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Fulltext Parasuicides in Kuala Lumpur. A descriptive study

Orr JW, Pu TN

Singapore Med J, 1985 Apr;26(2):161-70.
PMID: 4035398

This study presents the demographical characteristics of 271 cases of parasuicide seen at the Psychiatric Clinic, General Hospital, Kuala Lumpur, during 1982. The majority of cases were women in the 20 - 30 year age group, from a lower economic class, with minimal education. About one-half were single and 61.5% were actively religious. The racial breakdown was Indians 55%, Chinese 32% and Malays 13%. Self-poisoning using easily available drugs was the most common method employed and more than one-half intended to die at the time of the suicidal act. Most attempts were impulsive, carried out while alone, inside the
house. The findings are discussed and compared with earlier studies of attempted suicides in Malaysia and Singapore.

Study site: Psychiatric Clinic, General Hospital

Matched MeSH terms: Suicide, Attempted*
Fulltext Religious affiliation and suicidality among college students in China: A cross-sectional study across six provinces

Lew B, Kõlves K, Zhang J, Zhizhong W, Koenig HG, Yip PSF, et al.

PLoS One, 2021;16(5):e0251698.
PMID: 34010317 DOI: 10.1371/journal.pone.0251698

BACKGROUND: Several past studies indicated that religious beliefs, orientation, and practice are protective of suicide. Findings from recent studies in China suggest that religiosity may contribute to increased suicidality. However, few studies have examined the associations between religious affiliation across different faiths and suicidality in China.
OBJECTIVE: The current study examines the association between religious affiliation and suicidality among college students in six provinces in China.
METHODS: We conducted a cross-sectional study involving 11,407 college students from six universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, and Shaanxi. We collected the data between October 2017 and March 2018 using self-report questionnaires. They included self-report measures of depression, psychache, hopelessness, self-esteem, social support, and life purpose.
RESULTS: Participants with a Christian affiliation had 1.5 times (95% CI: 1.14, 1.99, p = 0.004) higher odds of indicating an elevated suicide risk, 3.1 times (95% CI: 1.90, 5.04, p<0.001) higher odds of indicating a previous suicide attempt, and increased overall suicidality (B = 0.105, p < 0.001) after accounting for demographic and risk/protective factors. Christians also scored the highest in depression, psychache, hopelessness, and the lowest social support, self-esteem, and purpose in life. Muslims reported decreased suicidality (B = -0.034, p = 0.031). Buddhism/Daoism yielded non-significant results in the multivariate analyses.
CONCLUSIONS: Christian college students reported increased suicidality levels, perhaps due to public policies on religion. The decreased suicidality levels among Muslims may be attributed to higher perceived social support. The associations between religious affiliation and suicidality, depression, and hopelessness contrast sharply with US samples. This finding may be influenced by interactions between the religious denomination, individual, and social/political factors. This conclusion includes the possibility of anti-religious discrimination, which this paper did not investigate as a possible mediator and therefore remains a conjecture worthy of future investigation.

Matched MeSH terms: Suicide, Attempted/psychology*
Fulltext Development and validation of Yatt Suicide Attitude Scale (YSAS) in Malaysia

Ibrahim N, Che Din N, Amit N, Ghazali SE, Mohd Safien A

PLoS One, 2019;14(2):e0209971.
PMID: 30811425 DOI: 10.1371/journal.pone.0209971

INTRODUCTION: Despite suicide rate becoming a growing trend in research locally and globally, there is no standard measuring instrument developed in Malaysia. The aim of this study is to establish the first ever Malay version of suicide screening tool that is suitable and fit with multiracial and complex culture of Malaysia.
METHODS: This study comprises of three phases, namely (1) items selection phase, (2) pilot study phase, and (3) scale validation phase. During the first phase, the items were selected from items pools which gathered from previous suicide ideation/ attitude scales. Then the pilot study was carried out to examine the items for Yatt Suicide Attitude Scale (YSAS). Lastly, the Yatt Suicide Attitude Scale (YSAS) validation study was conducted with 219 university students.
RESULTS: Initial version of YSAS comprised 16 items and three components. After factor analysis, the questionnaire was reduced into only two components (Suicide Ideation and Suicide Attempt) with 5 items each. Both of the components obtained high reliability value (.89 and.86 respectively) and the questionnaire accounted for 67.84% of the total variance.
CONCLUSION: The analysis showed that YSAS has an acceptable reliability and validity for Malaysian population. Although these findings corroborate literature on development of suicide ideation assessment instrument for specific cultural context, there is a need to further examine its reliability with clinical population and general population of different cultural context in Malaysia.

