The Profile of deliberate self-poisoning cases presenting at the emergency department of pelonomi regional hospital

Background Deliberate self-poisoning (DSP) remains a common method employed for suicide worldwide. Despite its frequent occurrence and the high cost required in its management, only few studies have been carried out on this subject in South Africa. Inadequate research into DSP in South Africa is a great concern as this may inadvertently result in an inadequate knowledge of health professionals on the general approach to victims presenting at emergency departments. This may consequently result in a poor clinical outcome of these cases. This study was aimed at determining the demographics of DSP cases presenting to the emergency department (ED) of Pelonomi hospital and also to enquire into the drugs/agents commonly used, reasons for DSP and the clinical outcome of these cases

Associations between Family Suicide and Personal Suicidal Behaviour among Youth in Kwazulu-Natal; South Africa

Background: For every suicide; a minimum of six people are affected. Given the increasing number of suicide deaths in South Africa; the associations between the suicide of a family member and personal suicidal behaviour were explored in grade 8 students.Method: Grade 8 students were asked to participate with parental consent and child assent. Demographic questionnaires were completed and formal psychometric assessment instruments were used.Results: Thirty-five (15.98) students reported knowing that a family member had committed suicide. The mean age was 13.3 years (range 13-15 years). There were significant associations between family suicide and students' self-reported involvement in physical fights; use of alcohol and concerns about physical health. Family suicide was associated with personal suicidal ideation; suicidal plans and suicide attempts. Higher scores were reported on the scales assessing depression; perceived stress and feelings of hopelessness by those having had a family member commit suicide. There were low scores for having a sense of mastery; self-esteem and perceived social support among those who had experienced a family member commit suicide.Conclusion: Significant associations were found between the suicide of a family member and personal suicidal behaviour among the participants. There appear to be negative associations at a psychological level for the youth in a family in which a family member has committed suicide. Family practitioners play an important role in the identification and management of suicidal behaviour. While there are organisations in South Africa that offer help to the family and friends of those who have committed suicide; specific programmes directed towards child/adolescent survivors appear to be limited; and this needs to be addressed. The limitations of the study are discussed

Religious beliefs, coping skills and responsibility to family as factors protecting against deliberate self-harm

Background. Deliberate self-harm (DSH) ranges from behaviours aiming to communicate distress or relieve tension; but where suicide is not intended, to suicide. Not all individuals are prone to DSH, which suggests that there are factors that protect against it. Identifying these could play an important role in the management and prevention of DSH. Objectives. This study examined whether religious beliefs, coping skills and responsibility to family serve as factors protecting against DSH in Kota Kinabalu, Sabah, Malaysia. Method. A cross-sectional comparative study assessed DSH patients consecutively admitted or directly referred to Queen Elizabeth General Hospital and Hospital Mesra Bukit Padang during the period December 2006 - April 2007. DSH patients (N=42) were matched with controls (N=42) for gender, age, religion, race, occupation and marital status. The DSH and control groups were compared using psychosocial tests that assess coping skills, religious beliefs and responsibility to family. Results. There were significant differences in religious beliefs (p=0.01) and responsibility to family (p=0.03) between the DSH patients and the control group. There were also significant differences in coping skills, DSH patients tending to use emotion-orientated coping (p=0.01) as opposed to taskand avoidance-orientated coping. caution is required in generalising the results owing to limitations of the study. Further extensive research on religious and psychotherapeutic interventions and prospective studies on protective factors will be helpful

A hundred cases of parasuicide: V. validation of the amharic version of hopelessness scale at St. Paul's General specialized referral hospital, AA, Ethiopia

Background: Hopelessness is an important variable in parasuicide and suicide. The need for a valid and reliable Amharic version (AV) of Hopelessness Scale (HS) for clinical screening is obvious. Objective: To test the validity and the reliability of the AV of HS. Methods: 100 consecutive parasuicide cases arriving at the OPD were included in this `retrospective descriptive clinical case study'. Self-rated AV of HS and interviewer-rated Expanded BPRS was administered. The AV of HS was validated against the corres- ponding item/items on the Expanded BPRS. Reliability test was also performed. Results: Concurrent validity: Yule's Q; between AV of HS and Expanded BPRS depression and suicidality items were 0.66265; p=0.00052 and 0.55585; p=0.04144 respectively. Construct validity: It was shown that cases with the intention `to die' had significantly higher (p=0.0028) HS scores than those without the intention. The association between the dichotomous measures of AV of HS and intention `to die' was very highly positive and significant (Yule's Q=0.89563; P=0.00011). No such relationships between the AV of HS scores and other 9 endorsed intentions/`reasons' for parasuicidal act with different themes. These findings indicate that the AV of HS has an acceptable construct validity to measure Hopelessness. Reliability: in item-total correlation test; only item no. 5 was eliminated due to low correlation coefficient (0.0370; p=0.715). Three more items were eliminated in factor analysis which yielded 3 factors similar to Beck's finding. Conclusion: The AV of HS has acceptable validity; reliability and factor loading. Items recommended to be discarded have to be re-translated/re-written to keep the meaning as close to the original (eng version) as possible. Further validation studies are advisable to be done. In the meantime; the AV of HS has to be applied clinically in vulnerable groups

A hundred cases of parasuicide: IV validation of the Amharic Version of IDA-Scale at St. Paul's General Specialised Referral Hospital; AA; Ethiopia

Background: There is a need for a valid and reliable Amharic version (AV) of IDA-Scale whose sub-scales measure irritability (inward and outward directed); depression and anxiety. Irritability which had emerged to be an important distinguishing characteristic of parasuicide cases can be easily tapped with IDA- Scale which is cost-effective andquickly administered. Objective: To test the validity and the reliability of each sub-scale. Methods: Retrospective and prospective data were collected from a cohort of 100 consecutive parasuicide cases and each followed for a period of five years. Self-rated AV of IDA-Scale and interviewer-rated Expanded BPRS (Brief Psychiatric Rating Scale) were administered. Each sub-scale was validated against the corresponding item/items on the Expanded BPRS. ROC curves were plotted for sub-scales to select the efficient cut-off scores. Reliability and validity tests were performed for each sub-scale. Results: The coefficient of association (Yule's Q) between depression; anxiety; extropunitiveness and intropunitiveness sub-scales and the corresponding item/items on Expanded BPRS were 0.83333 (p=0.0000); 0.72680 (p=0.00021); 0.49116 (p=0.01702) and 0.61821 (p=0.00029) respectively (all 2-tailed). One of the items of extropunitiveness sub-scale; IDA12; has low item-total correlation. This sub-scale; at its cut-off point; lacks the desired discriminating ability and could not manifest the expected relationship between PV+; specificity or positivity criterion. Its factor loading was also insignificant. Conclusion : Depression; anxiety and intropunitiveness sub-scales showed acceptable validity and reliability. IDA12 has to be re-translated/re-written to keep the meaning as close to the original (eng version) as possible and to ensure that terms are understood. Further validation of extropunitiveness sub-scale is advisable. In the meantime; the AV of IDA-Scale has to be applied clinically in vulnerable groups