., Eds., Images in Psychiatry: An Arab Perspective, World Psychiatric Association, WPA Publications, Cairo, 21-36.
[27] Miniño, A.M., Arias, E., Kochanek, K.D., Murphy, S.L. and Smith, B.L. (2002) Deaths: Final Data for 2000. National Vital Statistics Reports, 50, 1-119.
[28] Weissman, M.M., Bland, R.C., Canino, G.J., et al. (1999) Prevalence of Suicide Ideation and Suicide Attempts in Nine Countries. Psychological Medicine, 29, 9-17.
http://dx.doi.org/10.1017/S0033291798007867
[29] Lubin, G., Glasser, S., Boyko, V. and Barell, V. (2001) Epidemiology of Suicide in Israel: A Nationwide Population Study. Social Psychiatry and Psychiatric Epidemiology, 36, 123-127.
http://dx.doi.org/10.1007/s001270050300
[30] Henriksson, M.M., Aro, H.M., Marttunen, M.J., Heikkinen, M.E., Isometsä, E.T., Kuoppasalmi, K.I. and Lönnqvist, J.K. (1993) Mental Disorders and Comorbidity in Suicide. American Journal of Psychiatry, 150, 935-940.
[31] Baumeister, R.F. (1990) Suicide as Escape from Self. Psychological Review, 97, 90-113.
http://dx.doi.org/10.1037/0033-295X.97.1.90
[32] Joe, S., Baser, R.S., Neighbors, H.W., Caldwell, C.H. and Jackson, J.S. (2009) 12-Month and Lifetime Prevalence of Suicide Attempts among Black Adolescents in the National Survey of American Life. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 271-282.
http://dx.doi.org/10.1097/CHI.0b013e318195bccf
[33] OECD (2013) Israel Is Poorest of All Developed Countries. The Jerusalem Post, 15 May 2013.
[34] Blumenfeld, O., Dichtiar, R. and Shohat, T. (2013) Trends in the Incidence of Type 1 Diabetes among Jews and Arabs in Israel. Pediatric Diabetes, 1399-5448.
[35] Harris, E.C. and Barraclough, B. (1997) Suicide as an Outcome for Mental Disorders. A Meta-Analysis. British Journal of Psychiatry, 170, 205-228.
http://dx.doi.org/10.1192/bjp.170.3.205

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.