Matched MeSH terms: Suicide, Attempted/psychology*
Suicide attempts among depressed inpatients with depressive disorder in a Malaysian sample. Psychosocial and clinical risk factors

Chan LF, Maniam T, Shamsul AS

Crisis, 2011;32(5):283-7.
PMID: 21940256 DOI: 10.1027/0227-5910/a000088

Depressed inpatients constitute a high-risk population for suicide attempts.

Matched MeSH terms: Suicide, Attempted/psychology*; Suicide, Attempted/statistics & numerical data
Fulltext Suicide Precipitants Differ Across the Lifespan but Are Not Significant in Predicting Medically Severe Attempts

Choo CC, Chew PKH, Ho RC

Int J Environ Res Public Health, 2018 04 05;15(4).
PMID: 29621197 DOI: 10.3390/ijerph15040691

An important risk factor for suicide assessment is the suicide precipitant. This study explores suicide attempt precipitants across the lifespan. Three years of medical records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. These cases were divided into three age groups: Adolescence, Early Adulthood, and Middle Adulthood. A total of 540 cases were examined (70.9% females; 63.7% Chinese, 13.7% Malays, 15.9% Indians), whose ages ranged from 12 to 62. There were eight cases above the age of 65 years which were excluded from the analysis. Significant differences were found in precipitants for suicide attempts across the lifespan. Middle adults had relatively fewer relationship problems, and adolescents had comparatively fewer financial and medical problems. The models to predict medically severe attempts across the age groups using suicide precipitants were not significant. The findings were discussed in regards to implications in suicide assessment and primary prevention in Singapore, as well as limitations and recommendations for future research.

Matched MeSH terms: Suicide, Attempted/psychology*; Suicide, Attempted/statistics & numerical data*
A cross-sectional observation of the factors associated with deliberate self-poisoning with acetaminophen: impact of gender differences and psychiatric intervention

Zyoud SH, Awang R, Sulaiman SA, Al-Jabi SW

Hum Psychopharmacol, 2010 Aug;25(6):500-8.
PMID: 20737523 DOI: 10.1002/hup.1140

The objectives of this study were to determine the risk factors and life stressors that are prevalent among the acetaminophen deliberate self-poisoning (DSP) cases, to identify gender differences in the associated factors, and to determine the prevalence of psychiatric diagnosis and the patterns and types of psychotherapeutic interventions provided by psychiatrists.

Matched MeSH terms: Suicide, Attempted/prevention & control; Suicide, Attempted/psychology*; Suicide, Attempted/statistics & numerical data*
Self-poisoning by drugs and chemicals: variations in demographics, associated factors and final outcomes

Fathelrahman AI, Ab Rahman AF, Mohd Zain Z

Gen Hosp Psychiatry, 2008 Sep-Oct;30(5):467-70.
PMID: 18774431 DOI: 10.1016/j.genhosppsych.2008.04.004

OBJECTIVE: Drug overdose exposures were compared with chemical poisoning in terms of demographics, associated factors and final outcomes.
METHOD: Deliberate self-poisoning (DSP) cases admitted to Penang General Hospital during the years 2000-2004 were studied. Chi-square, independent t-test and binary logistic were used whenever applicable.
RESULTS: Indian patients were more likely to use household products, whereas Malay and Chinese patients were more likely to take drug overdoses (P=.001). Drug overdose victims experienced more socioeconomic problems (P=.05) and were more likely to be admitted to the intensive care unit (P=.052). Chemical poisoning patients presented earlier (P=.011), were hospitalized for shorter time (P=.001) and had a higher rate of mortality (P=.01).
CONCLUSION: The present study has identified a unique ethnic variation in the choice of suicide attempts from toxic substances. DSP associated with drug overdose showed significant morbidity, but increased mortality was seen in chemical poisoning.

