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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study</title><author><name sortKey="Ayehu, Moges" sort="Ayehu, Moges" uniqKey="Ayehu M" first="Moges" last="Ayehu">Moges Ayehu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Medicine,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation></author><author><name sortKey="Solomon, Tarekegn" sort="Solomon, Tarekegn" uniqKey="Solomon T" first="Tarekegn" last="Solomon">Tarekegn Solomon</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Public and Environmental Health,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation></author><author><name sortKey="Lemma, Kinfe" sort="Lemma, Kinfe" uniqKey="Lemma K" first="Kinfe" last="Lemma">Kinfe Lemma</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Medicine,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28439293</idno><idno type="pmc">5399339</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399339</idno><idno type="RBID">PMC:5399339</idno><idno type="doi">10.1186/s13033-017-0136-4</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000905</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000905</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study</title><author><name sortKey="Ayehu, Moges" sort="Ayehu, Moges" uniqKey="Ayehu M" first="Moges" last="Ayehu">Moges Ayehu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Medicine,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation></author><author><name sortKey="Solomon, Tarekegn" sort="Solomon, Tarekegn" uniqKey="Solomon T" first="Tarekegn" last="Solomon">Tarekegn Solomon</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Public and Environmental Health,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation></author><author><name sortKey="Lemma, Kinfe" sort="Lemma, Kinfe" uniqKey="Lemma K" first="Kinfe" last="Lemma">Kinfe Lemma</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Medicine,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Mental Health Systems</title><idno type="eISSN">1752-4458</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Suicide is a major public health problem worldwide. It contributes for more than one million deaths each year. Since previous suicidal attempt was considered as the best predictor of future suicide, identifying factors behind suicidal attempt are helpful to design suicide prevention strategies. The aim of this study was to assess socio-demographic characteristics, clinical profile and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of general hospitals in South Ethiopia.</p></sec><sec><title>Methods</title><p>We conducted a cross-sectional study on patients presenting with complications of suicidal attempt to emergency departments of two general hospitals in Hawassa city from November, 2014 to August, 2015. Data was collected using semi-structured questionnaire which contained socio-demographic and clinical variables. The Mini International Neuropsychiatric Interview version 5 (MINI PLUs) was used to assess the prevalence of existing mental illness among study participants. Data was entered and analyzed using IBM SPSS statistics 21 software package.</p></sec><sec><title>Results</title><p>A total of 96 individuals were assessed, of whom 56 (58.3%) were females. The mean age of study participants was 21.5 (8.0) years. The majority, 75 (78.1%), of the study participants were aged below 25 years. Ingesting pesticide poisons and corrosive agent were used by the majority to attempt suicide. Mental illness was found in only three (3.1%) of the study participants. Impulsivity (the time between decision to attempt suicide and the actual attempt of less than 5 min) was reported by 30 (31.2%) of the study participants, of whom 18 (60%) were males. Males were found three times more likely to attempt suicide impulsively than women (COR = 3.0, 95% CI 1.2–7.3). Quarreling with family members, facing financial crisis, and having unplanned and unwanted pregnancy were reported by the majority of study participants as immediate reasons to attempt suicide.</p></sec><sec><title>Conclusions</title><p>The presence of stressful life events and impulsivity behind suicidal behavior of the younger generation implies that designing suicide prevention strategies for this group is crucial. Moreover, further research is needed to systematically examine the relationship between the presence of mental illness and suicidal attempt with a larger sample size and more robust methodology.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bekry, Aa" uniqKey="Bekry A">AA Bekry</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alem, A" uniqKey="Alem A">A Alem</name></author><author><name sortKey="Jacobsson, L" uniqKey="Jacobsson L">L Jacobsson</name></author><author><name sortKey="Kebede, D" uniqKey="Kebede D">D Kebede</name></author><author><name sortKey="Kullgren, G" uniqKey="Kullgren G">G Kullgren</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lester, D" uniqKey="Lester D">D Lester</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vijayakumar, L" uniqKey="Vijayakumar L">L Vijayakumar</name></author><author><name sortKey="Nagaraj, K" uniqKey="Nagaraj K">K Nagaraj</name></author><author><name sortKey="Pirkis, J" uniqKey="Pirkis J">J Pirkis</name></author><author><name sortKey="Whiteford, H" uniqKey="Whiteford H">H Whiteford</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vijayakumar, L" uniqKey="Vijayakumar L">L Vijayakumar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jenkins, R" uniqKey="Jenkins R">R Jenkins</name></author><author><name sortKey="Kovess, V" uniqKey="Kovess V">V Kovess</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kessler, Rc" uniqKey="Kessler R">RC Kessler</name></author><author><name sortKey="Berglund, P" uniqKey="Berglund P">P Berglund</name></author><author><name sortKey="Borges, G" uniqKey="Borges G">G Borges</name></author><author><name sortKey="Nock, M" uniqKey="Nock M">M Nock</name></author><author><name sortKey="Wang, Ps" uniqKey="Wang P">PS Wang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lemaster, Pl" uniqKey="Lemaster P">PL LeMaster</name></author><author><name sortKey="Beals, J" uniqKey="Beals J">J Beals</name></author><author><name sortKey="Novina, Dk" uniqKey="Novina D">DK Novina</name></author><author><name sortKey="Manson, Sm" uniqKey="Manson S">SM Manson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Linden, M" uniqKey="Linden M">M Linden</name></author><author><name sortKey="Barnow, S" uniqKey="Barnow S">S Barnow</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baca Garcia, E" uniqKey="Baca Garcia E">E Baca-Garcia</name></author><author><name sortKey="Perez Rodruigez, M" uniqKey="Perez Rodruigez M">M Perez-Rodruigez</name></author><author><name sortKey="Oquendo, Ma" uniqKey="Oquendo M">MA Oquendo</name></author><author><name sortKey="Keyes, Km" uniqKey="Keyes K">KM Keyes</name></author><author><name sortKey="Hasin, Ds" uniqKey="Hasin D">DS Hasin</name></author><author><name sortKey="Grant, Bf" uniqKey="Grant B">BF Grant</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Brown, Gk" uniqKey="Brown G">GK Brown</name></author><author><name sortKey="Beck, At" uniqKey="Beck A">AT Beck</name></author><author><name sortKey="Steer, Ra" uniqKey="Steer R">RA Steer</name></author><author><name sortKey="Grisham, Jr" uniqKey="Grisham J">JR Grisham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fawcett, J" uniqKey="Fawcett J">J Fawcett</name></author><author><name sortKey="Scheftner, Wa" uniqKey="Scheftner W">WA Scheftner</name></author><author><name sortKey="Fogg, L" uniqKey="Fogg L">L Fogg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Goldstein, Rb" uniqKey="Goldstein R">RB Goldstein</name></author><author><name sortKey="Black, Dw" uniqKey="Black D">DW Black</name></author><author><name sortKey="Nasrallah, A" uniqKey="Nasrallah A">A Nasrallah</name></author><author><name sortKey="Winokur, G" uniqKey="Winokur G">G Winokur</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harris, Ec" uniqKey="Harris E">EC Harris</name></author><author><name sortKey="Barraclough, B" uniqKey="Barraclough B">B Barraclough</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shibre, T" uniqKey="Shibre T">T Shibre</name></author><author><name sortKey="Hanlon, C" uniqKey="Hanlon C">C Hanlon</name></author><author><name sortKey="Medhin, G" uniqKey="Medhin G">G Medhin</name></author><author><name sortKey="Alem, A" uniqKey="Alem A">A Alem</name></author><author><name sortKey="Kebede, D" uniqKey="Kebede D">D Kebede</name></author><author><name sortKey="Teferra, S" uniqKey="Teferra S">S Teferra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gunnell, Dj" uniqKey="Gunnell D">DJ Gunnell</name></author><author><name sortKey="Peters, Tj" uniqKey="Peters T">TJ Peters</name></author><author><name sortKey="Kammerling, Rm" uniqKey="Kammerling R">RM Kammerling</name></author><author><name sortKey="Brooks, J" uniqKey="Brooks J">J Brooks</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ramdurg, S" uniqKey="Ramdurg S">S Ramdurg</name></author><author><name sortKey="Goyal, S" uniqKey="Goyal S">S Goyal</name></author><author><name sortKey="Goyal, P" uniqKey="Goyal P">P Goyal</name></author><author><name sortKey="Sagar, R" uniqKey="Sagar R">R Sagar</name></author><author><name sortKey="Sharan, P" uniqKey="Sharan P">P Sharan</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Schlebusch, L" uniqKey="Schlebusch L">L Schlebusch</name></author><author><name sortKey="Vawda, Nb" uniqKey="Vawda N">NB Vawda</name></author><author><name sortKey="Bosch, Ba" uniqKey="Bosch B">BA Bosch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, K" uniqKey="Singh K">K Singh</name></author><author><name sortKey="Jindwani, K" uniqKey="Jindwani K">K Jindwani</name></author><author><name sortKey="Sahu, Rn" uniqKey="Sahu R">RN Sahu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, V" uniqKey="Singh V">V Singh</name></author><author><name sortKey="Gupta, Dk" uniqKey="Gupta D">DK Gupta</name></author><author><name sortKey="Desai, Ng" uniqKey="Desai N">NG Desai</name></author><author><name sortKey="Srivastava, A" uniqKey="Srivastava A">A Srivastava</name></author><author><name sortKey="Chaudhry, R" uniqKey="Chaudhry R">R Chaudhry</name></author><author><name sortKey="Varma, A" uniqKey="Varma A">A Varma</name></author><author><name sortKey="Sengupta, S" uniqKey="Sengupta S">S Sengupta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vijayakumar, L" uniqKey="Vijayakumar L">L Vijayakumar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Osvath, P" uniqKey="Osvath P">P Osvath</name></author><author><name sortKey="Voros, V" uniqKey="Voros V">V Voros</name></author><author><name sortKey="Fekete, S" uniqKey="Fekete S">S Fekete</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brown, L" uniqKey="Brown L">L Brown</name></author><author><name sortKey="Overholser, J" uniqKey="Overholser J">J Overholser</name></author><author><name sortKey="Spirito, A" uniqKey="Spirito A">A Spirito</name></author><author><name sortKey="Fritz, G" uniqKey="Fritz G">G Fritz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simon, Tr" uniqKey="Simon T">TR Simon</name></author><author><name sortKey="Swann, Ac" uniqKey="Swann A">AC Swann</name></author><author><name sortKey="Powell, Ke" uniqKey="Powell K">KE Powell</name></author><author><name sortKey="Potter, Lb" uniqKey="Potter L">LB Potter</name></author><author><name sortKey="Kresnow, M" uniqKey="Kresnow M">M Kresnow</name></author><author><name sortKey="O Arrol, Pw" uniqKey="O Arrol P">PW O’Carrol</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baca Garcia, E" uniqKey="Baca Garcia E">E Baca-Garcia</name></author><author><name sortKey="Diaze Sastre, C" uniqKey="Diaze Sastre C">C Diaze- Sastre</name></author><author><name sortKey="Resa, Eg" uniqKey="Resa E">EG Resa</name></author><author><name sortKey="Blasco, H" uniqKey="Blasco H">H Blasco</name></author><author><name sortKey="Conesa, Db" uniqKey="Conesa D">DB conesa</name></author><author><name sortKey="Oquendo, Ma" uniqKey="Oquendo M">MA Oquendo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Swann, Ac" uniqKey="Swann A">AC Swann</name></author><author><name sortKey="Dougherty, D" uniqKey="Dougherty D">D Dougherty</name></author><author><name sortKey="Pazzaglia, P" uniqKey="Pazzaglia P">P Pazzaglia</name></author><author><name sortKey="Pham, M" uniqKey="Pham M">M Pham</name></author><author><name sortKey="Steinberg, Jl" uniqKey="Steinberg J">JL Steinberg</name></author><author><name sortKey="Moeller, Fg" uniqKey="Moeller F">FG Moeller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stengel, E" uniqKey="Stengel E">E Stengel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kar, N" uniqKey="Kar N">N Kar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kessler, Rc" uniqKey="Kessler R">RC Kessler</name></author><author><name sortKey="Borges, G" uniqKey="Borges G">G Borges</name></author><author><name sortKey="Walters, Ee" uniqKey="Walters E">EE Walters</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kaminer, D" uniqKey="Kaminer D">D Kaminer</name></author><author><name sortKey="Stein, Dj" uniqKey="Stein D">DJ Stein</name></author><author><name sortKey="Mbanga, I" uniqKey="Mbanga I">I Mbanga</name></author><author><name sortKey="Zungu Dirwayi, N" uniqKey="Zungu Dirwayi N">N Zungu-Dirwayi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ertl, V" uniqKey="Ertl V">V Ertl</name></author><author><name sortKey="Pfeiffer, A" uniqKey="Pfeiffer A">A Pfeiffer</name></author><author><name sortKey="Saile, R" uniqKey="Saile R">R Saile</name></author><author><name sortKey="Schauer, E" uniqKey="Schauer E">E Schauer</name></author><author><name sortKey="Elbert, T" uniqKey="Elbert T">T Elbert</name></author><author><name sortKey="Neuner, F" uniqKey="Neuner F">F Neuner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Salah, Ttm" uniqKey="Salah T">TTM Salah</name></author><author><name sortKey="Abdelrahman, A" uniqKey="Abdelrahman A">A