











































Editorial-1 [Converted].eps


The term suicide originated from Latin word “Sui” (of 
oneself) and “caedere” (to kill).1 It was first used by 
British physician Sir Thomas Browne in 1642. In 
United Kingdom it is the third contributor to death after 
coronary heart disease and cancer.2 It is alarming that 
the rate of suicide is gradually increasing day by day 
among the teenage and young men and women. World 
Health Organization put attention for suicide prevention 
in national and international level. Higher rates of 
suicide are found in eastern and northern Europe and 
lower rates in Mediterranean countries; the rate is very 
low in Islamic countries2 due to religious constraint. In 
Bangladesh the suicide rates are increasing among 
teenage and young group. It is also reported that in 
Bangladesh the rates have been highest in Jhenaidah.

The epidemiology of suicide indicates that two-thirds of 
the depressive patients have suicidal ideation, but 
11–17% (average 15%) of depressive patients die by 
suicide.2-4 Researchers found that suicide rate is 3 times 
more in male than female (M:F=3:1); but the rate of 
parasuicide (deliberate self-harm) is 2 times more in 
female than male (M:F=1:2).2

It has been mentioned that there is a four-fold increase 
in death rates of patients over age 55 years having 
depressive disorders in western world.3 In one study in 
United States it was found that more than two-thirds of 
those who die by suicide have expressed previously 
about the idea of suicide.2 It was also found that risk of 
suicide is more in those persons who write suicide note 
or tear up the note after writing.2 Researchers found 
that people who have intentionally harmed themselves 
(deliberate self-harm) have a much increased risk of  
suicide later on.2 Patients may commit suicide during 
the treatment of depressive disorder when they begin to 
improve and regain energy needed for plan to carry out 
suicide. This is called paradoxical suicide.

The questions may arise why people commit suicide. 
The answers remain in the main two domains: A. 
Psychological causes and B. Social causes. Among the 
psychological causes the following conditions are 
included: 

1.  Personality disorder (30–50%): This is predisposed 
to depressive illness and/or alcoholism. 

2.    Depressive disorder (15%) 
3.    Alcohol misuse (7%) (More in old group) 
4.    Drug misuse 
5.    Schizophrenia (7%) 
6.    Epilepsy (7%) 
7.    Chronic painful illness, eg, cancer 
8.  Widow, widower, separated, older and unmarried 

male 

Among the social causes the following factors may be 
responsible: 
1.    Eve teasing 
2.    Sexual abuse 
3.  Problems in relationship with partner/breaking of 

affairs 
4.    Stressful life events 
5.    Social isolation 
6.    Unemployment 
7.    Poverty 
8.    Poor physical ill health 
9.    Students  
10.  Doctors 
11.  Immigrants 
12.  Farmers 
13. Media coverage of suicide: Showing of fictional 

television program and films depicting suicide.2  
Sometimes people copy methods of suicide that 
have received wide media attention.

14. Mass suicide among the members of special 
religious community, eg, 913 followers of temple 
cult died in  Guyana in 1978 and 39 members of 
Heaven gate cult in California in 1997.2 Recently 
in Mymensingh (Bangladesh) a group of people of 
same family committed mass suicide by jumping 
under the train. 

15.  Pack suicide: In this case dominant partner of love 
affair initiates the suicide. Suicide pacts have to be 

Editorial

Fight against Suicide
doi: 10.3329/jemc.v5i1.21490

 

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Journal of Enam Medical College
Vol 5 No 1 January 2015



distinguished from cases where homicide is 
followed by suicide or where one person aids 
another person’s suicide without intending to kill 
himself. 

16. Previous suicide attempts: 40–60% of those who die 
by suicide have made previous attempts.5

For prevention of suicide we need multiple approaches.  
Among the suicide cases 65% suffered from depressive 
disorder and 15% were chronic alcoholics.5 Following 
measures will help to fight against suicide.
1.   Family education about morality and sound 

religious knowledge and practice which help the 
children to make up their development of good 
adjustable personality.

2.  Teaching the general practitioners about diagnosis 
and treatment of depressive disorders and other 
psychiatric disorders related to suicide.

3.  Better and  more  available  psychiatric services 
should be disseminated in the community.

4. Public awareness by campaigning to educate the 
people regarding suicide.

5.  Restricting the means of suicide by reducing 
availability of methods of suicide.

6.   Counseling services by crisis centers and ‘Hotlines’: 
Here people in despair are encouraged to contact a 
widely published telephone numbers. The help 
offered (befriending) is provided by non-
professional volunteers who are trained to listen 
sympathetically and empathetically also. 

7.    Long term medication for psychiatric patients: Less 
toxic antidepressant drugs for treatment of 
depressive disorders reduce the risk of suicidal 
behaviors. Lithium prophylaxis (mood stabilizer) 
reduces the suicide rates of patient having bipolar 
mood disorder (both depression and 
mania/hypomania). Clozapine (antipsychotic) may 
reduce suicidal attempts by patients with 
schizophrenia and schizoaffective disorders.2

Dewan AKM Abdur Rahim
Professor, Department of Psychiatry
Enam Medical College, Savar, Dhaka
Email: emc_savar@yahoo.com

References

1.  DK Illustrated Oxford Dictionary. New Delhi: Penguin 
Books India, 2006: 832

2.   Suicide and deliberate self-harm. In: Gelder M, Harrison P, 
Crowen P (eds). Oxford textbook of psychiatry. 5th edn. 
New Delhi: Oxford University Press, 2006: 407–428.

3.  Mood disorders. Kaplan Hl, Sadock BJ, Grebb JA (eds). 
Kaplan and Sadock’s  synopsis of psychiatry. 7th edn. New 
Delhi: Bl Waverly Pvt Ltd., 1994: 332–333.

4.  Black D, Winokur G, Hasrallah A. Suicide in subtypes of 
major affective disorders. Archives of Gen Psych 1987; 44: 
878–880.

5.  Roy A. Self-destructive behavior. In: Hill P, Murray R, 
Thorley A (eds). Essentials of postgraduate psychiatry. 2nd 
edn. G&S London 1986: 445–460.

 

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J Enam Med Col  Vol 5  No 1 January 2015