Matched MeSH terms: Suicide, Attempted/ethnology*; Suicide, Attempted/psychology; Suicide, Attempted/statistics & numerical data
Fulltext Corrosive oesophageal stricture in Malaysian adults

Krishnan MMS, Tan KC

Med J Malaysia, 1983 Dec;38(4):325-6.
PMID: 6599992

M. M. Sudhakar Krishnan, MS, FRCS (Edin & Glasg).
Department of Surgery, University Hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Suicide, Attempted
Fulltext Pharmaceuticals Poisoning: Reported by the National Poison Centre in Malaysia between 2010 and 2015

Alwan IA, Awadh AI, Tangiisuran B, Khan HRM, Yahaya N, Majid MI

J Pharm Bioallied Sci, 2020 10 08;12(4):475-481.
PMID: 33679096 DOI: 10.4103/jpbs.JPBS_340_19

Background and Purpose: The wide availability of medications has led to an increased exposure of humans to the possibility of poisoning. An unavoidable effect due to the availability of these medications has also led to a rising increment in the number of poisoning cases. All drugs, especially when administered in large doses or overextended periods, can initiate a toxic condition. Therefore, the objective of this study was to examine nationwide, the patterns attributed to poisoning, and to describe the sociodemographic, and geographic distribution of poisoning, by identifying the category of substances implicated in these cases.
Data Sources and Methods: A retrospective study based on telephone calls reported on poisoning caused by pharmaceutical products undertaken by the National Poisoning Centre (NPC) in Penang (Malaysia) was used as the basis of this study covering the period between 2010 and 2015. The study included the mode and type of poisoning, exposure routes as well as the incidence locations.
Results: A total of 10,998 cases were examined, finding that females represented 5,899 cases (53.6%) being intoxicated more frequently compared to the number of males, 3,839 (34.9%). The age group of poisoning cases ranged between 20 and 29 years representing 2,579 (23.4%) of reported cases. The common mode of poisoning was attributed to suicide 5,203 (47.3%) from among the 10,998 cases and the highest poisoning agents reported were from the psychiatric group of pharmaceutical products of 2,287 (21%).
Conclusion and Implications: These findings indicate a rising trend of suicidal poisoning attempts between 2013 and 2015, which emphasizes the need for more stringent and effective enforcement protocols to limit the rising incidence of poisoning. As such, analyzing the trends in poisoning in a particular zone periodically could help health policy-makers to develop management policies and prevention strategies.

Matched MeSH terms: Suicide, Attempted
Factors Associated With Suicidal Attempt Among School-Going Adolescents in Malaysia

Abdul Aziz FA, Abd Razak MA, Ahmad NA, Awaluddin SM, Lodz NA, Sooryanarayana R, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):73S-79S.
PMID: 31353928 DOI: 10.1177/1010539519862161

Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
Study name: National Health and Morbidity Survey (NHMS-2017)

Matched MeSH terms: Suicide, Attempted
Malaysian Stakeholder Perspectives on Suicide-Related Reporting: Findings From Focus Group Discussions

Ng YP, Pheh KS, Panirselvam RR, Chan WL, Lim JBY, Lim JTY, et al.