Abdelrahman</name></author><author><name sortKey="Lien, L" uniqKey="Lien L">L Lien</name></author><author><name sortKey="Eide, Ah" uniqKey="Eide A">AH Eide</name></author><author><name sortKey="Martinez, P" uniqKey="Martinez P">P Martinez</name></author><author><name sortKey="Hauff, E" uniqKey="Hauff E">E Hauff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Heyningen, T" uniqKey="Heyningen T">T Heyningen</name></author><author><name sortKey="Myer, L" uniqKey="Myer L">L Myer</name></author><author><name sortKey="Onah, M" uniqKey="Onah M">M Onah</name></author><author><name sortKey="Field, S" uniqKey="Field S">S Field</name></author><author><name sortKey="Honikman, S" uniqKey="Honikman S">S Honikman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sweetland, Ac" uniqKey="Sweetland A">AC Sweetland</name></author><author><name sortKey="Belkin, Gs" uniqKey="Belkin G">GS Belkin</name></author><author><name sortKey="Verdeli, H" uniqKey="Verdeli H">H Verdeli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nakku, J" uniqKey="Nakku J">J Nakku</name></author><author><name sortKey="Kinyanda, E" uniqKey="Kinyanda E">E Kinyanda</name></author><author><name sortKey="Hoskins, S" uniqKey="Hoskins S">S Hoskins</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sheehan, Dv" uniqKey="Sheehan D">DV Sheehan</name></author><author><name sortKey="Lecrubier, Y" uniqKey="Lecrubier Y">Y Lecrubier</name></author><author><name sortKey="Sheehan, Kh" uniqKey="Sheehan K">KH Sheehan</name></author><author><name sortKey="Amorim, P" uniqKey="Amorim P">P Amorim</name></author><author><name sortKey="Janavs, J" uniqKey="Janavs J">J Janavs</name></author><author><name sortKey="Weiller, E" uniqKey="Weiller E">E Weiller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kebede, D" uniqKey="Kebede D">D Kebede</name></author><author><name sortKey="Alem, A" uniqKey="Alem A">A Alem</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Isacsson, G" uniqKey="Isacsson G">G Isacsson</name></author><author><name sortKey="Rich, Cl" uniqKey="Rich C">CL Rich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Varnik, P" uniqKey="Varnik P">P Varnik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vijayakumar, L" uniqKey="Vijayakumar L">L Vijayakumar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chang, B" uniqKey="Chang B">B Chang</name></author><author><name sortKey="Gitlin, D" uniqKey="Gitlin D">D Gitlin</name></author><author><name sortKey="Patel, R" uniqKey="Patel R">R Patel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krug, Eg" uniqKey="Krug E">EG Krug</name></author><author><name sortKey="Mercy, Ja" uniqKey="Mercy J">JA Mercy</name></author><author><name sortKey="Dahlberg, Ll" uniqKey="Dahlberg L">LL Dahlberg</name></author><author><name sortKey="Zwi, Ab" uniqKey="Zwi A">AB Zwi</name></author><author><name sortKey="Lozano, R" uniqKey="Lozano R">R Lozano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Denning, Dg" uniqKey="Denning D">DG Denning</name></author><author><name sortKey="Conwell, Y" uniqKey="Conwell Y">Y Conwell</name></author><author><name sortKey="King, D" uniqKey="King D">D King</name></author><author><name sortKey="Cox, C" uniqKey="Cox C">C Cox</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Murphy, Ge" uniqKey="Murphy G">GE Murphy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Goldston, Db" uniqKey="Goldston D">DB Goldston</name></author><author><name sortKey="Daniel, Ss" uniqKey="Daniel S">SS Daniel</name></author><author><name sortKey="Reboussin, Dm" uniqKey="Reboussin D">DM Reboussin</name></author><author><name sortKey="Reboussin, Ba" uniqKey="Reboussin B">BA Reboussin</name></author><author><name sortKey="Frazier, Ph" uniqKey="Frazier P">PH Frazier</name></author><author><name sortKey="Kelley, Ae" uniqKey="Kelley A">AE Kelley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hawton, K" uniqKey="Hawton K">K Hawton</name></author><author><name sortKey="Zahl, D" uniqKey="Zahl D">D Zahl</name></author><author><name sortKey="Weatherall, R" uniqKey="Weatherall R">R Weatherall</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suominen, K" uniqKey="Suominen K">K Suominen</name></author><author><name sortKey="Henriksson, M" uniqKey="Henriksson M">M Henriksson</name></author><author><name sortKey="Suokas, J" uniqKey="Suokas J">J Suokas</name></author><author><name sortKey="Isometsa, E" uniqKey="Isometsa E">E Isometsa</name></author><author><name sortKey="Ostamo, A" uniqKey="Ostamo A">A Ostamo</name></author><author><name sortKey="Lonnqvist, J" uniqKey="Lonnqvist J">J Lonnqvist</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kumar, Cts" uniqKey="Kumar C">CTS Kumar</name></author><author><name sortKey="Mohan, R" uniqKey="Mohan R">R Mohan</name></author><author><name sortKey="Ranjith, G" uniqKey="Ranjith G">G Ranjith</name></author><author><name sortKey="Chandrasekaran, R" uniqKey="Chandrasekaran R">R Chandrasekaran</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lecrubier, Y" uniqKey="Lecrubier Y">Y Lecrubier</name></author><author><name sortKey="Sheehan, D" uniqKey="Sheehan D">D Sheehan</name></author><author><name sortKey="Weiller, E" uniqKey="Weiller E">E Weiller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Soloff, Ph" uniqKey="Soloff P">PH Soloff</name></author><author><name sortKey="Lynch, Kg" uniqKey="Lynch K">KG Lynch</name></author><author><name sortKey="Kelly, Tm" uniqKey="Kelly T">TM Kelly</name></author><author><name sortKey="Malone, Km" uniqKey="Malone K">KM Malone</name></author><author><name sortKey="Mann, Jj" uniqKey="Mann J">JJ Mann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Soloff, Ph" uniqKey="Soloff P">PH Soloff</name></author><author><name sortKey="Chiappetta, L" uniqKey="Chiappetta L">L Chiappetta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Williams, C" uniqKey="Williams C">C Williams</name></author><author><name sortKey="Davidson, J" uniqKey="Davidson J">J Davidson</name></author><author><name sortKey="Montgomery, I" uniqKey="Montgomery I">I Montgomery</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alem, A" uniqKey="Alem A">A Alem</name></author><author><name sortKey="Jacobsson, L" uniqKey="Jacobsson L">L Jacobsson</name></author><author><name sortKey="Kebede, D" uniqKey="Kebede D">D Kebede</name></author><author><name sortKey="Kullgren, G" uniqKey="Kullgren G">G Kullgren</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mekonnen, D" uniqKey="Mekonnen D">D Mekonnen</name></author><author><name sortKey="Kebede, Y" uniqKey="Kebede Y">Y Kebede</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sudak, Hs" uniqKey="Sudak H">HS Sudak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Naidoo, Ss" uniqKey="Naidoo S">SS Naidoo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ji, J" uniqKey="Ji J">J Ji</name></author><author><name sortKey="Kleinman, A" uniqKey="Kleinman A">A Kleinman</name></author><author><name sortKey="Becker, Ae" uniqKey="Becker A">AE Becker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yip, Ps" uniqKey="Yip P">PS Yip</name></author><author><name sortKey="Liu, Ky" uniqKey="Liu K">KY Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alem, A" uniqKey="Alem A">A Alem</name></author><author><name sortKey="Kebede, D" uniqKey="Kebede D">D Kebede</name></author><author><name sortKey="Jacobsson, L" uniqKey="Jacobsson L">L Jacobsson</name></author><author><name sortKey="Kullgren, G" uniqKey="Kullgren G">G Kullgren</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marzuk, Pm" uniqKey="Marzuk P">PM Marzuk</name></author><author><name sortKey="Leon, Ac" uniqKey="Leon A">Ac Leon</name></author><author><name sortKey="Tardiff, K" uniqKey="Tardiff K">K Tardiff</name></author><author><name sortKey="Morgan, Eb" uniqKey="Morgan E">EB Morgan</name></author><author><name sortKey="Stajic, M" uniqKey="Stajic M">M Stajic</name></author><author><name sortKey="Mann, Jj" uniqKey="Mann J">JJ Mann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Karalliedde, L" uniqKey="Karalliedde L">L Karalliedde</name></author><author><name sortKey="Buckley, N" uniqKey="Buckley N">N Buckley</name></author><author><name sortKey="Fernando, R" uniqKey="Fernando R">R Fernando</name></author><author><name sortKey="Hutchinson, G" uniqKey="Hutchinson G">G Hutchinson</name></author><author><name sortKey="Isbister, G" uniqKey="Isbister G">G Isbister</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nandi, Dn" uniqKey="Nandi D">DN Nandi</name></author><author><name sortKey="Mukherjee, Sp" uniqKey="Mukherjee S">SP Mukherjee</name></author><author><name sortKey="Banerjee, G" uniqKey="Banerjee G">G Banerjee</name></author><author><name sortKey="Ghosh, A" uniqKey="Ghosh A">A Ghosh</name></author><author><name sortKey="Boral, Gc" uniqKey="Boral G">GC Boral</name></author><author><name sortKey="Chowdhury, A" uniqKey="Chowdhury A">A Chowdhury</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rich, Cl" uniqKey="Rich C">CL Rich</name></author><author><name sortKey="Warstadt, Gm" uniqKey="Warstadt G">GM Warstadt</name></author><author><name sortKey="Nemiroff, Ra" uniqKey="Nemiroff R">RA Nemiroff</name></author><author><name sortKey="Fowler, Rc" uniqKey="Fowler R">RC Fowler</name></author><author><name sortKey="Young, D" uniqKey="Young D">D Young</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Latha, Ks" uniqKey="Latha K">KS Latha</name></author><author><name sortKey="Bhat, Sm" uniqKey="Bhat S">SM Bhat</name></author><author><name sortKey="D Ouza, P" uniqKey="D Ouza P">P D’Souza</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Siwach, Sb" uniqKey="Siwach S">SB Siwach</name></author><author><name sortKey="Gupta, A" uniqKey="Gupta A">A Gupta</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Ment Health Syst</journal-id><journal-id journal-id-type="iso-abbrev">Int J Ment Health Syst</journal-id><journal-title-group><journal-title>International Journal of Mental Health Systems</journal-title></journal-title-group><issn pub-type="epub">1752-4458</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28439293</article-id><article-id pub-id-type="pmc">5399339</article-id><article-id pub-id-type="publisher-id">136</article-id><article-id pub-id-type="doi">10.1186/s13033-017-0136-4</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Ayehu</surname><given-names>Moges</given-names></name><address><email>ayehumoges@yahoo.com</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Solomon</surname><given-names>Tarekegn</given-names></name><address><email>tarekegn2solomon@yahoo.com</email></address><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Lemma</surname><given-names>Kinfe</given-names></name><address><email>kinfewudie@gmail.com</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Medicine,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>School of Public and Environmental Health,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8953 2273</institution-id><institution-id institution-id-type="GRID">grid.192268.6</institution-id><institution>College of Medicine and Health Sciences,</institution><institution>Hawassa University,</institution></institution-wrap>Hawassa, Ethiopia</aff></contrib-group><pub-date pub-type="epub"><day>20</day><month>4</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>20</day><month>4</month><year>2017</year></pub-date><pub-date pub-type="collection"><year>2017</year></pub-date><volume>11</volume><elocation-id>32</elocation-id><history><date date-type="received"><day>10</day><month>11</month><year>2016</year></date><date date-type="accepted"><day>6</day><month>4</month><year>2017</year></date></history><permissions><copyright-statement>© The Author(s) 2017</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Suicide is a major public health problem worldwide. It contributes for more than one million deaths each year. Since previous suicidal attempt was considered as the best predictor of future suicide, identifying factors behind suicidal attempt are helpful to design suicide prevention strategies. The aim of this study was to assess socio-demographic characteristics, clinical profile and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of general hospitals in South Ethiopia.</p></sec><sec><title>Methods</title><p>We conducted a cross-sectional study on patients presenting with complications of suicidal attempt to emergency departments of two general hospitals in Hawassa city from November, 2014 to August, 2015. Data was collected using semi-structured questionnaire which contained socio-demographic and clinical variables. The Mini International Neuropsychiatric Interview version 5 (MINI PLUs) was used to assess the prevalence of existing mental illness among study participants. Data was entered and analyzed using IBM SPSS statistics 21 software package.</p></sec><sec><title>Results</title><p>A total of 96 individuals were assessed, of whom 56 (58.3%) were females. The mean age of study participants was 21.5 (8.0) years. The majority, 75 (78.1%), of the study participants were aged below 25 years. Ingesting pesticide poisons and corrosive agent were used by the majority to attempt suicide. Mental illness was found in only three (3.1%) of the study participants. Impulsivity (the time between decision to attempt suicide and the actual attempt of less than 5 min) was reported by 30 (31.2%) of the study participants, of whom 18 (60%) were males. Males were found three times more likely to attempt suicide impulsively than women (COR = 3.0, 95% CI 1.2–7.3). Quarreling with family members, facing financial crisis, and having unplanned and unwanted pregnancy were reported by the majority of study participants as immediate reasons to attempt suicide.</p></sec><sec><title>Conclusions</title><p>The presence of stressful life events and impulsivity behind suicidal behavior of the younger generation implies that designing suicide prevention strategies for this group is crucial. Moreover, further research is needed to systematically examine the relationship between the presence of mental illness and suicidal attempt with a larger sample size and more robust methodology.