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Biomedical subjects

Lakshmi Vijayakumar

Publications and source records attributed to Lakshmi Vijayakumar.

10 recordsLinked to original sources
PubMed2006

Do all children need intervention after exposure to tsunami?

Children are uniquely vulnerable in the context of a major natural disaster like tsunami. Post disaster intervention studies in children are few, especially from developing countries like India. An intervention programme for children was developed and conducted at Srinivasapuram, a coastal hamlet in Chennai, a year after tsunami. Sixty-five children who participated in all the six intervention modules were compared to 70 children who did not participate in the intervention. All the children were assessed before and after intervention using the Youth Self Report (YSR) form of Child Behaviour Check List (CBCL) in addition to PTSD symptoms. Children in the two groups were comparable in socio-demographic factors and exposure to tsunami. Prevalence of family psychopathology was more in the intervention group. Only hyperactivity problems were significantly reduced after intervention (z = 2.41 p = 0.016). Children in the intervention group appreciated expression of positive emotions (F = 8.044 p = 0.005) and were also more likely to desist from smoking (F = 6.102 p = 0.003) compared to the control group. The majority of the children are likely to be resilient and only children with pre-existing vulnerability require specific and specialized interventions.

Child↗
PubMed2005

Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey.

BACKGROUND: The objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community. METHOD: The community survey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys. RESULTS: Suicide attempts (0.4-4.2%), plans (1.1-15.6%), and ideation (2.6-25.4%) varied by a factor of 10-14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22% and 88% of the attempts. CONCLUSIONS: The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed.

Adult↗
PubMed2005

Characteristics of attempted suicides seen in emergency-care settings of general hospitals in eight low- and middle-income countries.

BACKGROUND: The objective was to describe patients presenting themselves at emergency-care settings following a suicide attempt in eight culturally different sites [Campinas (Brazil), Chennai (India), Colombo (Sri Lanka), Durban (South Africa), Hanoi (Viet Nam), Karaj (Iran), Tallinn (Estonia), and Yuncheng, (China)]. METHOD: Subjects seen for suicide attempts, as identified by the medical staff in the emergency units of 18 collaborating hospitals were asked to participate in a 45-minute structured interview administered by trained health personnel after the patient was medically stable. RESULTS: Self-poisoning was the main method of attempting suicide in all eight sites. Self-poisoning by pesticides played a particularly important role in Yuncheng (71.6% females, 61.5% males), in Colombo (43.2% males, 19.6% females), and in Chennai (33.8% males, 23.8% females). The suicide attempt resulted in danger to life in the majority of patients in Yuncheng and in Chennai (over 65%). In four of the eight sites less than one-third of subjects received any type of referral for follow-up evaluation or care. CONCLUSIONS: Action for the prevention of suicide attempts can be started immediately in the sites investigated by addressing the one most important method of attempted suicide, namely self-poisoning. Regulations for the access to drugs, medicaments, pesticides, and other toxic substances need to be improved and revised regulations must be implemented by integrating the efforts of different sectors, such as health, agriculture, education, and justice. The care of patients who attempt suicide needs to include routine psychiatric and psychosocial assessment and systematic referral to professional services after discharge.

Adult↗
PubMed2005

Suicide in developing countries (1): frequency, distribution, and association with socioeconomic indicators.

OBJECTIVE: Suicide is a global public health problem, but relatively little epidemiological investigation of the phenomenon has occurred in developing countries. This paper aims to (1) examine the availability of rate data in developing countries, (2) provide a description of the frequency and distribution of suicide in those countries for which data are available, and (3) explore the relationship between country-level socioeconomic factors and suicide rates. It is accompanied by two companion papers that consider risk factors and preventive efforts associated with suicide in developing countries, respectively. METHOD: Using World Health Organization data, we calculated the average annual male, female, and total suicide rates during the 1990s for individual countries and regions (classified according to the Human Development Index [HDI]), and examined the association between a range of socioeconomic indicators and suicide rates. RESULTS: For reasons of data availability, we concentrated on medium HDI countries. Suicide rates in these countries were variable. They were generally comparable with those in high HDI countries from the same region, with some exceptions. High education levels, high telephone density, and high per capita levels of cigarette consumption were associated with high suicide rates; high levels of inequality were associated with low suicide rates. CONCLUSION: Epidemiological investigations of this kind have the potential to inform suicide prevention efforts in developing countries, and should be encouraged.

