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Suicidal Thoughts, Attempts and Motives Among University Students in 12 Muslim-Majority Countries

Psychiatric Quarterly volume 90, pages 229–248 (2019)Cite this article

Abstract

There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.

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References

  1. World Health Organisation. Preventing suicide: A global imperative. Geneva: WHO; 2014.

    Google Scholar 

  2. Goldman-Mellor SJ, Caspi A, Harrington H, Hogan S, Nada-Raja S, Poulton R, et al. Suicide attempt in young people: a signal for long-term health care and social needs. JAMA Psychiat. 2014;71:119–27.

    Article  Google Scholar 

  3. Shepard DS, Gurewich D, Lwin AK, Reed GA, Silverman MM. Suicide and suicidal attempts in the United States: costs and policy implications. Suicide Life Threat Behav. 2016;46:352–62.

    Article  PubMed  Google Scholar 

  4. Han B, Compton WM, Eisenberg D, Milazzo-Sayre L, McKeon R, Hughes A. Prevalence and mental health treatment of suicidal ideation and behavior among college students aged 18-25 years and their non-college-attending peers in the United States. J Clin Psychiatry. 2016;77:815–24.

    Article  PubMed  Google Scholar 

  5. Borges G, Benjet C, Orozco R, Medina-Mora ME, Menendez D. Alcohol, cannabis and other drugs and subsequent suicide ideation and attempt among young Mexicans. J Psychiatr Res. 2017;91:74–82.

    Article  PubMed  Google Scholar 

  6. Testa RJ, Michaels MS, Bliss W, Rogers ML, Balsam KF, Joiner T. Suicidal ideation in transgender people: gender minority stress and interpersonal theory factors. J Abnorm Psychol. 2017;126:125–36.

    Article  Google Scholar 

  7. Miranda-Mendizábal A, Castellví P, Parés-Badell O, Almenara J, Alonso I, Blasco MJ, et al. Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis. Br J Psychiatry. 2017;211:77–87.

    Article  PubMed  Google Scholar 

  8. Björkenstam E, Kosidou K, Björkenstam C. Childhood household dysfunction and risk of self-harm: a cohort study of 107 518 young adults in Stockholm County. Int J Epidemiol. 2016;45:501–11.

    Article  PubMed  Google Scholar 

  9. Björkenstam E, Dalman C, Vinnerljung B, Weitoft GR, Walder DJ, Burström B. Childhood household dysfunction, school performance and psychiatric care utilisation in young adults: a register study of 96 399 individuals in Stockholm County. J Epidemiol Community Health. 2016;70:473–80.

    Article  PubMed  Google Scholar 

  10. Rostila M, Berg L, Arat A, Vinnerljung B, Hjern A. Parental death in childhood and self-inflicted injuries in young adults-a national cohort study from Sweden. Eur Child Adolesc Psychiatry. 2016;25:1103–11.

    Article  PubMed  Google Scholar 

  11. Rosiek A, Rosiek-Kryszewska A, Leksowski Ł, Leksowski K. Chronic stress and suicidal thinking among medical students. Int J Environ Res Public Health. 2016;13:212.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Buron P, Jimenez-Trevino L, Saiz PA, Garcia-Portilla MP, Corcoran P, Carli V, et al. Reasons for attempted suicide in Europe: prevalence, associated factors, and risk of repetition. Arch Suicide Res. 2016;20:45–58.

    Article  CAS  PubMed  Google Scholar 

  13. Kleiman EM, Liu RT. Social support as a protective factor in suicide: findings from two nationally representative samples. J Affect Disord. 2013;150:540–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mackin DM, Perlman G, Davila J, Kotov R, Klein DN. Social support buffers the effect of interpersonal life stress on suicidal ideation and self-injury during adolescence. Psychol Med. 2017;47:1149–61.

    Article  CAS  PubMed  Google Scholar 

  15. Koch HJ. Suicides and suicide ideation in the Bible: an empirical survey. Acta Psychiatr Scand. 2005;112:167–72.

    Article  CAS  PubMed  Google Scholar 

  16. Nelson G, Hanna R, Houri A, Klimes-Dougan B. Protective functions of religious traditions for suicide risk. Suicidol Online. 2012;3:59–71.

    Google Scholar 

  17. Eskin M, Voracek M, Stieger S, Altinyazar V. A cross-cultural investigation of suicidal behavior and attitudes in Austrian and Turkish medical students. Soc Psychiatry Psychiatr Epidemiol. 2011;46:813–23.

    Article  PubMed  Google Scholar 

  18. Eskin M. Gender and cultural differences in the 12-month prevalence of suicidal thoughts and attempts in Swedish and Turkish adolescents. J Gend Cult Heal. 1999;4:187–200.