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Suicide</kwd><kwd>Suicidal attempt</kwd><kwd>Psychiatric disorders</kwd><kwd>Mental illness</kwd><kwd>Impulsivity</kwd><kwd>Low and middle income countries</kwd><kwd>Ethiopia</kwd></kwd-group><funding-group><award-group><funding-source><institution>Hawassa University</institution></funding-source></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2017</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="Sec1"><title>Background</title><p>Suicide is a major public health concern worldwide. Over one million suicide deaths, 16 people per 100,000 persons or one death per 40 s each year occur worldwide [<xref ref-type="bibr" rid="CR1">1</xref>]. Among these deaths 75% of them were reported from low and middle-income countries (LMICs) [<xref ref-type="bibr" rid="CR2">2</xref>]. According to a World Health Organization report [<xref ref-type="bibr" rid="CR3">3</xref>], the highest suicide rate which is 44.2 per 100,000 persons per year (70.8 men, 22.1 women) was reported recently from Guyana, a country found in the north eastern edge of South America. North Korea (38.5 per 100,000 persons), South Korea (28.9 per 100,000 persons), Sri Lanka (28.8 per 100,000 persons), and Lithuania (28.2 per 100,000 persons) were the other countries where the highest suicide rates were documented. Among African countries, the highest suicide rates were reported from Mozambique (27.4 per 100,000 persons), Tanzania (24.9 per 100,000 persons), and Burundi (23.1 per 100,000 persons) [<xref ref-type="bibr" rid="CR3">3</xref>]. In Ethiopia, 7.6 up to 11.5 suicide deaths per 100,000 persons per year were reported [<xref ref-type="bibr" rid="CR3">3</xref>, <xref ref-type="bibr" rid="CR4">4</xref>]. Moreover, suicide is under-reported in various countries due to the high level of stigma, religious and cultural taboos linked to it [<xref ref-type="bibr" rid="CR5">5</xref>–<xref ref-type="bibr" rid="CR7">7</xref>]. For example, Vijayakumar reported that the annual estimated suicide rate could be between six and nine times higher than the official figure [<xref ref-type="bibr" rid="CR8">8</xref>]. Studies reported that before someone committed suicide, depressive thought, thinking that life is not worth living, suicidal thought, suicidal plan and finally suicidal attempt preceded [<xref ref-type="bibr" rid="CR9">9</xref>–<xref ref-type="bibr" rid="CR13">13</xref>].</p><p>Many studies have shown that the numbers of suicide attempters have been increasing worldwide. According to studies in the past, suicide attempts were 20–40 times more frequent than suicide [<xref ref-type="bibr" rid="CR14">14</xref>, <xref ref-type="bibr" rid="CR15">15</xref>]. On the other hand, attempted suicide was found the leading risk factor for suicide [<xref ref-type="bibr" rid="CR16">16</xref>–<xref ref-type="bibr" rid="CR18">18</xref>]. A meta-analysis study has shown that suicide was 30–40 times higher in those individuals who attempted suicide than the general population [<xref ref-type="bibr" rid="CR19">19</xref>].</p><p>The contribution of mental disorders such as bipolar 1 disorder and major depression disorders to attempt suicide was also found significant. For example, an Ethiopian based 10 years population study has shown that 26.3% of patients with major depression and 23.8% of patients with bipolar 1 disorder attempted suicide [<xref ref-type="bibr" rid="CR20">20</xref>]. In this cohort study, more than one-tenth (13.1%) of patients with schizophrenia also attempted suicide within the study period [<xref ref-type="bibr" rid="CR20">20</xref>]. According to different studies conducted in the past, the prevalence of mental illness among patients present to the hospital following suicidal attempt was found in the ranges of 60–80% [<xref ref-type="bibr" rid="CR21">21</xref>–<xref ref-type="bibr" rid="CR23">23</xref>]. Moreover, socio-demographic factors like young age, female sex, low level of education, history of previous attempt [<xref ref-type="bibr" rid="CR24">24</xref>, <xref ref-type="bibr" rid="CR25">25</xref>], being unemployed and living in urban areas [<xref ref-type="bibr" rid="CR26">26</xref>, <xref ref-type="bibr" rid="CR27">27</xref>] were found highly associated with suicide. Psychosocial factors like problems with love affairs, illegitimate pregnancy, extra-marital affairs and marriage [<xref ref-type="bibr" rid="CR28">28</xref>], living in socio-economically deprived situations [<xref ref-type="bibr" rid="CR21">21</xref>], and stressful life events one month prior to suicidal attempt [<xref ref-type="bibr" rid="CR29">29</xref>] were also found significantly associated with suicidal attempt. In addition to these, many studies in the past had associated suicidal attempt with impulsive behavior; particularly among adolescents [<xref ref-type="bibr" rid="CR30">30</xref>–<xref ref-type="bibr" rid="CR33">33</xref>].</p><p>Even though having a better understanding of suicidal behavior was very helpful to prevent suicide, there is a paucity of data in developing countries including Ethiopia. Since attempted suicide is very helpful to estimate future suicide, it is good to know factors that are associated with suicidal attempt. Thus, this study was conducted to assess sociodemographic characteristics, clinical profiles and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of two general hospitals in South Ethiopia.</p></sec><sec id="Sec2"><title>Methods</title><sec id="Sec3"><title>Study design and setting</title><p>A facility based cross-sectional study was conducted from November 2014 to August 2015 at Hawassa University Referral Hospital and Adare Primary Hospital. Both hospitals are found in Hawassa City, which is located about 270 km south of Addis Ababa. Hawassa University Referral Hospital is the only referral hospital in Southern Nations, Nationalities and Peoples’ Region (SNNPR), and is expected to provide services for more than 18 million people. In contrast, Adare Primary Hospital was established to treat primarily patients coming from Hawassa City. Even though both hospitals have inpatient and outpatient services in major medical disciplines, psychiatric services are limited to outpatient services only. The psychiatric clinic in Hawassa University Referral has two psychiatrists and two psychiatric nurses whereas; Adare Primary Hospital has one psychiatric nurse. Patients with clear cases of mental illness are usually referred directly from the triage to the psychiatric outpatient department (OPD). Moreover, those patients who are referred from the triage to other medical clinics because of poor triaging are referred back to the psychiatric clinic if health professionals working in other disciplines suspect the presence of psychiatric problems in the patient. Patients with suicidal attempts are supposed to be treated at the general emergency OPD and inpatient services till they become medically stable. After having been stabilized medically, they are usually referred to psychiatric outpatient services for psychiatric evaluation and treatment.</p></sec><sec id="Sec4"><title>Participants</title><p>Participants of this study were all those suicide attempters who consecutively presenting to the emergency and inpatient services of the two general hospitals from November 2014 to August 2015. The emergency and inpatient teams were informed to refer every patient with suicidal attempt to psychiatric OPD after making them medically stable. For the purpose of this study, suicide attempt is defined as “any act of self-damage inflicted with self-destructive intentions” [<xref ref-type="bibr" rid="CR34">34</xref>, <xref ref-type="bibr" rid="CR35">35</xref>]. Patients with accidental injuries without the intention of self-harm, and those who did not survive were excluded from the study. In the study periods one-hundred-one patients were presenting to emergency departments of the two hospitals. Among these, five of them died within few minutes to hours of hospital visit while they were on treatment at emergency OPD. Nine (9.4%) suicide attempters were discharged from emergency OPD since they did not have serious complications which required admission. On the other hand, 87 (86.1%) suicide attempters were admitted to inpatient services either for having serious medical complications or for further observation. After making them medically stable, both the latter groups were interviewed at psychiatric OPD before discharge.</p></sec><sec id="Sec5"><title>Assessment</title><p>Semi-structured questionnaires were prepared by the investigators containing the following study variables: socio-demographic characteristics, history of previous suicidal attempt, method of suicidal attempt, presence of previously known mental illness, intention of suicidal attempt, immediate reasons for suicide, whether the patient made suicidal attempt impulsively or with premeditative plan, patient condition during arrival, patient outcome after treatment, attitude towards surviving the incident, and presence of known medical illness. Although impulsivity was not defined in a similar way in previous studies, in our study like in the study done by Simon et al. [<xref ref-type="bibr" rid="CR31">31</xref>], impulsive suicidal attempt was considered to happen if the respondent reported the spending of <5 min between the decision to attempt suicide and the actual attempt. The Mini International Neuropsychiatric Interview version 5 (MINI PLUS) was used to assess the prevalence of an existing mental illness among study participants based on Diagnostic and Statistical Manual-IV edition (DSM-IV) [<xref ref-type="bibr" rid="CR36">36</xref>]. The instrument was designed to assess major psychiatric disorders such as psychosis, mood disorders, anxiety disorders, suicide, alcohol and drug related disorders, eating disorders, and somatoform disorders. Among childhood disorders, attention deficit hyperactivity disorder (ADHD) and conduct disorders were included, but among personality disorders, only antisocial personality was incorporated in the instrument. MINI PLUS was translated in various languages and its’ validity and reliability was found to be high [<xref ref-type="bibr" rid="CR34">34</xref>, <xref ref-type="bibr" rid="CR35">35</xref>]. Though the instrument was not validated in Ethiopia, it was validated [<xref ref-type="bibr" rid="CR37">37</xref>–<xref ref-type="bibr" rid="CR39">39</xref>] and used [<xref ref-type="bibr" rid="CR40">40</xref>–<xref ref-type="bibr" rid="CR42">42</xref>] in various African settings. The instrument was also selected based on its broad coverage, easy to use by data collectors and quick administration time. We used the English version of the instrument. Although short time of administration (mean 18.7 + 6 min) was mentioned as one of the advantages of using MINI-Plus [<xref ref-type="bibr" rid="CR43">43</xref>], in our study the average time required to fill it was 30 min.</p></sec><sec id="Sec6"><title>Procedures</title><p>Data was collected by three psychiatric nurses who had lots of experiences of working with people suffering from mental illness. Moreover, these data collectors had also prior experiences in conducting various psychiatric surveys. They received a 1 day theoretical and practical training on how to administer the data collection instruments, and how to approach patients, parents and guardians and obtain informed consent. In addition, the primary investigator, the psychiatrist, was assigned to organize, facilitate, and control the whole process of the data collection. His phone was always on for any consultation and queries. Informed consent was secured from patients or the guardians if the patients’ decision-making capacity was compromised and for those patients aged less than 18. Parents and guardians were required to leave the room until data collectors had completed interviewing patients to avoid response bias in the case of minors. No refusal was noted from the parents or guardians. After finishing the interview with minors, parents and guardians were interviewed for additional information with the consent of patients. Usual care treatments were provided by psychiatric nurses in consultation with psychiatrists. Moreover, patients were allowed appointments to visit psychiatric clinic for follow up and to get future psychiatric care plan.</p></sec><sec id="Sec7"><title>Data management</title><p>Every week, the principal investigator checked the completeness and consistency of the information in the questionnaires. Data was entered and analyzed using IBM SPSS statistics 21 software package. Descriptive statistics was used to present frequencies, means and standard deviation. Chi square test was used to present association. Crude odds ratio and 95% confidence interval were used to show the direction of association. Since our sample size was small we have not done multivariate analysis.</p></sec></sec><sec id="Sec8"><title>Results</title><sec id="Sec9"><title>Socio-demographic characteristics of the study participants</title><p>During the study period 101 individuals showed up in the emergency OPD with complications of suicidal attempt. Among these five of them died while they were on treatment at the emergency OPD. A total of 96 individuals were referred to the psychiatric clinic and all of them volunteered to be part of the study. Among the study participants 56 (58.3%) were females and 74 (77.1%) were from Hawassa city. The Mean (SD) age was 21.5 (8.0) years. Seventy-five (78.1%) of them were aged below 25 years. The majority, 91 (94.8%) were Christians, of whom 54 (59.3%) were Protestant while 37 (40.7%) were Orthodox Christians. Eighty-four (93.8%) participants attended grades 7 up to 12. Sixty-one (63.5%) participants were students by the time they attempted suicide. Eighty-one (84.4%) were single. The majority, 87 (90.6%), of the participants were living either with their parents or siblings. Sixty-eight (70.8%) of the participants received economic support from their parents or close relatives (Table <xref rid="Tab1" ref-type="table">1</xref>).