Integrating a suicide prevention program into the primary health care network: a field trial study in Iran.

OBJECTIVE: To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. METHODOLOGY: This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. RESULTS: We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ (2) = 14.8, P < 0.001). We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. CONCLUSION: Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

Survey of suicide attempts in sari.

OBJECTIVE: Studying suicide can be of assistance to prepare the ground for the adoption of effective preventative measures. In the present study, our aim was an in-depth review of suicide epidemiology in the city of Sari, in the northern part of Iran. Our focus was on geo-demographic and other risk factors affecting the frequency of suicide in order to demonstrate populations with greater risk of suicide for future preventive and protective measures. METHOD: In a prospective study, during a one year period, a descriptive semi-structured questionnaire was used to conduct interviews with subjects who attempted suicide and referred to one of the four major trauma and emergency centers in the city of Sari, or with the relatives of those who completed their attempt. Convenience sampling method was used. Statistical analysis was performed using SPSS-20 software. Multivariate tests were based on χ(2) values. Logistic regression was performed estimating the effect of risk -factors. RESULTS: In this study, 228 suicide attempters were enrolled; of whom, 78.5% were female; 28.5% of all the attempts resulted in death. The odds of suicide completion were significantly increased in the following cases: married status (OR: 3.49; 95% CI 2.82,4.53), illiteracy (OR:2.71;95%CI 2.10,3.64), presence of comorbid physical illness (OR:2.22;95%CI 1.64,3.21), history of previous suicide attempt (OR:2.03; 95%CI 1.56,2.81), and age over 50 (OR: 2.01, 95% CI 1.14,3.05). Suicide outcome estimated worst in the married illiterate attempters. The leading method of use was suicide by burn (SBB). CONCLUSION: The variety observed in the regional distribution of suicide risk factors calls for more non-discriminatory attention and adoption of precautionary, preventative and protective measures for each section of the society accordingly.

The effect of "parental loss" under 18 on developing "MDD" in adult age.

OBJECTIVE: The aim of the study has been to search for the relations between Parental Loss in Childhood and Adolescence, and developing Major Depressive Disorder in Adulthood. METHOD: The Study had chosen the "Retrospective Case Control" method carried out over 64 patients admitted in University Hospitals of Tehran, who were suffering from MDD (matching DSM-IV-TR criteria), as the "Case Group" and 68 non-depressive admitted patients as the "Control Group." RESULTS: The study found that 19 out of 64 members of the "case group" (29.7%), and 7 out of 68 members of the "control group" (10.3%), has lost at least one parent under the age of 18. In other words, the prevalence of "parental loss" under 18 shows a meaningful increase in MDD among the "case group" in comparison with the "control group." CONCLUSION: The study concludes that there is a noticeable statistical relationship between the variants of "parental loss during childhood and adolescence" and the "MDD during adult age."