Front Psychol, 2021;12:673287.
PMID: 34079502 DOI: 10.3389/fpsyg.2021.673287

Media guidelines on safe suicide-related reporting are within the suicide prevention armamentarium. However, implementation issues beleaguer real-world practice. This study evaluated the perspectives of the Malaysian media community, persons with lived experience of suicidal behavior (PLE), and mental health professionals (MHP) on suicide-related reporting in terms of the impact, strategies, challenges, and the implementation of guidelines on safe reporting. Three focus group discussions of purposively sampled Malaysian media practitioners (n = 8), PLE (n = 6), and MHP (n = 7) were audio-recorded, transcribed, coded and thematically analyzed. Inclusion criteria were: English fluency, no clinical depression or suicidal ideation (current), no recent previous suicide attempts or suicide bereavement. Three major themes emerged: (1) Unsafe Reporting; (2) Impact; and (3) Safe Reporting. Most described current reporting as unsafe by being potentially triggering to media users and may contribute to contagion effect. Positive impacts identified included raised awareness toward suicide and its prevention. Unsafe reporting was attributed to inadequate awareness, knowledge, and guidance, lack of empathy and accountability, job-related factors, popularity-seeking, lack of monitoring and governance, and information source(s) with unsafe content. Majority agreed on how suicide stories should be framed to produce a safe report. The media community diverged on how detailed a suicide story should be. Safe reporting challenges included difficulties in balancing beneficial versus harmful details, social media ubiquity and its citizen reporters. Participants suggested these safe reporting strategies: stakeholder engagement, educational approaches, improving governance and surveillance, and guidelines revision. Most acknowledged the relevance of guidelines but were unaware of the existence of local guidelines. Implementation challenges included the dilemma in balancing media industry needs vis-à-vis safe reporting requirements, stakeholder engagement difficulties and social media regulation. There is poor awareness regarding safe suicide-related reporting across all groups. PLE and MHP were negatively impacted by current unsafe messaging which aggravated trauma and grief reactions. Postvention support gaps for mental health professionals were highlighted. Safe reporting promotion strategies should include stakeholder engagement to increase awareness on minimizing Werther and maximizing Papageno effects. Strategic re-examination and dissemination of local media guidelines to address new media issues, and effective surveillance mechanisms, are crucial in sustainable improvement of safe reporting practices.

Matched MeSH terms: Suicide, Attempted
Fulltext Delayed neuropsychiatry sequelae (DNS) Of carbon monoxide (CO) poisoning - a case report

Arasalingam, Shamini, Ahmad Faizal Shamsuddin, Hatta Sidi, Hjh Rabai'ah Mohd Salleh

ASEAN Journal of Psychiatry, 2015;16(1):131-134.
MyJurnal

Objective: Several cases of suicide attempt by charcoal burning producing CO have been reported in Malaysia. This case report highlights a case of delayed delayed neuropsychiatry sequelae (DNS) in CO poisoning.
Method: We report a young Chinese homemaker who presented with DNS who was detained in a Malaysian forensic psychiatric ward.
Results: After approximately two weeks of admission, in a familicide attempt, she had started to exhibit subtle changes in her behaviour, including social withdrawal, impaired memory, and there was lack of emotional distress.
Conclusion: We report an interesting DNS as one of the two forms of chronic sequelae of CO poisoning, whereas the other type of neuropsychiatric sequelae is the persistently progressive type.

Matched MeSH terms: Suicide, Attempted
Fulltext Cannabis as a risk factor for persistent and severe depression: a case report

Khadijah Hasanah, A.A., Aia Harlina, A.R., Nik Ruzyanei, N.J.

Malaysian Journal of Psychiatry, 2014;23(2):73-76.
MyJurnal

Evidence linking cannabis use and depression remains inconsistent. Variations of clinical features were observed in those with history of cannabis use presented with affective symptoms. We report a case of a 19-year-old male college student with a history of heavy cannabis use for at least seven months. A month after stopping cannabis, he presented with severe persistent depressive symptoms. He had no withdrawal symptoms prior to this. He had severe depressive symptoms with melancholic features and progressed to multiple and serious suicidal attempts. While the use of cannabis is implicated in neither the patient’s diagnosis nor management, its use has a significant role in influencing the clinical features and course of the illness. This case suggests that depression can start long after cessation of cannabis use with the history of cannabis remained as a significant risk factor.