<table-wrap id="Tab1"><label>Table 1</label><caption><p>Socio-demographic characteristics of suicide attempters at general hospitals in Hawassa city from Nov 2014–Aug 2015</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Characteristics</th><th align="left">Number (%)</th></tr></thead><tbody><tr><td align="left" colspan="2">Age</td></tr><tr><td align="left"> 14–24</td><td char="(" align="char">75 (78.1)</td></tr><tr><td align="left"> ≥25</td><td char="(" align="char">21 (21.9)</td></tr><tr><td align="left" colspan="2">Sex</td></tr><tr><td align="left"> Male</td><td char="(" align="char">40 (41.7)</td></tr><tr><td align="left"> Female</td><td char="(" align="char">56 (58.3)</td></tr><tr><td align="left" colspan="2">Religion</td></tr><tr><td align="left"> Protestant Christian</td><td char="(" align="char">54 (56.2)</td></tr><tr><td align="left"> Orthodox Christian</td><td char="(" align="char">37 (38.5)</td></tr><tr><td align="left"> Others</td><td char="(" align="char">4 (4.1)</td></tr><tr><td align="left" colspan="2">Place</td></tr><tr><td align="left"> Hawassa city</td><td char="(" align="char">74 (77.7)</td></tr><tr><td align="left"> Sidama zone</td><td char="(" align="char">17 (17.7)</td></tr><tr><td align="left"> Others</td><td char="(" align="char">5 (5.2)</td></tr><tr><td align="left" colspan="2">Ethnicity</td></tr><tr><td align="left"> Sidama</td><td char="(" align="char">46 (47.7)</td></tr><tr><td align="left"> Wolayita</td><td char="(" align="char">17 (17.7)</td></tr><tr><td align="left"> Amhara</td><td char="(" align="char">15 (15.6)</td></tr><tr><td align="left"> Oromo</td><td char="(" align="char">9 (9.4)</td></tr><tr><td align="left"> Others</td><td char="(" align="char">9 (9.4)</td></tr><tr><td align="left" colspan="2">Marital status</td></tr><tr><td align="left"> Married</td><td char="(" align="char">15 (15.6)</td></tr><tr><td align="left"> Single</td><td char="(" align="char">81 (84.4)</td></tr><tr><td align="left" colspan="2">Lives with</td></tr><tr><td align="left"> Either parent or sibling</td><td char="(" align="char">87 (90.6)</td></tr><tr><td align="left"> Spouse and children or a lone</td><td char="(" align="char">9 (9.4)</td></tr><tr><td align="left" colspan="2">Occupation</td></tr><tr><td align="left"> Students</td><td char="(" align="char">61 (63.5)</td></tr><tr><td align="left"> Self employed</td><td char="(" align="char">16 (16.7)</td></tr><tr><td align="left"> House wife</td><td char="(" align="char">9 (9.4)</td></tr><tr><td align="left"> Unemployed</td><td char="(" align="char">6 (6.2)</td></tr><tr><td align="left"> Government employ</td><td char="(" align="char">4 (4.1)</td></tr><tr><td align="left" colspan="2">Income sources</td></tr><tr><td align="left"> From parent or close relatives</td><td char="(" align="char">68 (70.8)</td></tr><tr><td align="left"> Has personal income</td><td char="(" align="char">28 (29.2)</td></tr><tr><td align="left" colspan="2">Educational status</td></tr><tr><td align="left"> Unable to read and write</td><td char="(" align="char">3 (3.1)</td></tr><tr><td align="left"> Read and write</td><td char="(" align="char">1 (1.0)</td></tr><tr><td align="left"> Primary school</td><td char="(" align="char">6 (6.2)</td></tr><tr><td align="left"> Secondary school</td><td char="(" align="char">84 (87.5)</td></tr><tr><td align="left"> Tertiary</td><td char="(" align="char">2 (2.1)</td></tr></tbody></table></table-wrap></p></sec><sec id="Sec10"><title>Methods of suicide attempt and clinical states at arrival and discharge</title><p>Forty-two (43.8%) of the study participants attempted suicide by ingesting pesticide poisons, 37 (38.5%) by ingesting a corrosive agent, and the remaining 17 (17.7%) used one of the following three methods: hanging, medication overdose or cutting their neck with a knife.</p><p>During arrival at the emergency services, 79 (78.2%) were alert, 11 (10.9%) were lethargic and 11 (10.9%) were in a comatose state. Among these, 5 (4.9%) of them died within few minutes of arrival at the emergency OPD while 9 (9.4%) of them were sent back to their homes within few minutes to hours of stay at emergency OPD. On the other hand, 50 (52.1%) of the study participants were made to stay in the hospital for around 12 h while the remaining 37 (38.5%) were kept in the hospital for more than 24 h either for observation or because of having serious medical complications. The maximum hospital stay was 72 h. Moreover, among the admitted patients, 83 (95.4%) of them were discharged from the hospital without having any suicide related complications while only 4 (4.6%) were discharged with non-serious complications such as scar marks, slurred speech and esophageal discomfort during swallowing.</p><p>The majority, 84 (87.5%) of the patients attempted suicide inside their living rooms while the rest in the field, in the forest, in the back yard and inside wash rooms. Fifty-five (57.3%) of the suicidal attempts were found and intervened by a parent while 21 (21.9) and 13 (13.5%) were terminated by a sibling, and by close friends, respectively. As an immediate intervention, 62 (64.6%) of the family members had given them milk whereas the rest did not get any intervention except being brought to the hospital (Table <xref rid="Tab2" ref-type="table">2</xref>).<table-wrap id="Tab2"><label>Table 2</label><caption><p>Situation of suicide attempters at general hospitals in Hawassa city from Nov 2014–Aug 2015</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Variable</th><th align="left">Number (%)</th></tr></thead><tbody><tr><td align="left" colspan="2">Methods of suicidal attempt</td></tr><tr><td align="left"> Hanging</td><td char="(" align="char">8 (8.3)</td></tr><tr><td align="left"> Organophosphate poisoning</td><td char="(" align="char">42 (43.8)</td></tr><tr><td align="left"> Medication overdose</td><td char="(" align="char">6 (6.2)</td></tr><tr><td align="left"> Bleaching agent</td><td char="(" align="char">37 (38.5)</td></tr><tr><td align="left"> Others</td><td char="(" align="char">3 (3.1)</td></tr><tr><td align="left" colspan="2">Immediate reason for suicide</td></tr><tr><td align="left"> Quarrel with the family</td><td char="(" align="char">59 (61.5)</td></tr><tr><td align="left"> Problem related with love affairs</td><td char="(" align="char">6 (6.2)</td></tr><tr><td align="left"> Quarrel with spouse</td><td char="(" align="char">3 (3.1)</td></tr><tr><td align="left"> Quarrel with friends</td><td char="(" align="char">1 (1)</td></tr><tr><td align="left"> Academic difficulties</td><td char="(" align="char">4 (4.2)</td></tr><tr><td align="left"> Financial crisis</td><td char="(" align="char">6 (6.2)</td></tr><tr><td align="left"> Unplanned and unwanted pregnancy</td><td char="(" align="char">10 (10.4)</td></tr><tr><td align="left"> Other</td><td char="(" align="char">(7.3)</td></tr><tr><td align="left" colspan="2">Clinical status during arrival<sup>a</sup></td></tr><tr><td align="left"> Lethargic</td><td char="(" align="char">11 (10.9)</td></tr><tr><td align="left"> Comatose</td><td char="(" align="char">11 (10.9)</td></tr><tr><td align="left"> Alert</td><td char="(" align="char">79 (78.2)</td></tr><tr><td align="left" colspan="2">Hospital stay</td></tr><tr><td align="left"> Sent home immediately</td><td char="(" align="char">9 (9.6)</td></tr><tr><td align="left"> Kept for ≤12 h</td><td char="(" align="char">50 (52.1)</td></tr><tr><td align="left"> Kept for more than 24 h</td><td char="(" align="char">37 (38.5)</td></tr><tr><td align="left" colspan="2">Impulsivity of suicide attempt</td></tr><tr><td align="left"> Within 5 min of decision</td><td char="(" align="char">30 (31.3)</td></tr><tr><td align="left"> After 5 min of decision</td><td char="(" align="char">66 (68.8)</td></tr><tr><td align="left" colspan="2">Intention of suicidal attempt</td></tr><tr><td align="left"> I made the attempt to kill myself and it was only luck that I did not succeed</td><td char="(" align="char">32 (33.3)</td></tr><tr><td align="left"> My attempt was a cry for help and I did not intend to die</td><td char="(" align="char">64 (66.7)</td></tr><tr><td align="left">Attitude towards being survive</td><td char="(" align="char"></td></tr><tr><td align="left"> Angry</td><td char="(" align="char">9 (9.4)</td></tr><tr><td align="left"> Glad</td><td char="(" align="char">85 (88.5)</td></tr><tr><td align="left"> Indifferent</td><td char="(" align="char">2 (2.1)</td></tr><tr><td align="left" colspan="2">Warning sign</td></tr><tr><td align="left"> Yes</td><td char="(" align="char">41 (42.7)</td></tr><tr><td align="left"> No</td><td char="(" align="char">55 (57.3)</td></tr><tr><td align="left" colspan="2">Type of warning sign</td></tr><tr><td align="left"> Hopelessness</td><td char="(" align="char">33 (34.4)</td></tr><tr><td align="left"> Threatening to hurt or kill self</td><td char="(" align="char">4 (4.2)</td></tr><tr><td align="left"> Looking for ways to kill self</td><td char="(" align="char">3 (3.1)</td></tr><tr><td align="left"> Talking or writing about death, dying or suicide</td><td char="(" align="char">1 (1.0)</td></tr><tr><td align="left" colspan="2">Recent(≤6 months) hospital visits</td></tr><tr><td align="left"> Yes</td><td char="(" align="char">76 (79.2)</td></tr><tr><td align="left"> No</td><td char="(" align="char">15 (15.6)</td></tr><tr><td align="left" colspan="2">Reason for hospital visit</td></tr><tr><td align="left"> Medical</td><td char="(" align="char">76 (95.0)</td></tr><tr><td align="left"> Psychiatric</td><td char="(" align="char">4 (5.0)</td></tr><tr><td align="left" colspan="2">Site of suicidal attempt</td></tr><tr><td align="left"> Inside living room</td><td char="(" align="char">84 (88.4)</td></tr><tr><td align="left"> Inside washroom</td><td char="(" align="char">2 (2.1)</td></tr><tr><td align="left"> Backyard</td><td char="(" align="char">1 (1.1)</td></tr><tr><td align="left"> Field</td><td char="(" align="char">4 (4.2)</td></tr><tr><td align="left"> Forest</td><td char="(" align="char">2 (2.1)</td></tr><tr><td align="left"> Others</td><td char="(" align="char">1 (1.1)</td></tr><tr><td align="left" colspan="2">Support for suicide failure</td></tr><tr><td align="left"> Parent</td><td char="(" align="char">55 (57.3)</td></tr><tr><td align="left"> Siblings</td><td char="(" align="char">21 (21.9)</td></tr><tr><td align="left"> Friends</td><td char="(" align="char">13 (13.5)</td></tr><tr><td align="left"> Close relative</td><td char="(" align="char">1 (1.0)</td></tr><tr><td align="left"> Neighbor</td><td char="(" align="char">5 (5.2)</td></tr><tr><td align="left"> Passer by</td><td char="(" align="char">1 (1.0)</td></tr><tr><td align="left" colspan="2">Psychiatry diagnosis</td></tr><tr><td align="left"> Present</td><td char="(" align="char">3 (3.1)</td></tr><tr><td align="left"> Absent</td><td char="(" align="char">93 (96.9)</td></tr></tbody></table><table-wrap-foot><p><sup>a</sup>The percentage was calculating among 101 patients presenting to emergency OPD while the percentage of other variables were calculated among 96 study participants included in the study</p></table-wrap-foot></table-wrap></p></sec><sec id="Sec11"><title>Psychosocial factors and clinical situations before suicidal attempt</title><p>Quarreling with a family member was reported by 59 (61.5%) of the participants as the immediate reason to attempt suicide. Twelve (12.4%) of the study participants reported problems related to their love affairs and financial crises, and 8 (8.3%) were due to other reasons like quarreling with a spouse or friends, and academic difficulties. On the other hand, among female study participants, 10 (10.4%) of them attempted suicide because they had unplanned and unwanted pregnancy (Table <xref rid="Tab2" ref-type="table">2</xref>). Though among 56 females study participants 10 of them attempt suicide because of having the unplanned and unwanted pregnancy, a correction has to make on table two variable said "Immediate reason for suicide". The figure for unplanned and unwanted pregnancy 10 (10.4)-(it is not 12 (12.5). This percentage is calculated out of 96 total study participants.</p><p>Nevertheless, 64 (66.7%) of the participants reported that their intention for attempting suicide was a cry for help while 32 (33.3%) of them said they made the attempt to kill themselves; however, it was only luck that they did not succeed. Eighty-five (88.5%) of the study participants were glad to survive from their suicidal attempts without serious complications while 9 (9.4%) felt angry since they did not succeed. Among the 9 patients who had felt angry, 8 of them reported that the intention of their attempt was wanting to truly kill themselves. Moreover, 41 (42.7%) of the study participants had shown warning signs to kill themselves before their action; a feeling of hopelessness was reported by 33 (80.5%) of them as a warning sign. Seventy-six (79.2%) individuals had history of hospital visits within 6 months prior to their suicidal attempt for different medical reasons. Only, 5 (6.2%) had visited the hospital for psychiatric reasons. But none of them were asked about suicidal ideation (Table <xref rid="Tab2" ref-type="table">2</xref>).</p></sec><sec id="Sec12"><title>Prevalence of mental illness among suicide attempters</title><p>Mental illness was found only in three (3.1%) participants (Table <xref rid="Tab2" ref-type="table">2</xref>). All of them were males. Among these, two of them were suffering from major depressive episodes and one participant had a history of alcohol, khat and cigarette abuse. Depressed mood nearly every day; loss of interest, decreased appetite, talking slowly, easy fatigability, feeling of worthlessness, difficulty in concentrating, and suicidal ideation were the symptoms reported by two of the patients with depression.</p><p>Thirty (31.2%) of the study participants attempted suicide within 5 min of their decision to kill themselves. Among these, 18 (60%) of them were male. Males were found three times more likely to attempt suicide impulsively than females (COR = 3, 95% CI 1.2–7.3) (Table <xref rid="Tab3" ref-type="table">3</xref>).