Cause of Death↗
PubMed2005

Suicide in developing countries (2): risk factors.

The majority of studies on risk factors for suicide have been conducted in developed countries, and less work has been done to systematically profile risk factors in developing countries. The current paper presents a selective review of sociodemographic, clinical, and environmental/situational risk factors in developing countries. Taken together, the evidence suggests that the profiles of risk factors in developing countries demonstrate some differences from those in developed countries. In some developing countries, at least, being female, living in a rural area, and holding religious beliefs that sanction suicide may be of more relevance to suicide risk than these factors are in developed countries. Conversely, being single or having a history of mental illness may be of less relevance. Risk factors that appear to be universal include youth or old age, low socioeconomic standing, substance use, and previous suicide attempts. Recent stressful life events play a role in both developing and developed countries, although their nature may differ (e.g., social change may have more of an influence in the former). Likewise, access to means heightens risk in both, but the specific means may vary (e.g., access to pesticides is of more relevance in developing countries). These findings have clear implications for suicide prevention, suggesting that preventive efforts that have shown promise in developed countries may need to be tailored differently to address the risk factor profile of developing countries.

Adolescent↗
PubMed2005

Suicide in developing countries (3): prevention efforts.

Until now, suicide prevention efforts have been limited in developing countries, although there are pockets of excellent achievement. Various universal, selective, and indicated interventions have been implemented, many of which target a different pattern of risk factors to those in developed countries. In the absence of sufficient mental health services, developing countries rely heavily on nongovernment organizations (NGOs) to provide crisis interventions for suicidal individuals, as well as proactive interventions aimed at raising community awareness and building resilience. Often these NGOs work within a social and public health framework, collaborating with others to provide nested suicide prevention programs that are responsive to local community needs. There is a clear need to develop appropriate, relevant and effective national suicide prevention plans in developing countries, since, to date, only Sri Lanka has done so. These plans should focus on a range of priority areas, specify the actions necessary to achieve positive change in these priority areas, consider the range of collaborators required to implement these actions, and structure their efforts at national, regional, and local levels. The plans should also promote the collection of accurate data on completed and attempted suicide, and should foster evaluation efforts.

Crisis Intervention↗
PubMed2005

Suicide and mental disorders in Asia.

Sixty one percent of the suicides in the world occur in Asia. The suicide rate of Asia has been calculated as 12.6/100,000. This is an underestimate as data is unavailable for 20.7% of the Asian population. Population-based studies on suicide in Asia reveal that 68-97% had diagnosable psychiatric disorders. Only 35-40% of suicides in India and China received the diagnosis of depression. The association between depression and suicide is less pronounced in Asia. Demographic and socio-cultural risk factors for suicide in Asia are different from Western countries but clinical factors appear to be more similar than different. Suicide is a major public and mental health problem in Asia and there is an urgent need to develop effective national suicide prevention strategy in Asian countries.

Alcoholism↗
PubMed2004

Altruistic suicide in India.

Altruistic suicide has a long history in India, even being noted in the Dharmashastras, an ancient religious text. In ancient India, two forms of altruistic suicide were practiced. One was Jauhar, a kind of mass suicide by women of a community when their menfolk suffered defeat in battle; the other was Sati, a suicide of a widow on the funeral pyre of her husband or after the cremation. The practice of Jauhar ended with the fall of the Muslim rule and the practice of Sati is against the law, but cases of Sati still occur. The act of Sati is now seen as suicide, not as altruistic, and there are laws against abetment and glorification. Specific ancient cases and more modern ones are presented to illustrate this type of suicide.

Journal Article↗