Risk Factors Associated with Overdose Among Bahraini Youth
Corresponding Author
Ahmed M. Al Ansari MBCHB, FRCPc
Consultant Child Psychiatrist, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Consultant Child Psychiatrist, Ministry of Health, Psychiatric Hospital, P.O. Box 12, State of Bahrain. Tel.: (0973) 279300. Fax: (0973) 686022. E-mail: [email protected].Search for more papers by this authorRandah R. Hamadeh BSc, MSc, DPhil (Oxon)
Associate Professor with the College of Medicine and Medical Sciences, Arabian Gulf University, Manama, State of Bahrain.
Search for more papers by this authorAli M. Matar MD, MPH
Consultant Psychiatrist, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Search for more papers by this authorHuda Marhoon MD
Chief Resident, Child & Adolescent Unit, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Search for more papers by this authorBana Y. Buzaboon PHD
Clinical Psychologist with the Bahrain Defence Force Hospital, State of Bahrain.
Search for more papers by this authorAhmed G. Raees PhD
Clinical Psychologist, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Search for more papers by this authorCorresponding Author
Ahmed M. Al Ansari MBCHB, FRCPc
Consultant Child Psychiatrist, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Consultant Child Psychiatrist, Ministry of Health, Psychiatric Hospital, P.O. Box 12, State of Bahrain. Tel.: (0973) 279300. Fax: (0973) 686022. E-mail: [email protected].Search for more papers by this authorRandah R. Hamadeh BSc, MSc, DPhil (Oxon)
Associate Professor with the College of Medicine and Medical Sciences, Arabian Gulf University, Manama, State of Bahrain.
Search for more papers by this authorAli M. Matar MD, MPH
Consultant Psychiatrist, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Search for more papers by this authorHuda Marhoon MD
Chief Resident, Child & Adolescent Unit, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Search for more papers by this authorBana Y. Buzaboon PHD
Clinical Psychologist with the Bahrain Defence Force Hospital, State of Bahrain.
Search for more papers by this authorAhmed G. Raees PhD
Clinical Psychologist, Psychiatric Hospital, Ministry of Health, P.O. Box 12, Manama, State of Bahrain.
Search for more papers by this authorThis study was partially supported by a grant from The College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.
Abstract
The aim of this study was to identify the risk factors of overdose among Bahraini youth (15–24 years). These factors included psychiatric disorders, family pathology, and psychosocial stress. All suicide attempters in the country during an 18-month period (N = 100) were identified prospectively. One hospital-matched control was selected for each case. Both cases and controls underwent a semistructured personal interview in the two state general hospitals. A matched pair analysis was done, as well as computation of McNemar's continuity corrected chi-square test, odds ratio, and the 95% confidence interval of the odds ratio. The overdose attempter was more likely than the control to be unemployed, a member of a non-intact family, having a mother whose education was high school or above, not having a friend, involved in a boy/girlfriend relationship, and a cigarette smoker. More students among attempters had failed an examination in the past year than matched controls. Father's education, social class, death of father, recent row with a friend, use of drugs and alcohol, relationship with teachers, recent mobility, financial difficulties, and legal problems were similar in both groups. Stresses generated from living in a non-intact family, interpersonal relationships mainly with the opposite sex, unemployment, and school performance came out as the main risk factors. The association of previously identified risk factors such as depression, aggressive behavior, and use of drug and alcohol was low among attempters. While the results of this study are consistent with the present view that suicidal behaviors are multifactorial in origin, the magnitude and effect of each factor are culturally determined.
REFERENCES
- Adam, S.D.M., Overholser, D. C., & Spirito, A. (1994). Stressful life events associated with adolescent suicide attempts. Canadian Journal of Psychiatry, 39, 43–48.
- Al Ansari, A., & Matar, A. M. (1993). Recent stressful life events among Bahraini adolescents with adjustment disorders. Adolescence, 28, 339–346.
- Al. Ansari, A.M.S., Hamadeh, R. R., Matar, A. M., Buzahoon, B., Marhoon, H., & Raees, A. G. (1997). Overdose among youth in Bahrain: Psychosocial characteristics, contact with helping agencies and problems. Journal of Royal Society for Health, 117, 366–373.