<table-wrap id="Tab3"><label>Table 3</label><caption><p>Cross-tabulation of gender vs. socio-demographic and clinical variables at general hospitals in Hawassa city from Nov 2014–Aug 2015</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2">Variables</th><th align="left" colspan="2">Gender</th><th align="left" rowspan="2">χ2 test, <italic>P</italic> value</th></tr><tr><th align="left">Male n (%)</th><th align="left">Female n (%)</th></tr></thead><tbody><tr><td align="left" colspan="4">Age</td></tr><tr><td align="left"> 14–24</td><td align="left">29 (72.5)</td><td align="left">46 (83.6)</td><td align="left" rowspan="2">1.73, 0.19</td></tr><tr><td align="left"> ≥25</td><td align="left">11 (27.5)</td><td align="left">9 (16.4)</td></tr><tr><td align="left" colspan="4">Marital status</td></tr><tr><td align="left"> Married</td><td align="left">6 (15)</td><td align="left">9 (16)</td><td align="left" rowspan="2">0.02, 0.89</td></tr><tr><td align="left"> Single</td><td align="left">34 (85)</td><td align="left">47 (84)</td></tr><tr><td align="left" colspan="4">Income sources</td></tr><tr><td align="left"> From parent or close relatives</td><td align="left">25 (62.5)</td><td align="left">43 (76.8)</td><td align="left" rowspan="2">2.3, 0.13</td></tr><tr><td align="left"> Has personal income</td><td align="left">15 (37.5)</td><td align="left">13 (23.2)</td></tr><tr><td align="left" colspan="4">Warning sign</td></tr><tr><td align="left"> Yes</td><td align="left">14 (35)</td><td align="left">27 (48.2)</td><td align="left" rowspan="2">1.67, 0.20</td></tr><tr><td align="left"> No</td><td align="left">26 (65)</td><td align="left">29 (51.8)</td></tr><tr><td align="left" colspan="4">Intention of suicidal attempt</td></tr><tr><td align="left"> I made the attempt to kill myself and it was only luck that I did not succeed</td><td align="left">10 (25)</td><td align="left">22 (39.3)</td><td align="left" rowspan="2">2.14, 0.14</td></tr><tr><td align="left"> My attempt was a cry for help and I did not intend to die</td><td align="left">30 (75)</td><td align="left">34 (60.7)</td></tr><tr><td align="left" colspan="4">Impulsivity of suicide attempt<sup>a</sup></td></tr><tr><td align="left"> Within 5 min of decision</td><td align="left">18 (45)</td><td align="left">12 (21.4)</td><td align="left" rowspan="2">6.03, 0.01</td></tr><tr><td align="left"> After 5 min of decision</td><td align="left">22 (55)</td><td align="left">44 (78.6)</td></tr></tbody></table><table-wrap-foot><p><sup>a</sup>COR of male gender = 3.0, 95% CI 1.2–7.3</p></table-wrap-foot></table-wrap></p></sec></sec><sec id="Sec13"><title>Discussion</title><p>We have evaluated a total of 96 patients. Seventy-five (78.1%) of our study participants were below the age of 25 years. This finding is comparable with other studies which reported that the productive younger age groups are highly vulnerable to suicidal attempt [<xref ref-type="bibr" rid="CR20">20</xref>, <xref ref-type="bibr" rid="CR24">24</xref>, <xref ref-type="bibr" rid="CR25">25</xref>, <xref ref-type="bibr" rid="CR44">44</xref>]. In terms of gender differences, female suicide attempters outnumbered male attempters with a ratio of 1.4. Consistent with our findings, female sex preponderance have been documented in previous studies [<xref ref-type="bibr" rid="CR24">24</xref>, <xref ref-type="bibr" rid="CR25">25</xref>, <xref ref-type="bibr" rid="CR36">36</xref>, <xref ref-type="bibr" rid="CR45">45</xref>]. In general, male die three to four times more frequently by suicide than females [<xref ref-type="bibr" rid="CR46">46</xref>, <xref ref-type="bibr" rid="CR47">47</xref>]; whereas, females attempt suicide two to four times more often than males [<xref ref-type="bibr" rid="CR48">48</xref>, <xref ref-type="bibr" rid="CR49">49</xref>]. This discrepancy arises because of the method they use to kill themselves; males use more lethal methods such as hanging and firearm, while females use less lethal methods such as drowning or poisoning [<xref ref-type="bibr" rid="CR47">47</xref>, <xref ref-type="bibr" rid="CR50">50</xref>]. Despite the high prevalence of suicidal attempt in females, there is lack of attention to female suicidal behaviors resulting from viewing female suicidal behaviors as manipulative and non-dangerous [<xref ref-type="bibr" rid="CR47">47</xref>, <xref ref-type="bibr" rid="CR51">51</xref>]. However, many studies in the past have shown that the risk of suicidal attempt increases with history of previous suicidal attempt; 10% of the individuals re-attempt suicide within 6 months while 42% re-attempt suicide within 21 months of follow up periods [<xref ref-type="bibr" rid="CR52">52</xref>, <xref ref-type="bibr" rid="CR53">53</xref>]. Moreover, among the risks of suicide, suicidal attempt was said to be the best predictor of suicide; for example, succeeding in suicidal act is 30–40 times higher in those individuals who attempted suicide than the general population [<xref ref-type="bibr" rid="CR19">19</xref>].</p><p>The most striking finding in this study was the low prevalence rate of mental illness among study participants; appearing only in 3 (3.1%) of the study participants. This is in contrast to other studies [<xref ref-type="bibr" rid="CR21">21</xref>–<xref ref-type="bibr" rid="CR23">23</xref>] where mental illness was found highly prevalent among individuals who attempted suicide; in the range of 60–80%. The presence of mental illness among individuals who attempted suicide has also been evidenced by many other studies. For example, a study conducted on 114 suicide attempters at a general hospital in Helsinki had shown that prevalence of mental illness may reach as high as 98% among suicide attempters [<xref ref-type="bibr" rid="CR54">54</xref>]. Among mental disorders reported in patients with suicidal behavior, depression was the commonest one. A study conducted by Suominen et al. [<xref ref-type="bibr" rid="CR54">54</xref>] in 1996 had reported that 67% of patients who attempt suicide had been suffering from depression. Furthermore, a study conducted by Kumar et al. [<xref ref-type="bibr" rid="CR55">55</xref>] in 2006 showed that 81% of their study participants were suffering from one form of mental disorder; depression being the commonest one. Even if further study will be needed to find why mental illness is low among individuals who attempted suicide in our settings, being in a younger age, before the expected age of developing common mental disorders, could be one of the possible explanations why mental disorders were low in this study. Although MINI PLUS was said to be a highly reliable and valid instrument to pick major mental illnesses [<xref ref-type="bibr" rid="CR43">43</xref>, <xref ref-type="bibr" rid="CR56">56</xref>], and in spite of its use in various countries, including Sub-Saharan African countries [<xref ref-type="bibr" rid="CR37">37</xref>–<xref ref-type="bibr" rid="CR39">39</xref>], the absence of its validation in our setting could have its own contribution to the low prevalence of mental illness in this study. Moreover, except for antisocial personality the instrument does not incorporate other personality disorders such us borderline personality disorders. Given the high prevalence of suicide attempt risk, as high as 70% of patients with borderline personality disorders [<xref ref-type="bibr" rid="CR57">57</xref>, <xref ref-type="bibr" rid="CR58">58</xref>], the lack of its inclusion in the MINI PLUS may also have its own role to lessen prevalence of mental disorders in this study.</p><p>The other important finding of this study was the impulsive nature of the study participants; 30 (31.2%) of them attempted suicide impulsively. This figure is higher than the study conducted by Simon et al. [<xref ref-type="bibr" rid="CR31">31</xref>] in 2001, but lower than that of Williams et al. [<xref ref-type="bibr" rid="CR59">59</xref>] in 1980; 24 and 40%, respectively. In this study impulsivity was found associated with male gender (COR = 3, 95% CI 1.2–7.3). Male gender association with impulsivity was also reported by previous studies [<xref ref-type="bibr" rid="CR31">31</xref>, <xref ref-type="bibr" rid="CR59">59</xref>].</p><p>Like other studies [<xref ref-type="bibr" rid="CR60">60</xref>–<xref ref-type="bibr" rid="CR63">63</xref>], ingesting poisonous materials was found to be the most commonly used method to attempt suicide; 79 (82.3%) of the study participants ingested either pesticide poisons or corrosive agents. In contrast to these studies, hanging was found the least method used by the victims in this study, that is by only 8 (8.3%) of the study participants. Consistent with other studies [<xref ref-type="bibr" rid="CR64">64</xref>–<xref ref-type="bibr" rid="CR66">66</xref>], females predominantly use either pesticides or corrosive agents than male. Easy availability of lethal methods at home or around may play an important role in the methods of choice, particularly if the nature of suicide attempt is an impulsive one [<xref ref-type="bibr" rid="CR67">67</xref>]. In this study, a significant number of participants used corrosive agent, medication overdose and pesticides which are used for domestic purposes in a majority of Ethiopian households. Despite some controversy in their effectiveness in reducing suicide attempts, restricting the availability of lethal methods is generally helpful to prevent deaths related to suicide [<xref ref-type="bibr" rid="CR68">68</xref>, <xref ref-type="bibr" rid="CR69">69</xref>].</p><p>Though many studies [<xref ref-type="bibr" rid="CR24">24</xref>, <xref ref-type="bibr" rid="CR25">25</xref>] suggest that having previous suicidal attempts were the main risk factors for next suicidal attempt or suicide, in this study, no participant had a history of previous suicidal attempt. This might be explained by the age of participants in this study. Since the majority, 75 (78.1%) are below the age of 25 years; the current suicidal attempt might be their first experience. The majority of our study participants reported psychosocial stressors as immediate reasons to attempt suicide. For example, 59 (61.5%) of the study participants had quarreled with a family member; 6 (6.2%) had problems related to their love affairs; 6 (6.2%) faced financial crisis. Moreover, among the female study participants, 10 (17.9%) of them attempted suicide because of unplanned and unwanted pregnancy. These finding show that our youngsters might have problems in solving psychosocial crises. Likewise, other previous studies conducted in India and other western countries, have reported that different life events to be important risk factors for deliberate self-harm/suicide attempt [<xref ref-type="bibr" rid="CR23">23</xref>, <xref ref-type="bibr" rid="CR70">70</xref>, <xref ref-type="bibr" rid="CR71">71</xref>]. Similarly, an earlier study conducted by Siwach and Gupata reported that marital disharmony, economic hardships, and scolding/disagreement with other family members as the major precipitating factors [<xref ref-type="bibr" rid="CR72">72</xref>].</p><p>The absence of skills to solve psychosocial crises and the presence of unsafe sexual practices among youths warn us to design strategies to prevent suicide. An urgent need to prompt education regarding a variety of family planning methods, and training on problems solving skills to younger generation to allow them detect problems early and get treatment timely might be necessary.</p><p>The study results may not be generalized since our sample size was small and derived from patients referred from emergency and inpatient services of only two hospitals in SNNPR. On the other hand, because of the stigma associated with suicide, families may not report the case to health professionals. Moreover, those patients who did not appear at the hospital because of non-serious suicidal attempt or died at home and after arrived at emergency department were automatically excluded from our study. Finally, not using a validating instrument and the absence of borderline personality disorder in the MINI PLUS have to be taken into consideration during the interpretation of the results of this study.</p></sec><sec id="Sec14"><title>Conclusions</title><p>The majority of the suicide attempters were below the age of 25. The prevalence of mental illness was found very low compared to those reported figures elsewhere, which are in the range of 60–80%. The presence of impulsivity among youngsters suggests that there is a need to develop suicide prevention strategies. Restricting lethal methods, like pesticides and corrosive agents, may either prevent or decrease suicidal attempts. Having a clear policy on how one can sale and possess these lethal agents is necessary. High numbers of the study participants reported various stressful life events as immediate reasons for suicidal attempt. These findings may suggest the need for the preparation of training programs on problem solving skills for this group of the population. In addition, public education on healthy coping mechanisms under stress and improving communication skills of youths are also crucial to prevent suicidal attempt. Our findings were exploratory, which signaled the need for further focused research to confirm these observations and systematically examine the relationship between the presence of mental illness and suicidal attempt with a larger sample size and more robust methodology.</p></sec></body><back><glossary><title>Abbreviations</title><def-list><def-item><term>MINI PLUs</term><def><p>Mini International Neuropsychiatric Interview version 5</p></def></def-item><def-item><term>SNNPR</term><def><p>Southern Nations, Nationalities and Peoples’ Region</p></def></def-item><def-item><term>OPD</term><def><p>outpatient department</p></def></def-item></def-list></glossary><ack><title>Authors’ contributions</title><p>MA conceived the study, collected, analyzed and interpreted the data. TS supervised the research process, contributed to data analysis and interpretation. MA prepared the draft manuscript. TS and KL contributed in drafting the manuscript. All authors read and approved the final manuscript.