    Article  Google Scholar 

  19. Eskin M, Palova E, Krokavcova M. Suicidal behavior and attitudes in slovak and Turkish high school students: a cross-cultural investigation. Arch Suicide Res. 2014;18:58–73.

    Article  PubMed  Google Scholar 

  20. Eskin M, Sun J-M, Abuidhail J, Yoshimasu K, Kujan O, Janghorbani M, et al. Suicidal behavior and psychological distress in university students: a 12-nation study. Arch Suicide Res. 2016;20:369–88.

    Article  PubMed  Google Scholar 

  21. Lester D. Suicide and islam. Arch Suicide Res. 2006;10:77–97.

    Article  PubMed  Google Scholar 

  22. Pritchard C, Amanullah S. An analysis of suicide and undetermined deaths in 17 predominantly Islamic countries contrasted with the UK. Psychol Med. 2007;37:421–30.

    Article  PubMed  Google Scholar 

  23. Boehnke K, Lietz P, Schreier M, Wilhelm A. Sampling: the selection of cases for culturally comparative psychological research. Sampling: the selection of cases for culturally comparative psychological research. In: Matsumoto D, van de Vijver FJR, editors. Culture and psychology. Cross-cultural research methods in psychology. New York: Cambridge University Press; 2011. p. 101–29.

    Google Scholar 

  24. WHO. Suicide rates, age-standardized data by country. http://apps.who.int/gho/data/node.main.MHSUICIDEASDR?lang=en. 2015. Accessed 23 Feb 2017.

  25. Behling O, Law KS. Translating questionnaires and other research instruments: problems and solutions. Thousand Oaks: Sage; 2000.

    Book  Google Scholar 

  26. Boergers J, Spirito A, Donaldson D. Reasons for adolescent suicide attempts: associations with psychological functioning. J Am Acad Child Adolesc Psychiatry. 1998;37:1287–93.

    Article  CAS  PubMed  Google Scholar 

  27. Amiri L, Voracek M, Yousef S, Galadari A, Yammahi S, Sadeghi MR, et al. Suicidal behavior and attitudes among medical students in the United Arab Emirates. Crisis. 2013;34:116–23.

    Article  PubMed  Google Scholar 

  28. Eskin M. Suicidal behavior as related to social support and assertiveness among Swedish and Turkish high school students: a cross-cultural investigation. J Clin Psychol. 1995;51:158–72.

    Article  CAS  PubMed  Google Scholar 

  29. Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014;13:153–60.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ferrari AJ, Norman RE, Freedman G, Baxter AJ, Pirkis JE, Harris MG, et al. The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the global burden of disease study 2010. PLoS One. 2014;9:e91936.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Charara R, Forouzanfar M, Naghavi M, Moradi-Lakeh M, Afshin A, Vos T, et al. The burden of mental disorders in the eastern mediterranean region, 1990-2013. PLoS One. 2017;12:e0169575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Garlow SJ, Rosenberg J, Moore JD, Haas AP, Koestner B, Hendin H, et al. Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College screening project at Emory University. Depress Anxiety. 2008;25:482–8.

    Article  PubMed  Google Scholar 

  33. Wilcox HC, Arria AM, Caldeira KM, Vincent KB, Pinchevsky GM, O’Grady KE. Prevalence and predictors of persistent suicide ideation, plans, and attempts during college. J Affect Disord. 2010;127:287–94.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Sun L, Zhou C, Xu L, Li S, Kong F, Chu J. Suicidal ideation, plans and attempts among medical college students in China: the effect of their parental characteristics. Psychiatry Res. 2017;247:139–43.

    Article  PubMed  Google Scholar 

  35. Esen B, Gumuscu S. Rising competitive authoritarianism in Turkey. Third World Q. 2016;37:1581–606.

    Article  Google Scholar 

  36. Hoffman M, Jamal A. The youth and the Arab spring: cohort differences and similarities. Middle East Law Gov. 2012;4:168–88.

    Article  Google Scholar 

  37. Ciftci A, Jones N, Corrigan PW. Mental health stigma in the Muslim community. J Muslim Ment Health. 2013;7:17–32.

    Article  Google Scholar 

  38. Pompili M, Goracci A, Giordano G, Erbuto D, Girardi P, Klonsky ED, et al. Relationship of non-suicidal self-injury and suicide attempt: a psychopathological perspective. J Psychopathol. 2015;21:348–53.

    Google Scholar 

  39. Ajdacic-Gross V, Weiss MG, Ring M, Hepp U, Bopp M, Gutzwiller F, et al. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bull World Health Organ. 2008;86:726–32.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Stack S, Wasserman I. Race and method of suicide: culture and opportunity. Arch Suicide Res. 2005;9:57–68.

