Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Bridging the gap: Policy recommendations to address suicides committed by Indigenous youth in Victoria(AccScience Publishing, 2024-12) Shoib, S.; Das, S.; Saeed, F.; Chandradasa, M.; Zaidi, I.The Aboriginal population comprises 3.3% of the total Australian population, and youth represent 19% of this segment. In general, the Aboriginal inhabitants of Australia experience discrimination, limited access to education, and low socioeconomic conditions, and exhibit high mental disorder rates. The rate of suicide attempts by the Indigenous people of Victoria increased by 75% in 2021. This study examined the possible risk factors associated with suicides committed by Indigenous youth in Victoria. It focused on the health profiles of Victorian Aboriginal individuals, identified stakeholders who could help improve their mental well-being, addressed the needs and issues related to Aboriginal mental health, and examined substance abuse in this population segment. Finally, recommendations are offered to mitigate the studied problem. Rising suicide rates represent an urgent concern because they reflect the diminished mental health conditions of a society, particularly among its marginalized populations. It is crucial to develop an integrated suicide prevention act that takes into account the biological, psychological, social, cultural, and spiritual determinants of this population.Item Suicide among psychiatrists: From healers to seekers of mental health care(Elsevier, 2024) Shoib, S.; Saeed, F.; Ahmed, S.; Park, C.; Roza, T.H.; Nazari, S.K.; Armiya'u, A.Y.; Berardis, D.; Mahesar, R.A.; Chandradasa, M.Addressing suicide and mental health issues among psychiatrists, particularly during a crisis such as the COVID-19 pandemic is important. several factors contribute to this risk, such as long duty hours, burnout, emotional exhaustion, exposure to secondary trauma, and the impact of the pandemic on the mental health of healthcare workers. This paper emphasizes the urgent need for interventions at individual and organizational levels to address burnout and mental health issues among psychiatrists. Supporting the mental resilience of mental health professionals will improve the mental health of the community.Item Early career psychiatrists' perspectives on managing stigma and discrimination related to suicide(Elsevier, 2024) Shoib, S.; Chandradasa, M.; Lengvenyte, A.; Armiya'u, A.Y.; Saleem, T.; Ahmed, S.; Noor, I.M.; Nazari, S.K.; de Berardis, D.; Park, C.; Gürcan, A.; Saeed, F.No abstract availableItem The effectiveness of telehealth interventions in suicide prevention: A systematic review and meta-analysis(Sage Publishing, 2024) Shoib, S.; Shaheen, N.; Anwar, A.; Saad, A.M.; Akr, L.M.; Saud, A.I.; Kundu, M.; Nahidi, M.; Chandradasa, M.; Swed, S.; Saeed, F.BACKGROUND: Suicidal attempt is a significant risk factor for future attempts, with the highest risk during the first-year post-suicide. Telepsychiatry has shown promise by providing easy access to evidence-based interventions during mental health crises. AIMS: investigation the effectiveness of telehealth interventions in suicide prevention. METHODS: Four electronic databases (PubMed, Scopus, Web of Science, and Ovid) were systematically searched for studies on patients undergoing telepsychiatry intervention (TPI) up to June 2022. Following PRISMA guidelines, a systematic review and meta-analysis were conducted to investigate the effectiveness of telehealth interventions in suicide prevention. Continuous data were pooled as standardised mean difference (SMD), and dichotomous data were pooled as risk ratio using the random effects model with the corresponding 95% confidence intervals (CI). RESULTS: Sixteen studies were included in the review. Most studies were case-control and randomised controlled trials conducted in Europe and North America. The findings of the studies generally showed that TPIs are effective in reducing suicide rates (odds ratio = 0.68; 95% CI [-0.47, 0.98], p = .04) and suicidal reattempts. The interventions were also found to be well-accepted, with high retention rates. CONCLUSION: Our results suggest that TPIs are well-accepted and effective in reducing suicide rates and reattempts. It is recommended to maintain telephone follow-ups for at least 12 months. Further research is needed to understand the potential of telepsychiatry in suicide prevention fully.Item Suicide by suffocation with a plastic bag(Ceylon Medical Association, 1998) Tennakoon, U.A.; Jayawardena, H.Death by suffocation using a plastic bag has not been recorded in Sri Lanka. We report such a case here. Findings at the scene, the history, and autopsy and laboratory investigations assisted in arriving at the conclusion of suicide.Item Association between loneliness and suicidal behaviour: A scoping review(Ankara:Türkiye Sinir ve Ruh Sağliği Derneği, 2023) Shoib, S.; Amanda, T.W.; Saeed, F.; Ransing, R.; Bhandari, S.S.; Armiya'u, A.Y.; Gürcan, A.; Chandradasa, M.OBJECTIVE: Suicide is a public health issue, and there are several factors leading to suicide, like mental illness