</p><sec id="FPar1"><title>Acknowledgements</title><p>We would like to acknowledge patients who voluntarily participated in the study and Hawassa University for funding the study. We are also grateful to Dr. Tesfay S. Tsegay, Assistant Professor of English Language Teaching, School of Language and Communication Studies, Hawassa University, for editing the language of the manuscript.</p></sec><sec id="FPar2"><title>Competing interests</title><p>The authors declare they have no competing interests.</p></sec><sec id="FPar3"><title>Availability of data and materials</title><p>The data can be obtained from the corresponding author whenever needed.</p></sec><sec id="FPar4"><title>Ethical approval and consent to participate</title><p>The proposal was approved on 06/11/2014 by the Hawassa University College of Medicine and Health Sciences Institutional Review Board, and permission letter to conduct the study was given with the following reference number: IRB/008/07. In addition, written permission was obtained from medical directors of the hospitals. All participants of the study were provided with information clearly stating the objectives of the study and their rights to refuse or to participate in it. Informed consent was secured from patients or their guardians if the patients’ decision capacity was compromised and was less than 18 years old. Patients with psychiatric disorders were treated at respective psychiatric OPDs by psychiatric nurses in consultation with a psychiatrist. Those patients who needed ongoing follow up were also given appointments for their usual care.</p></sec><sec id="FPar5"><title>Funding</title><p>The authors did the study from fund given from Hawassa University.</p></sec><sec id="FPar6"><title>Publisher’s Note</title><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></sec></ack><ref-list id="Bib1"><title>References</title><ref id="CR1"><label>1.</label><mixed-citation publication-type="other">Suicide Statistics. AFSP.Centers for Disease Control and Prevention (CDC) Data and Statistics Fatal Injury Report for 2015.</mixed-citation></ref><ref id="CR2"><label>2.</label><mixed-citation publication-type="other">Preventing global suicide: a global imperative. Geneva: World Health Organization; 2014. <ext-link ext-link-type="uri" xlink:href="http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/">http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/</ext-link>. Accessed 24 Jan 2017.</mixed-citation></ref><ref id="CR3"><label>3.</label><mixed-citation publication-type="other">Suicide rates Data by country. World Health Organization; 2012.</mixed-citation></ref><ref id="CR4"><label>4.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bekry</surname><given-names>AA</given-names></name></person-group><article-title>Trends in suicide, parasuicide and accidental poisoning in Addis Ababa, Ethiopia</article-title><source>Ethiop J Health Dev</source><year>1999</year><volume>13</volume><issue>3</issue><fpage>247</fpage><lpage>261</lpage></element-citation></ref><ref id="CR5"><label>5.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Alem</surname><given-names>A</given-names></name><name><surname>Jacobsson</surname><given-names>L</given-names></name><name><surname>Kebede</surname><given-names>D</given-names></name><name><surname>Kullgren</surname><given-names>G</given-names></name></person-group><article-title>Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour. A key informant study in Butajira, Ethiopia</article-title><source>Acta Psychiatr Scand Suppl</source><year>1999</year><volume>397</volume><fpage>65</fpage><lpage>69</lpage><pub-id pub-id-type="doi">10.1111/j.1600-0447.1999.tb10696.x</pub-id><pub-id pub-id-type="pmid">10470357</pub-id></element-citation></ref><ref id="CR6"><label>6.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lester</surname><given-names>D</given-names></name></person-group><article-title>Suicide and islam</article-title><source>Arch Suicide Res.</source><year>2006</year><volume>10</volume><issue>1</issue><fpage>77</fpage><lpage>97</lpage><pub-id pub-id-type="doi">10.1080/13811110500318489</pub-id><pub-id pub-id-type="pmid">16287698</pub-id></element-citation></ref><ref id="CR7"><label>7.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vijayakumar</surname><given-names>L</given-names></name><name><surname>Nagaraj</surname><given-names>K</given-names></name><name><surname>Pirkis</surname><given-names>J</given-names></name><name><surname>Whiteford</surname><given-names>H</given-names></name></person-group><article-title>Suicide in developing countries (1): frequency, distribution, and association with socioeconomic indicators</article-title><source>Crisis.</source><year>2005</year><volume>26</volume><fpage>10411</fpage></element-citation></ref><ref id="CR8"><label>8.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vijayakumar</surname><given-names>L</given-names></name></person-group><article-title>Suicide and its prevention: the urgent need in India</article-title><source>Indian J Psychiatry</source><year>2007</year><volume>49</volume><fpage>814</fpage></element-citation></ref><ref id="CR9"><label>9.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jenkins</surname><given-names>R</given-names></name><name><surname>Kovess</surname><given-names>V</given-names></name></person-group><article-title>Evaluation of suicide prevention: a European approach</article-title><source>Int Rev Psychiatry.</source><year>2002</year><volume>14</volume><fpage>34</fpage><lpage>41</lpage><pub-id pub-id-type="doi">10.1080/09540260120114041</pub-id></element-citation></ref><ref id="CR10"><label>10.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kessler</surname><given-names>RC</given-names></name><name><surname>Berglund</surname><given-names>P</given-names></name><name><surname>Borges</surname><given-names>G</given-names></name><name><surname>Nock</surname><given-names>M</given-names></name><name><surname>Wang</surname><given-names>PS</given-names></name></person-group><article-title>Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003</article-title><source>JAMA</source><year>2005</year><volume>293</volume><fpage>2487</fpage><lpage>2495</lpage><pub-id pub-id-type="doi">10.1001/jama.293.20.2487</pub-id><pub-id pub-id-type="pmid">15914749</pub-id></element-citation></ref><ref id="CR11"><label>11.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>LeMaster</surname><given-names>PL</given-names></name><name><surname>Beals</surname><given-names>J</given-names></name><name><surname>Novina</surname><given-names>DK</given-names></name><name><surname>Manson</surname><given-names>SM</given-names></name></person-group><article-title>The prevalence of suicidal behaviours among Northern Plans American Indians</article-title><source>Suicide Life Threat Behav</source><year>2004</year><volume>34</volume><fpage>242</fpage><lpage>254</lpage><pub-id pub-id-type="doi">10.1521/suli.34.3.242.42780</pub-id><pub-id pub-id-type="pmid">15385179</pub-id></element-citation></ref><ref id="CR12"><label>12.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Linden</surname><given-names>M</given-names></name><name><surname>Barnow</surname><given-names>S</given-names></name></person-group><article-title>The wish to die in very old persons near the end of life: a psychiatric problem? Results from the Berlin aging study</article-title><source>Int Psychogeriatr</source><year>1997</year><volume>9</volume><fpage>291</fpage><lpage>307</lpage><pub-id pub-id-type="doi">10.1017/S1041610297004456</pub-id><pub-id pub-id-type="pmid">9513029</pub-id></element-citation></ref><ref id="CR13"><label>13.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Baca-Garcia</surname><given-names>E</given-names></name><name><surname>Perez-Rodruigez</surname><given-names>M</given-names></name><name><surname>Oquendo</surname><given-names>MA</given-names></name><name><surname>Keyes</surname><given-names>KM</given-names></name><name><surname>Hasin</surname><given-names>DS</given-names></name><name><surname>Grant</surname><given-names>BF</given-names></name><etal></etal></person-group><article-title>Estimating risk for suicide attempt: are we asking the right questions? Passive suicidal ideation as a marker for suicidal behavior</article-title><source>J Affect Disord</source><year>2011</year><volume>134</volume><fpage>327</fpage><lpage>332</lpage><pub-id pub-id-type="doi">10.1016/j.jad.2011.06.026</pub-id><pub-id pub-id-type="pmid">21784532</pub-id></element-citation></ref><ref id="CR14"><label>14.</label><mixed-citation publication-type="other">World Health Organization (WHO) Reports; International suicide statistics. 2000.</mixed-citation></ref><ref id="CR15"><label>15.</label><element-citation publication-type="book"><person-group person-group-type="author"><collab>World Health Organization</collab></person-group><source>Figures and facts about suicide</source><year>1999</year><publisher-loc>Geneva</publisher-loc><publisher-name>Department of Mental Health, WHO</publisher-name></element-citation></ref><ref id="CR16"><label>16.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brown</surname><given-names>GK</given-names></name><name><surname>Beck</surname><given-names>AT</given-names></name><name><surname>Steer</surname><given-names>RA</given-names></name><name><surname>Grisham</surname><given-names>JR</given-names></name></person-group><article-title>Risk factors for suicide in psychiatric outpatients: a 20-year prospective study</article-title><source>J Consult Clin Psychol</source><year>2000</year><volume>68</volume><fpage>371</fpage><lpage>377</lpage><pub-id pub-id-type="doi">10.1037/0022-006X.68.3.371</pub-id><pub-id pub-id-type="pmid">10883553</pub-id></element-citation></ref><ref id="CR17"><label>17.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fawcett</surname><given-names>J</given-names></name><name><surname>Scheftner</surname><given-names>WA</given-names></name><name><surname>Fogg</surname><given-names>L</given-names></name><etal></etal></person-group><article-title>Timerelated predictors of suicide in major affective disorder</article-title><source>Am J Psychiatry</source><year>1990</year><volume>147</volume><fpage>1189</fpage><lpage>1194</lpage><pub-id pub-id-type="doi">10.1176/ajp.147.9.1189</pub-id><pub-id pub-id-type="pmid">2104515</pub-id></element-citation></ref><ref id="CR18"><label>18.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Goldstein</surname><given-names>RB</given-names></name><name><surname>Black</surname><given-names>DW</given-names></name><name><surname>Nasrallah</surname><given-names>A</given-names></name><name><surname>Winokur</surname><given-names>G</given-names></name></person-group><article-title>The prediction of suicide: sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patientswith affective disorders</article-title><source>Arch Gen Psychiatry</source><year>1991</year><volume>48</volume><fpage>418</fpage><lpage>422</lpage><pub-id pub-id-type="doi">10.1001/archpsyc.1991.01810290030004</pub-id><pub-id pub-id-type="pmid">2021294</pub-id></element-citation></ref><ref id="CR19"><label>19.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Harris</surname><given-names>EC</given-names></name><name><surname>Barraclough</surname><given-names>B</given-names></name></person-group><article-title>Suicide as an outcome for mental disorders. A meta-analysis</article-title><source>Br J Psychiatry</source><year>1997</year><volume>170</volume><issue>3</issue><fpage>205</fpage><lpage>228</lpage><pub-id pub-id-type="doi">10.1192/bjp.170.3.205</pub-id><pub-id pub-id-type="pmid">9229027</pub-id></element-citation></ref><ref id="CR20"><label>20.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Shibre</surname><given-names>T</given-names></name><name><surname>Hanlon</surname><given-names>C</given-names></name><name><surname>Medhin</surname><given-names>G</given-names></name><name><surname>Alem</surname><given-names>A</given-names></name><name><surname>Kebede</surname><given-names>D</given-names></name><name><surname>Teferra</surname><given-names>S</given-names></name><etal></etal></person-group><article-title>Suicide and suicide attempts in people with severe mental disorders in Butajira, Ethiopia: 10 year follow-up of a population-based cohort</article-title><source>BMC Psychiatry</source><year>2014</year><volume>14</volume><fpage>150</fpage><pub-id pub-id-type="doi">10.1186/1471-244X-14-150</pub-id><pub-id pub-id-type="pmid">24886518</pub-id></element-citation></ref><ref id="CR21"><label>21.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gunnell</surname><given-names>DJ</given-names></name><name><surname>Peters</surname><given-names>TJ</given-names></name><name><surname>Kammerling</surname><given-names>RM</given-names></name><name><surname>Brooks</surname><given-names>J</given-names></name></person-group><article-title>Relation between parasuicide, suicide, psychiatric admissions, and socio-economic deprivation</article-title><source>BMJ</source><year>1995</year><volume>311</volume><fpage>226</fpage><lpage>230</lpage><pub-id pub-id-type="doi">10.1136/bmj.311.6999.226</pub-id><pub-id pub-id-type="pmid">7627035</pub-id></element-citation></ref><ref id="CR22"><label>22.</label><mixed-citation publication-type="other">Self-harm. National Institute for Health and Clinical Excellence (NICE) CG 16, United Kingdom; 2004.</mixed-citation></ref><ref id="CR23"><label>23.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ramdurg</surname><given-names>S</given-names></name><name><surname>Goyal</surname><given-names>S</given-names></name><name><surname>Goyal</surname><given-names>P</given-names></name><name><surname>Sagar</surname><given-names>R</given-names></name><name><surname>Sharan</surname><given-names>P</given-names></name></person-group><article-title>Sociodemographic profile, clinical factors, and mode of attempt in suicide attempters in consultation liaison psychiatry in a tertiary care center</article-title><source>Ind Psychiatry J</source><year>2011</year><volume>20</volume><issue>1</issue><fpage>11</fpage><lpage>16</lpage><pub-id pub-id-type="doi">10.4103/0972-6748.98408</pub-id><pub-id pub-id-type="pmid">22969174</pub-id></element-citation></ref><ref id="CR24"><label>24.