    Article  PubMed  Google Scholar 

  41. Nock MK. Self-injury. Annu Rev Clin Psychol. 2010;6:339–63.

    Article  PubMed  Google Scholar 

  42. Ward-Ciesielski EF, Schumacher JA, Bagge CL. Relations between nonsuicidal self-injury and suicide attempt characteristics in a sample of recent suicide attempters. Crisis. 2016;37:310–3.

    Article  PubMed  Google Scholar 

  43. Schrijvers DL, Bollen J, Sabbe BGC. The gender paradox in suicidal behavior and its impact on the suicidal process. J Affect Disord. 2012;138:19–26.

    Article  PubMed  Google Scholar 

  44. Värnik P. Suicide in the world. Int J Environ Res Public Health. 2012;9:760–71.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Denning DG, Conwell Y, King D, Cox C. Method choice, intent, and gender in completed suicide. Suicide Life Threat Behav. 2000;30:282–8.

    CAS  PubMed  Google Scholar 

  46. Kleiman EM, Adams LM, Kashdan TB, Riskind JH. Grateful individuals are not suicidal: buffering risks associated with hopelessness and depressive symptoms. Pers Individ Differ. 2013;55:595–9.

    Article  Google Scholar 

  47. Miller AB, Esposito-Smythers C, Leichtweis RN. Role of social support in adolescent suicidal ideation and suicide attempts. J Adolesc Health. 2015;56:286–92.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, College of Social Sciences and Humanities, Koc University, Rumelifeneriyolu 34450 Sariyer, Istanbul, Turkey

    Mehmet Eskin

  2. Al Dara Hospital and Medical Center, Riyadh, Saudi Arabia

    Fadia AlBuhairan

  3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Fadia AlBuhairan

  4. Epidemiology and Biostatistics, Rafsanjan Medical School, Rafsanjan, Iran

    Mohsen Rezaeian & Bahareh Behzadi

  5. Department of Psychology, Faculty of Arts, Alexandria University, Alexandria, Egypt

    Ahmed M. Abdel-Khalek

  6. Department of Psychology, Faculty of Arts and Sciences, Adnan Menderes University, Aydin, Turkey

    Hacer Harlak & Cennet Şafak Öztürk

  7. Department of Psychology, Faculty of Human Sciences, Beirut Arab University, Beirut, Lebanon

    Mayssah El-Nayal

  8. Department of Psychiatry, Medical College, Aga Khan University, Karachi, Pakistan

    Nargis Asad & Murad Moosa Khan

  9. Faculty of Education, Universiti Teknologi Malaysia, Johor, Malaysia

    Aqeel Khan

  10. Department of Psychiatry, University hospital of Monastir, Monastir, Tunisia

    Anwar Mechri

  11. Dr Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia

    Isa Multazam Noor

  12. School of Public Health, Al-Quds University, Jerusalem, Palestine

    Motasem Hamdan

  13. Department of Psychology, Khazar University, Baku, Azerbaijan

    Ulker Isayeva

  14. Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan

    Yousef Khader & Albaraa Khader

  15. Population Health Research Section-Hospital-MNGHA, King Abdullah International Medical Research Center / King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Alaa Al Sayyari

  16. Faculty of Medicine, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia

    Laifa Annisa Hendarmin

  17. Faculty of Health Professions, Department of Nursing, Al-Quds University, Jerusalem, Palestine

    Salam Khatib

Authors
  1. Mehmet Eskin
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  2. Fadia AlBuhairan
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  3. Mohsen Rezaeian
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  8. Aqeel Khan
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  17. Cennet Şafak Öztürk
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  19. Murad Moosa Khan
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  20. Salam Khatib
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Corresponding author

Correspondence to Mehmet Eskin.

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There is no conflict of interest for this paper.

Ethical Approval

Ethical or IRB approval was obtained in all study sites (countries). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Since participation in the study was voluntary and full anonymity was guaranteed informed consent was not obtained from all individual participants. This was written in the first page of the survey.

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Except the first author, the first twelve authors are by random order and the last seven authors are by alphabetical (first name) order.

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Eskin, M., AlBuhairan, F., Rezaeian, M. et al. Suicidal Thoughts, Attempts and Motives Among University Students in 12 Muslim-Majority Countries. Psychiatr Q 90, 229–248 (2019). https://doi.org/10.1007/s11126-018-9613-4

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Keywords

  • Suicide ideation
  • Suicide attempt
  • Suicidal motives
  • Young adults
  • Muslim world