Matched MeSH terms: Suicide, Attempted
Half a century of suicide studies - a plea for new directions in research and prevention

Maniam T, L. F. Chan

Sains Malaysiana, 2013;42:399-402.

Suicide studies in Malaysia tend to be repetitive. Data from hospital studies, small scale community surveys and national epidemiological studies over nearly 50 years have consistently shown that there are real ethnic differences in terms of suicides and attempted suicides in this country, though some of these differences appear to be narrowing somewhat. Malays have shown significantly lower rates of suicidal ideas, attempts and completed suicides. Indians, on the other hand, figure prominently at the other end with high rates in all the above parameters. The reasons for these are also necessarily complex. Experience elsewhere from studies of the Indian diaspora have elucidated a number of explanations, which include the effects of poverty, acculturation, alcoholism, the lack of a strong religious protective factor as well as increased rates of mental ill-health. Efforts to contain this public health problem have been somewhat patchy. This has largely depended on efforts by non-government organizations such as the Befrienders whereas the public response
lags behind in providing the financial and other resources necessary for a comprehensive national program. This paper reviews the relevant literature and suggest new areas for research as well as steps to provide a fresh impetus to suicide prevention in Malaysia.

Matched MeSH terms: Suicide, Attempted
Fulltext Gender differences and psychological factors associated with suicidal ideation among youth in Malaysia

Ibrahim N, Amit N, Che Din N, Ong HC

Psychol Res Behav Manag, 2017;10:129-135.
PMID: 28496374 DOI: 10.2147/PRBM.S125176

Suicide is a global phenomenon that has been showing an upward trend in recent years. It is the second leading cause of death among youth. Studies on suicidal ideation warrant greater attention, as it leads to suicide attempts and other health risk behaviors. Thus, the objective of this study was to compare gender differences in suicidal ideation and determine the predictors of suicidal ideation among youth. This cross-sectional study was carried out among 232 youths aged between 15 and 25 years from selected urban areas in Malaysia. The results showed that suicidal ideation was higher among male participants compared with female participants. Age was the predictor of suicidal ideation for males, while depression and loss of motivation, as components of hopelessness, were the predictors of suicidal ideation among females. Hence, it is important that professionals conduct early identification tests for suicidality among young people. This will facilitate the early detection of depression and hopelessness, which is important, in order to prevent suicidal behaviors or other problems before these occur.

Matched MeSH terms: Suicide, Attempted
Fulltext Reasons for Living and Coping with Suicidal Ideation among Adolescents in Malaysia

Din NC, Ibrahim N, Amit N, Kadir NBA, Halim MRTA

Malays J Med Sci, 2018 Sep;25(5):140-150.
PMID: 30914870 MyJurnal DOI: 10.21315/mjms2018.25.5.13

Introduction: The rate of suicide ideation everywhere continues to increase, and adolescents are therefore at risk of displaying suicidal behaviour. This study examined the protective role of the reasons for living and coping strategies in reducing suicidal ideation among young adolescents in Malaysia.
Methods: A cross-sectional survey was conducted among 176 adolescents aged between 13 and 19 years of age with the majority being Malay and Muslim. The Brief Reasons for Living for Adolescents (BRFL-A), Jalowiec Coping Scale and Suicide Ideation Scale were employed.
Results: The results showed that the reasons for living and palliative coping strategy correlated negatively with suicide ideation; although, further analysis using multiple regression revealed that family alliance and optimistic and palliative coping strategies were found to be significant reasons for living that protect adolescents from suicidal thoughts. Also, those adolescents who used emotive and evasive coping strategies had higher suicidal ideation.
Conclusion: Cultural and social values continue to play an important role in protecting adolescents in Malaysia from suicidal behaviour.

Matched MeSH terms: Suicide, Attempted
Meta-analysis of polymorphisms in TPH2 gene and suicidal behavior

Choong MY, Tee SF, Tang PY

Psychiatry Res, 2014 Dec 30;220(3):1163-6.
PMID: 25219619 DOI: 10.1016/j.psychres.2014.07.076
Matched MeSH terms: Suicide, Attempted/psychology*
Fulltext Clinical and sociodemographic correlates of suicidality in patients with major depressive disorder from six Asian countries

Lim AY, Lee AR, Hatim A, Tian-Mei S, Liu CY, Jeon HJ, et al.