</label><mixed-citation publication-type="other">Schlebusch L. Suicidal behaviour in South Africa. 1st ed. Pietermaritzburg University of KwaZulu-Natal Press; 2005.</mixed-citation></ref><ref id="CR25"><label>25.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schlebusch</surname><given-names>L</given-names></name><name><surname>Vawda</surname><given-names>NB</given-names></name><name><surname>Bosch</surname><given-names>BA</given-names></name></person-group><article-title>Suicidal behaviour in black South Africans’</article-title><source>Crisis</source><year>2003</year><volume>24</volume><issue>1</issue><fpage>24</fpage><lpage>28</lpage><pub-id pub-id-type="doi">10.1027//0227-5910.24.1.24</pub-id><pub-id pub-id-type="pmid">12809149</pub-id></element-citation></ref><ref id="CR26"><label>26.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Singh</surname><given-names>K</given-names></name><name><surname>Jindwani</surname><given-names>K</given-names></name><name><surname>Sahu</surname><given-names>RN</given-names></name></person-group><article-title>Demographic profile of patients with attempted suicide</article-title><source>Biomed Res</source><year>2012</year><volume>23</volume><issue>2</issue><fpage>234</fpage><lpage>236</lpage></element-citation></ref><ref id="CR27"><label>27.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Singh</surname><given-names>V</given-names></name><name><surname>Gupta</surname><given-names>DK</given-names></name><name><surname>Desai</surname><given-names>NG</given-names></name><name><surname>Srivastava</surname><given-names>A</given-names></name><name><surname>Chaudhry</surname><given-names>R</given-names></name><name><surname>Varma</surname><given-names>A</given-names></name><name><surname>Sengupta</surname><given-names>S</given-names></name></person-group><article-title>Sociodemographic and clinical profile of patients with attempted suicide attending emergency services at the mental health institute in Northern India</article-title><source>J Mental Health Hum Behav</source><year>2014</year><volume>19</volume><issue>2</issue><fpage>69</fpage><lpage>73</lpage><pub-id pub-id-type="doi">10.4103/0971-8990.153713</pub-id></element-citation></ref><ref id="CR28"><label>28.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vijayakumar</surname><given-names>L</given-names></name></person-group><article-title>Suicide and its prevention: the urgent need in India</article-title><source>Indian J Psychiatry</source><year>2007</year><volume>49</volume><fpage>81</fpage><lpage>84</lpage><pub-id pub-id-type="doi">10.4103/0019-5545.33252</pub-id><pub-id pub-id-type="pmid">20711387</pub-id></element-citation></ref><ref id="CR29"><label>29.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Osvath</surname><given-names>P</given-names></name><name><surname>Voros</surname><given-names>V</given-names></name><name><surname>Fekete</surname><given-names>S</given-names></name></person-group><article-title>Life events and psychopathology in a group of suicide attempters</article-title><source>Psychopathology</source><year>2004</year><volume>37</volume><fpage>36</fpage><lpage>44</lpage><pub-id pub-id-type="doi">10.1159/000077018</pub-id><pub-id pub-id-type="pmid">14988649</pub-id></element-citation></ref><ref id="CR30"><label>30.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brown</surname><given-names>L</given-names></name><name><surname>Overholser</surname><given-names>J</given-names></name><name><surname>Spirito</surname><given-names>A</given-names></name><name><surname>Fritz</surname><given-names>G</given-names></name></person-group><article-title>The correlates of planning in adolescent suicide attempts</article-title><source>J Am Acad Child Adolesc Psychiatry</source><year>1991</year><volume>30</volume><fpage>95</fpage><lpage>99</lpage><pub-id pub-id-type="doi">10.1097/00004583-199101000-00014</pub-id><pub-id pub-id-type="pmid">2005070</pub-id></element-citation></ref><ref id="CR31"><label>31.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Simon</surname><given-names>TR</given-names></name><name><surname>Swann</surname><given-names>AC</given-names></name><name><surname>Powell</surname><given-names>KE</given-names></name><name><surname>Potter</surname><given-names>LB</given-names></name><name><surname>Kresnow</surname><given-names>M</given-names></name><name><surname>O’Carrol</surname><given-names>PW</given-names></name></person-group><article-title>Characteristics of impulsive suicide attempts and attempters</article-title><source>Suicide Life-Threat Behav</source><year>2001</year><volume>32</volume><fpage>49</fpage><lpage>59</lpage><pub-id pub-id-type="doi">10.1521/suli.32.1.5.49.24212</pub-id><pub-id pub-id-type="pmid">11924695</pub-id></element-citation></ref><ref id="CR32"><label>32.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Baca-Garcia</surname><given-names>E</given-names></name><name><surname>Diaze- Sastre</surname><given-names>C</given-names></name><name><surname>Resa</surname><given-names>EG</given-names></name><name><surname>Blasco</surname><given-names>H</given-names></name><name><surname>conesa</surname><given-names>DB</given-names></name><name><surname>Oquendo</surname><given-names>MA</given-names></name><etal></etal></person-group><article-title>Suicide and Impulsivity</article-title><source>Eur Arch Psychiatry Clin Neurosci</source><year>2005</year><volume>255</volume><fpage>152</fpage><lpage>156</lpage><pub-id pub-id-type="doi">10.1007/s00406-004-0549-3</pub-id><pub-id pub-id-type="pmid">15549343</pub-id></element-citation></ref><ref id="CR33"><label>33.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Swann</surname><given-names>AC</given-names></name><name><surname>Dougherty</surname><given-names>D</given-names></name><name><surname>Pazzaglia</surname><given-names>P</given-names></name><name><surname>Pham</surname><given-names>M</given-names></name><name><surname>Steinberg</surname><given-names>JL</given-names></name><name><surname>Moeller</surname><given-names>FG</given-names></name></person-group><article-title>Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder</article-title><source>Am J Psychiatry</source><year>2005</year><volume>162</volume><fpage>1680</fpage><lpage>1687</lpage><pub-id pub-id-type="doi">10.1176/appi.ajp.162.9.1680</pub-id><pub-id pub-id-type="pmid">16135628</pub-id></element-citation></ref><ref id="CR34"><label>34.</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Stengel</surname><given-names>E</given-names></name></person-group><source>Suicide and attempted suicide</source><year>1964</year><publisher-loc>Baltimore</publisher-loc><publisher-name>Penguin</publisher-name></element-citation></ref><ref id="CR35"><label>35.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kar</surname><given-names>N</given-names></name></person-group><article-title>Profile of risk factors associated with suicide attempts: A study from Orissa, India</article-title><source>Indian J Psychiatry</source><year>2010</year><volume>52</volume><issue>1</issue><fpage>48</fpage><pub-id pub-id-type="doi">10.4103/0019-5545.58895</pub-id><pub-id pub-id-type="pmid">20174518</pub-id></element-citation></ref><ref id="CR36"><label>36.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kessler</surname><given-names>RC</given-names></name><name><surname>Borges</surname><given-names>G</given-names></name><name><surname>Walters</surname><given-names>EE</given-names></name></person-group><article-title>Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey</article-title><source>Arch Gen Psychiatry</source><year>1999</year><volume>56</volume><fpage>61726</fpage><pub-id pub-id-type="doi">10.1001/archpsyc.56.7.617</pub-id></element-citation></ref><ref id="CR37"><label>37.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kaminer</surname><given-names>D</given-names></name><name><surname>Stein</surname><given-names>DJ</given-names></name><name><surname>Mbanga</surname><given-names>I</given-names></name><name><surname>Zungu-Dirwayi</surname><given-names>N</given-names></name></person-group><article-title>The truth and Reconcilaation Commission in South Africa: relation to psychiatric status and forgivenes among survivvors of human rights abuses</article-title><source>Br J Psychiatry</source><year>2001</year><volume>178</volume><issue>3</issue><fpage>373</fpage><lpage>377</lpage><pub-id pub-id-type="doi">10.1192/bjp.178.4.373</pub-id><pub-id pub-id-type="pmid">11282818</pub-id></element-citation></ref><ref id="CR38"><label>38.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ertl</surname><given-names>V</given-names></name><name><surname>Pfeiffer</surname><given-names>A</given-names></name><name><surname>Saile</surname><given-names>R</given-names></name><name><surname>Schauer</surname><given-names>E</given-names></name><name><surname>Elbert</surname><given-names>T</given-names></name><name><surname>Neuner</surname><given-names>F</given-names></name></person-group><article-title>Validation of mental health assessment in an African conflict population</article-title><source>Psychol Assess</source><year>2010</year><volume>22</volume><issue>2</issue><fpage>318</fpage><lpage>324</lpage><pub-id pub-id-type="doi">10.1037/a0018810</pub-id><pub-id pub-id-type="pmid">20528059</pub-id></element-citation></ref><ref id="CR39"><label>39.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Salah</surname><given-names>TTM</given-names></name><name><surname>Abdelrahman</surname><given-names>A</given-names></name><name><surname>Lien</surname><given-names>L</given-names></name><name><surname>Eide</surname><given-names>AH</given-names></name><name><surname>Martinez</surname><given-names>P</given-names></name><name><surname>Hauff</surname><given-names>E</given-names></name></person-group><article-title>The mental health of internally displaced persons: an epidemilogical study of adults in two settlements in Central Sudan</article-title><source>Int J Soc Psychiatry.</source><year>2013</year><volume>59</volume><issue>8</issue><fpage>782</fpage><lpage>788</lpage><pub-id pub-id-type="doi">10.1177/0020764012456810</pub-id><pub-id pub-id-type="pmid">22982816</pub-id></element-citation></ref><ref id="CR40"><label>40.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Heyningen</surname><given-names>T</given-names></name><name><surname>Myer</surname><given-names>L</given-names></name><name><surname>Onah</surname><given-names>M</given-names></name><name><surname>Field</surname><given-names>S</given-names></name><name><surname>Honikman</surname><given-names>S</given-names></name></person-group><article-title>Antenatal depression and adversity in urban South Africa</article-title><source>J Affect Disord</source><year>2016</year><volume>203</volume><fpage>121</fpage><lpage>129</lpage><pub-id pub-id-type="doi">10.1016/j.jad.2016.05.052</pub-id><pub-id pub-id-type="pmid">27285725</pub-id></element-citation></ref><ref id="CR41"><label>41.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sweetland</surname><given-names>AC</given-names></name><name><surname>Belkin</surname><given-names>GS</given-names></name><name><surname>Verdeli</surname><given-names>H</given-names></name></person-group><article-title>Measuring depression and anxiety in Sub-Saharan Africa</article-title><source>NIH Public Acces</source><year>2014</year><volume>32</volume><issue>3</issue><fpage>223</fpage><lpage>232</lpage></element-citation></ref><ref id="CR42"><label>42.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Nakku</surname><given-names>J</given-names></name><name><surname>Kinyanda</surname><given-names>E</given-names></name><name><surname>Hoskins</surname><given-names>S</given-names></name></person-group><article-title>Prevalence and factors associated with probable HIV dementia in an African population: a cross-sectional study of an HIV/AIDS clinic population</article-title><source>BMC Psychiatry</source><year>2013</year><volume>13</volume><fpage>126</fpage><pub-id pub-id-type="doi">10.1186/1471-244X-13-126</pub-id><pub-id pub-id-type="pmid">23641703</pub-id></element-citation></ref><ref id="CR43"><label>43.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sheehan</surname><given-names>DV</given-names></name><name><surname>Lecrubier</surname><given-names>Y</given-names></name><name><surname>Sheehan</surname><given-names>KH</given-names></name><name><surname>Amorim</surname><given-names>P</given-names></name><name><surname>Janavs</surname><given-names>J</given-names></name><name><surname>Weiller</surname><given-names>E</given-names></name><etal></etal></person-group><article-title>The Mini International Neuropsychiatric Interview (MINI): the development and validation of structured diagnostic psychiatric interview for DSM-IV and ICD-10</article-title><source>J Clin Psychiatry</source><year>1998</year><volume>59</volume><issue>20</issue><fpage>22</fpage><lpage>33</lpage><pub-id pub-id-type="pmid">9881538</pub-id></element-citation></ref><ref id="CR44"><label>44.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kebede</surname><given-names>D</given-names></name><name><surname>Alem</surname><given-names>A</given-names></name></person-group><article-title>Suicide attempts and ideation among adults in Addis Ababa, Ethiopia</article-title><source>Acta Psychiatr Scand Suppl</source><year>1999</year><volume>397</volume><fpage>35</fpage><lpage>39</lpage><pub-id pub-id-type="doi">10.1111/j.1600-0447.1999.tb10692.x</pub-id><pub-id pub-id-type="pmid">10470353</pub-id></element-citation></ref><ref id="CR45"><label>45.