and psychosocial stressors. Actual loneliness (living alone) and subjective loneliness (feeling of being alone) and different suicidal behaviors have been reported to have some link. This scoping review aimed to assess the association between loneliness and suicidal behaviour by exploring the existing literature. METHODS: A scoping review was conducted implementing the appropriate framework and in accord with the PRISMA-ScR extension. A PubMed database search was made using a combination of terms to find publications in English from 2011 to 2021. Studies were included if they reported quantitative outcomes of the association between loneliness and suicidal experiences, including suicidal thoughts, plans, and/or attempts. Screening and data charting of the published literature was conducted by a panel of authors. The accuracy and clarity of extracted data was checked by three reviewers. RESULTS: Among 421 articles found, 31 full texts were evaluated based on exclusion and inclusion criteria, out of which, 18 papers that reported quantitative outcomes of the association between loneliness and suicidal experiences were included. We found that association between loneliness and suicidal behaviour is determined by individual, social and cultural factors. Co-existing mental illness, substance use disorder and economic hardship play an important role for the completion of suicide. CONCLUSION: Loneliness is correlated with suicide, and the knowledge about this association could assist in the identification of suicidal individuals or those at elevated risk of suicidal behaviour. Future studies should focus on loneliness and its relation to suicidal ideation in individuals with different mental health disorders and personalities.Item Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis(Royal College of Psychiatrists, 2023) Arafat, S.M.Y.; Baminiwatta, A.; Menon, V.; Singh, R.; Varadharajan, N.; Guhathakurta, S.; Mahesar, R.A.; Rezaeian, M.BACKGROUND: Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention. AIMS: We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries. METHOD: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts. RESULTS: From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean. CONCLUSIONS: The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.Item Depression and suicidal behavior in South Asia: a systematic review and meta-analysis(Cambridge University Press, 2022) Arafat, S.M.Y.; Saleem, T.; Menon, V.; Ali, S.A.Z.; Baminiwatta, A.; Kar, S.K.; Akter, H.; Singh, R.Background. Estimates of depression in suicidal behavior in South Asia would help to formulate suicide prevention strategies in the region that hasn’t been assessed yet. Objectives. We aimed to systematically assess the prevalence of depression in fatal and nonfatal attempts of suicide in eight South Asian countries. Methods. We searched Medline, Embase, and PsychINFO by specific search terms to identify articles assessing depression in fatal and non-fatal attempts of suicide in South Asian countries published between 2001 and 2020. Two separate meta-analyses were conducted for fatal and non-fatal attempts. Due to the high heterogeneity of studies (96–98%), randomeffects models were used to calculate pooled prevalence rates. Results. A total of 38 studies was identified from five south Asian countries (India [27], Pakistan [6], Sri Lanka [3], Nepal [1], and Bangladesh [1]). The majority of studies (n = 27) were published after 2010. Twenty-two studies reported non-fatal attempts, and sixteen reported suicide. The prevalence of depression among non-fatal attempts ranged from 14% to 78% where the pooled prevalence rate was 32.7% [95% CI 26–39.3%]. The prevalence of depression among suicides ranged from 8% to 79% where the pooled prevalence estimate was 37.3% [95% CI 26.9–47.6%]. Conclusions. This review revealed the pooled prevalence of depression among fatal and nonfatal suicidal attempts in South Asian countries, which seems to be lower when compared to the Western countries. However, a cautious interpretation is warranted due to the heterogeneity of study methods, sample size, and measurement of depression.Item A possible link between air pollution and suicide?(Paris Masson-Elsevier, 2023) Shoib, S.; Khan, M.A.; Javed, S.; Das, S.; Chandradasa, M.; Soron, T.R.; Saeed, F.No abstract availableItem Emerging pesticides responsible for suicide in rural Sri Lanka following the 2008-2014 pesticide bans.(BioMed Central, 2020) Weerasinghe, M.; Pearson, M.; Konradsen, F.; Agampodi, S.; Sumith, J. A.; Jayamanne, S.; Senanayake, S. M. H. M. K.; Rajapaksha, S.; Eddleston, M.BACKGROUND: Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. METHODS: We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners' records, and the person's family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides. RESULTS: We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time was statistically significant (R square 0.846, F 16.541, p 0.027). CONCLUSIONS: Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka. KEYWORDS: Pesticide; Pesticide regulation; Self-poisoning; Sri Lanka; Suicide.