- American Psychiatric Association (APA). (1987). Diagnostic and statistical manual of mental disorders ( 3rd ed. rev.) Washington, DC: APA.
- Andrews, J. A., & Lewinsohn, P. M. (1992). Suicide attempts among older adolescents: Prevalence and co-occurrence with psychiatric disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 655–662.
- Bahrain Health Information Directorate (BHID). (1998). Health Statistics, 1996–1997. Bahrain: Health Information Directorate, Ministry of Health.
- Beautrias, A. L., Joyce, P. R., & Mulder, R. T. (1996). Risk factors for serious suicide attempts among youth aged 13 through 24 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1174–1182.
- Beskow, J. (1979). Suicide and mental disorder in Swedish men. Acta Psychiatrica Scandinavica, Suppl., 277.
- Blumenthal, S. J. (1988). Suicide: A guide to risk factors, assessment, and treatment of suicidal patients. Medical Clinic of North America, 72, 937–971.
- Brent, D. A. (1995). Risk factors for adolescent suicide and suicidal behavior: Mental and substance abuse disorders, family environmental factors, and life stress. Suicide and Life Threatening Behavior, 25, (Suppl.), 52–63.
- Brent, D. A., Perper, J. A., & Allman, C. J. (1987). Alcohol, firearms and suicide among youth. Journal of the American Medical Association, 257, 3369–3372.
- Cheng, A. T. (1995). Mental illness and suicide. Archives of General Psychiatry, 52, 594–603.
- Clark, D. C., Sommerfeldt, S. M., Hedeker, D., & Watel, L. (1990). Physical recklessness in adolescence, trait or byproduct of depression/suicidal states. Journal of Nervous Disease and Mental Disorder, 178, 423–433.
- Directorate of Statistics. (1994). Statistical abstract 1993, Bahrain: Directorate of Statistics, Central Statistics Organization.
-
Eskin, M. (1995). Suicidal behavior as related to social support and assertiveness among Swedish and Turkish high school students: A cross-cultural investigation.
Journal of Clinical Psychology, 51, 158–172.
10.1002/1097-4679(199503)51:2<158::AID-JCLP2270510204>3.0.CO;2-H CAS PubMed Web of Science® Google Scholar
- Farmer, R., & Creed, F. (1989). Life events and hostility in self poisoning. British Journal of Psychiatry, 154, 390–395.
- Fergusson, D. M., & Lynsky, M. T. (1995). Childhood circumstance, adolescent adjustment and suicidal attempts in New Zealand birth cohort. Journal of American Academy of Child and Adolescent Psychiatry, 34, 612–622.
- Garnefski, N., & Diekstra, R.F.W. (1997). Adolescents from one parent, stepparent and intact families: Emotional problems and suicide attempts. Journal of Adolescence, 20, 201–208.
- Garrison, C. Z., McKeown, R. E., Valois, R. F., & Vincent, M. L. (1993). Aggression, substance use and suicide behaviors in high school students. American Journal of Public Health, 83, 179–184.
- Grossman, D. C., Milligan, C., & Deyo, R. A. (1991). Risk factors for suicide attempts among Navajo adolescents. American Journal of Public Health, 81, 870–874.
- Hawton, J., O'Grady, J., Oshorn, M., & Cole, D. (1982). Adolescents who take overdose: Their characteristics, problems and contact with helping agencies. British Journal of Psychiatry, 140, 118–123.
- Hawton, K. (1987). Assessment of suicide risk. British Journal of Psychiatry, 150, 145–153.
- Hawton, K., Fagg, J., & Hawkins, M. (1993). Factors associated with suicide after parasuicide in young people. British Medical Journal, 306, 1641–1644.
-
Hollingshead, A. B., &
Redlich, F. C. (1958). Social class and mental illness. New York: Wiley.
10.1037/10645-000 Google Scholar
- Iga, M. (1981). Suicide of Japanese youth. Suicide and Life-Threatening Behavior, 11, 17–30.
- Joun, H. S., Nam, J. J., & Ensminger, I.M.E. (1994). Epidemiology of suicidal behavior among Korean adolescents. Journal of Child Psychology and Psychiatry, 35, 663–676.
- Kerfoot, M., & Huxley, P. (1995). Suicide and deliberate self-harm in young people. Current Opinon in Psychiatry, 8, 214–217.