BMC Psychiatry, 2014;14:37.
PMID: 24524225 DOI: 10.1186/1471-244X-14-37

BACKGROUND: East Asian countries have high suicide rates. However, little is known about clinical and sociodemographic factors associated with suicidality in Asian populations. The aim of this study was to evaluate the factors associated with suicidality in patients with major depressive disorder (MDD) from six Asian countries.
METHODS: The study cohort consisted of 547 outpatients with MDD. Patients presented to study sites in China (n = 114), South Korea (n = 101), Malaysia (n = 90), Singapore (n = 40), Thailand (n = 103), and Taiwan (n = 99). All patients completed the Mini-International Neuropsychiatric Interview (MINI), the Montgomery-Asberg Depression Rating Scale (MADRS), the Global Severity Index(SCL-90R), the Fatigue Severity Scale, the 36-item short-form health survey, the Sheehan Disability Scale, and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients were classified as showing high suicidality if they scored ≥ 6 on the MINI suicidality module. Multivariate logistic regression analysis was used to examine sociodemographic and clinical factors related to high suicidality.
RESULTS: One hundred and twenty-five patients were classed as high suicidality. Unemployed status (adjusted odds ratio [OR] 2.43, p < 0.01), MADRS score (adjusted OR 1.08), p < 0.001, and GSI (SCL-90R) score (adjusted OR 1.06, p < 0.01) were positively related to high suicidality. Hindu (adjusted OR 0.09, p < 0.05) or Muslim (adjusted OR 0.21, p < 0.001) religion and MSPSS score (adjusted OR 0.82, p < 0.05) were protective against high suicidality.
CONCLUSIONS: A variety of sociodemographic and clinical factors were associated with high suicidality in Asian patients with MDD. These factors may facilitate the identification of MDD patients at risk of suicide.

Matched MeSH terms: Suicide, Attempted/psychology*
Fulltext National Suicide Registry Malaysia (NSRM)

Hayati AN, Kamarul AK

Med J Malaysia, 2008 Sep;63 Suppl C:50-4.
PMID: 19227674

To create a nationwide system to capture data on completed suicide in Malaysia i.e. the morbidity, geographic and temporal trends and the population at high risk of suicide. Data from this registry can later be used to stimulate and facilitate further research on suicide. This paper describes the rationale and processes involved in developing a national suicide registry in 2007. The diagnosis of suicide is based on the ICD-10 codes for fatal intentional self-harm (X60-X84). A case report form with an accompanying instruction manual had been prepared to ensure systematic and uniform data collection. State Forensic Pathologist's offices are responsible for data collection in their respective states, and in turn will submit the data to a central data management unit. Data collection began in July 2007 and currently in data cleaning process. Training for source data producers is ongoing. In 2008, the NSRM plans to involve university hospitals into its network as currently only Ministry of Health hospitals are involved. The NSRM will be launching its online application for case registration this year while an overview of results will be available via its public domain at www.nsrm.gov.my beginning 20 April 2008. To efficiently capture the data on suicide, a concerted effort between various agencies is needed. A lot of conceptual work and data base development remains to be done in order to position preventive efforts on a more solid foundation.

Matched MeSH terms: Suicide, Attempted/statistics & numerical data
The prevalence and correlates of alcohol use disorder amongst bipolar patients in a hospital setting, Malaysia

Yee HA, Loh HS, Ng CG

Int J Psychiatry Clin Pract, 2013 Oct;17(4):292-7.
PMID: 23170840 DOI: 10.3109/13651501.2012.752012

To determine the prevalence of alcohol-use disorder and associated correlates amongst bipolar patients in a university hospital in Malaysia.

Matched MeSH terms: Suicide, Attempted/statistics & numerical data*

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