- N. Kreitman (Ed.). (1977). Parasuicide. London: John Wiley.
- Miettinen, O. S. (1974). Simple interval estimation of risk ratio [Abstract]. American Journal of Epidemiology, 100, 515–516.
- Moscicki, E. K. (1995). Suicide in childhood and adolescence. In The epidemiology of child and adolescent psychopathology (pp. 291–308). F. C. Verhulst, & H. M. Koot, (Eds.), New York: Oxford University Press.
- Newcomb, M. D., & Bentler, P. M. (1986). Cocaine use among adolescents: longitudinal associates with social contest, psychopathology and use of other substance. Addictive Behavior, 11, 263–273.
- Nordstom, P., Samaelsson, M., & Asberg, M. (1995). Survival analysis of suicide risk after attempted suicide. Acta Psychiatrica Scandinavica, 91, 336–340.
- Overholser, J. C., Freiheit, S. R., & DiFilippo, J. M. (1997). Emotional distress and substance abuse as risk factor for suicide attempts. Canadian Journal of Psychiatry, 42, 402–407.
- Paluszny, M., Davenport, C. & Kim W. J. (1991). Suicide attempts and ideation: Adolescents evaluation on a pediatric ward. Adolescence, 26, 210–215.
- Paykel, E. S. (1976). Life stress, depression and attempted suicide. Journal of Human Stress, 2, 3–12.
- Paykel, E. S., Prusoff, B. A., & Myers, J. K. (1975). Suicide attempts and recent life events. Archive of General Psychiatry, 32, 327–333.
- Power, K. G., Cocke, D. J., & Brooks, D. N. (1985). Life stress, medical lethality and suicide intent. British Journal of Psychiatry, 147, 655–659.
- Rich, C. L., Fowler, R. C., Fogarty, L. A., & Young, D. (1988). San Diego suicide study 111—Relationships between diagnoses and stresses. Archives of General Psychiatry, 45, 589–92.
- Rich, C. L., Young, D., & Fowler, R. C. (1986). San Diego suicide study I. Young vs old subjects. Archives of General Psychiatry, 43, 577–582.
- Rich, C. L., Warsradt, G., Nemiroff, R., Fowler, R. C., & Young, D. (1991). Suicide, stresses and the life cycle. American Journal of Psychiatry, 148, 524–527.
- Roy, A. (1982). Risk factors for suicide in psychiatric patients. Archives of General Psychiatry, 39, 1089–1095.
- Runeson, B. (1990). Suicide and mental disorder in Swedish Youth. Unpublished doctoral dissertation, University of Goteberg, Sweden.
- Schlesselman, J. J. (1982). Case control studies: Design, conduct, analysis. Oxford: Oxford University Press.
-
Schmidtke, A.,
Bille-Brahe, U.,
Deleo, D.,
Kerkhof, A.,
Bjerke, T.,
Crepet, P.,
Haring C.,
Hawton, K.,
Lonnqvist, J.,
Michel, K.,
Pommereau, Y.,
Querejeta, I.,
Phillipe, I.,
Slander-Reuberg, E.,
Temesvary, B.,
Wasserman, D.,
Fricke, S.,
Weinacker, B., &
Sampaio-Faria, J. G. (1996). Attempted suicide in Europe: Rates, trends and sociodemographic characteristics of suicide attempters during the period 1982–1992. Results of WHO/EUPO Multicentre study on parasuicide.
Acta Psychiatrica Scandinavica, 93, 327–338.
10.1111/j.1600-0447.1996.tb10656.x Google Scholar
- Spirito, A., Overholser, J., & Stark, L. (1989). Common problems and coping strategies, II. Findings with adolescent suicide attempters. Journal Abnormal Child Psychology, 17, 213–221.
- Swedo, S. E., Rettew, D. C., Kuppenheimer, M., Lum, D., Dolan, S., & Goldberger, E. (1991). Can adolescent suicide attempters be distinguished from at-risk adolescents Pediatrics, 98, 620–629.
- Woods, E. R., Lin, Y. G., Middleman, A., Beckford, P., Chase, L., & Durant, R.I.F. (1997). The association of suicide attempts in adolescents. Pediatrics, 99, 791–796.