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Isacsson</surname><given-names>G</given-names></name><name><surname>Rich</surname><given-names>CL</given-names></name></person-group><article-title>Management of patients who deliberately harm themselves</article-title><source>BMJ</source><year>2001</year><volume>322</volume><fpage>2135</fpage><pub-id pub-id-type="doi">10.1136/bmj.322.7280.213</pub-id></element-citation></ref><ref id="CR46"><label>46.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Varnik</surname><given-names>P</given-names></name></person-group><article-title>Suicide in the world</article-title><source>Int J Environ Res Public Health</source><year>2012</year><volume>9</volume><issue>3</issue><fpage>760</fpage><lpage>771</lpage><pub-id pub-id-type="doi">10.3390/ijerph9030760</pub-id><pub-id pub-id-type="pmid">22690161</pub-id></element-citation></ref><ref id="CR47"><label>47.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vijayakumar</surname><given-names>L</given-names></name></person-group><article-title>Suicide in women</article-title><source>Indian J Psychiatry</source><year>2015</year><volume>57</volume><issue>2</issue><fpage>233</fpage><lpage>238</lpage><pub-id pub-id-type="doi">10.4103/0019-5545.161484</pub-id></element-citation></ref><ref id="CR48"><label>48.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chang</surname><given-names>B</given-names></name><name><surname>Gitlin</surname><given-names>D</given-names></name><name><surname>Patel</surname><given-names>R</given-names></name></person-group><article-title>The depressed patient and suicidal patient in the emergency department: evidence-based management and treatment strategies</article-title><source>Emerg Med Pract</source><year>2011</year><volume>13</volume><issue>9</issue><fpage>1</fpage><lpage>23</lpage><pub-id pub-id-type="pmid">22164363</pub-id></element-citation></ref><ref id="CR49"><label>49.</label><element-citation publication-type="book"><person-group person-group-type="editor"><name><surname>Krug</surname><given-names>EG</given-names></name><name><surname>Mercy</surname><given-names>JA</given-names></name><name><surname>Dahlberg</surname><given-names>LL</given-names></name><name><surname>Zwi</surname><given-names>AB</given-names></name><name><surname>Lozano</surname><given-names>R</given-names></name></person-group><source>World report on violence and health</source><year>2002</year><publisher-loc>Geneva</publisher-loc><publisher-name>World Health Organization</publisher-name></element-citation></ref><ref id="CR50"><label>50.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Denning</surname><given-names>DG</given-names></name><name><surname>Conwell</surname><given-names>Y</given-names></name><name><surname>King</surname><given-names>D</given-names></name><name><surname>Cox</surname><given-names>C</given-names></name></person-group><article-title>Merthod choice, intent, and gender in completed suicide</article-title><source>Suicide Life Threat Behav</source><year>2000</year><volume>30</volume><fpage>282</fpage><lpage>288</lpage><pub-id pub-id-type="pmid">11079640</pub-id></element-citation></ref><ref id="CR51"><label>51.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Murphy</surname><given-names>GE</given-names></name></person-group><article-title>Why women are less likely than men to commit suicide</article-title><source>Compr Psychiatry</source><year>1998</year><volume>39</volume><fpage>165</fpage><lpage>175</lpage><pub-id pub-id-type="doi">10.1016/S0010-440X(98)90057-8</pub-id><pub-id pub-id-type="pmid">9675500</pub-id></element-citation></ref><ref id="CR52"><label>52.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Goldston</surname><given-names>DB</given-names></name><name><surname>Daniel</surname><given-names>SS</given-names></name><name><surname>Reboussin</surname><given-names>DM</given-names></name><name><surname>Reboussin</surname><given-names>BA</given-names></name><name><surname>Frazier</surname><given-names>PH</given-names></name><name><surname>Kelley</surname><given-names>AE</given-names></name></person-group><article-title>Suicide attempts among formerly hospitalized adolescents: A prospective naturalistic study of risk during the first 5 years after discharge</article-title><source>J Am Acad Child Adolesc Psychiatry</source><year>1999</year><volume>38</volume><issue>6</issue><fpage>660</fpage><lpage>671</lpage><pub-id pub-id-type="doi">10.1097/00004583-199906000-00012</pub-id><pub-id pub-id-type="pmid">10361783</pub-id></element-citation></ref><ref id="CR53"><label>53.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hawton</surname><given-names>K</given-names></name><name><surname>Zahl</surname><given-names>D</given-names></name><name><surname>Weatherall</surname><given-names>R</given-names></name></person-group><article-title>Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital</article-title><source>Br J Psychiatry</source><year>2003</year><volume>182</volume><fpage>537</fpage><lpage>542</lpage><pub-id pub-id-type="doi">10.1192/bjp.182.6.537</pub-id><pub-id pub-id-type="pmid">12777346</pub-id></element-citation></ref><ref id="CR54"><label>54.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Suominen</surname><given-names>K</given-names></name><name><surname>Henriksson</surname><given-names>M</given-names></name><name><surname>Suokas</surname><given-names>J</given-names></name><name><surname>Isometsa</surname><given-names>E</given-names></name><name><surname>Ostamo</surname><given-names>A</given-names></name><name><surname>Lonnqvist</surname><given-names>J</given-names></name></person-group><article-title>Mental disorders and comorbidity in attempted suicide</article-title><source>Acta Psychiatr Scand</source><year>1996</year><volume>94</volume><fpage>234</fpage><lpage>240</lpage><pub-id pub-id-type="doi">10.1111/j.1600-0447.1996.tb09855.x</pub-id><pub-id pub-id-type="pmid">8911558</pub-id></element-citation></ref><ref id="CR55"><label>55.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kumar</surname><given-names>CTS</given-names></name><name><surname>Mohan</surname><given-names>R</given-names></name><name><surname>Ranjith</surname><given-names>G</given-names></name><name><surname>Chandrasekaran</surname><given-names>R</given-names></name></person-group><article-title>Characterstics of high intent suicide attempters admitted to a general hospital</article-title><source>J Affect Disord</source><year>2006</year><volume>91</volume><fpage>77</fpage><lpage>81</lpage><pub-id pub-id-type="doi">10.1016/j.jad.2005.12.028</pub-id><pub-id pub-id-type="pmid">16443283</pub-id></element-citation></ref><ref id="CR56"><label>56.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lecrubier</surname><given-names>Y</given-names></name><name><surname>Sheehan</surname><given-names>D</given-names></name><name><surname>Weiller</surname><given-names>E</given-names></name></person-group><article-title>The Mini-International Neuropsychiatric Interview (MINI). a short diagnostic structured interview: reliability and validity according to the CIDI</article-title><source>Eur Psychiatry</source><year>1997</year><volume>12</volume><fpage>224</fpage><lpage>231</lpage><pub-id pub-id-type="doi">10.1016/S0924-9338(97)83296-8</pub-id></element-citation></ref><ref id="CR57"><label>57.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Soloff</surname><given-names>PH</given-names></name><name><surname>Lynch</surname><given-names>KG</given-names></name><name><surname>Kelly</surname><given-names>TM</given-names></name><name><surname>Malone</surname><given-names>KM</given-names></name><name><surname>Mann</surname><given-names>JJ</given-names></name></person-group><article-title>Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study</article-title><source>Am J Psychiatry</source><year>2000</year><volume>157</volume><fpage>601</fpage><lpage>608</lpage><pub-id pub-id-type="doi">10.1176/appi.ajp.157.4.601</pub-id><pub-id pub-id-type="pmid">10739420</pub-id></element-citation></ref><ref id="CR58"><label>58.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Soloff</surname><given-names>PH</given-names></name><name><surname>Chiappetta</surname><given-names>L</given-names></name></person-group><article-title>Prospective predictors of suicidal behavior in borderline personality disorder at 6-year follow-up</article-title><source>Am J Psychiatry</source><year>2012</year><volume>169</volume><fpage>484</fpage><lpage>490</lpage><pub-id pub-id-type="doi">10.1176/appi.ajp.2011.11091378</pub-id><pub-id pub-id-type="pmid">22549208</pub-id></element-citation></ref><ref id="CR59"><label>59.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Williams</surname><given-names>C</given-names></name><name><surname>Davidson</surname><given-names>J</given-names></name><name><surname>Montgomery</surname><given-names>I</given-names></name></person-group><article-title>Impulsive suicidal behavior</article-title><source>J Clin Psychol</source><year>1980</year><volume>36</volume><fpage>90</fpage><lpage>94</lpage><pub-id pub-id-type="doi">10.1002/1097-4679(198001)36:1<90::AID-JCLP2270360104>3.0.CO;2-F</pub-id><pub-id pub-id-type="pmid">7391258</pub-id></element-citation></ref><ref id="CR60"><label>60.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Alem</surname><given-names>A</given-names></name><name><surname>Jacobsson</surname><given-names>L</given-names></name><name><surname>Kebede</surname><given-names>D</given-names></name><name><surname>Kullgren</surname><given-names>G</given-names></name></person-group><article-title>Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour. A key informant study in Butajira, Ethiopia</article-title><source>Acta Psychiatr Scand Suppl</source><year>1999</year><volume>397</volume><fpage>65</fpage><lpage>69</lpage><pub-id pub-id-type="doi">10.1111/j.1600-0447.1999.tb10696.x</pub-id><pub-id pub-id-type="pmid">10470357</pub-id></element-citation></ref><ref id="CR61"><label>61.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mekonnen</surname><given-names>D</given-names></name><name><surname>Kebede</surname><given-names>Y</given-names></name></person-group><article-title>The prevalence of suicidal ideation and attempts among individuals attending an adult psychiatry out-patient clinic in Gondar, Ethiopia</article-title><source>Afr Health Sci</source><year>2011</year><volume>11</volume><issue>1</issue><fpage>103</fpage><lpage>107</lpage><pub-id pub-id-type="pmid">21572865</pub-id></element-citation></ref><ref id="CR62"><label>62.</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Sudak</surname><given-names>HS</given-names></name></person-group><person-group person-group-type="editor"><name><surname>Sadock</surname><given-names>BJ</given-names></name><name><surname>Sadock</surname><given-names>VA</given-names></name></person-group><article-title>Psychiatric emergencies: Suicide</article-title><source>Kaplan and Sadock's Comprehensive Textbook of Psychiatry</source><year>2009</year><edition>9</edition><publisher-loc>Philadelphia</publisher-loc><publisher-name>Lippincott Williams & Wilkins</publisher-name><fpage>2723</fpage></element-citation></ref><ref id="CR63"><label>63.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Naidoo</surname><given-names>SS</given-names></name></person-group><article-title>Sociodemographic and clinical profiles of suicidal patients requiring admission to hospitals south of Durban</article-title><source>S Afr Fam Pract</source><year>2013</year><volume>55</volume><issue>4</issue><fpage>373</fpage><lpage>379</lpage><pub-id pub-id-type="doi">10.1080/20786204.2013.10874379</pub-id></element-citation></ref><ref id="CR64"><label>64.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ji</surname><given-names>J</given-names></name><name><surname>Kleinman</surname><given-names>A</given-names></name><name><surname>Becker</surname><given-names>AE</given-names></name></person-group><article-title>Suicide in contemporary China: a review of China’s distinctive suicide demographics in their sociocultural context</article-title><source> Harv Rev Psychiatry</source><year>2001</year><volume>9</volume><fpage>1</fpage><lpage>12</lpage><pub-id pub-id-type="doi">10.1080/10673220127875</pub-id><pub-id pub-id-type="pmid">11159928</pub-id></element-citation></ref><ref id="CR65"><label>65.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yip</surname><given-names>PS</given-names></name><name><surname>Liu</surname><given-names>KY</given-names></name></person-group><article-title>The ecological fallacy and the gender ratio of suicide in China</article-title><source>Br J Psychiatry</source><year>2006</year><volume>189</volume><fpage>465</fpage><lpage>466</lpage><pub-id pub-id-type="doi">10.1192/bjp.bp.106.021816</pub-id><pub-id pub-id-type="pmid">17077441</pub-id></element-citation></ref><ref id="CR66"><label>66.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Alem</surname><given-names>A</given-names></name><name><surname>Kebede</surname><given-names>D</given-names></name><name><surname>Jacobsson</surname><given-names>L</given-names></name><name><surname>Kullgren</surname><given-names>G</given-names></name></person-group><article-title>Suicide attempts among adults in Butajira, Ethiopia</article-title><source>Acta Psychiatr Scand</source><year>1999</year><volume>100</volume><fpage>70</fpage><lpage>76</lpage><pub-id pub-id-type="doi">10.1111/j.1600-0447.1999.tb10697.x</pub-id></element-citation></ref><ref id="CR67"><label>67.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Marzuk</surname><given-names>PM</given-names></name><name><surname>Leon</surname><given-names>Ac</given-names></name><name><surname>Tardiff</surname><given-names>K</given-names></name><name><surname>Morgan</surname><given-names>EB</given-names></name><name><surname>Stajic</surname><given-names>M</given-names></name><name><surname>Mann</surname><given-names>JJ</given-names></name></person-group><article-title>The effect of access to lethal methods of injury on suicide rates</article-title><source>Arch Gen Psychiatry</source><year>1992</year><volume>49</volume><fpage>451</fpage><lpage>458</lpage><pub-id pub-id-type="doi">10.1001/archpsyc.1992.01820060031005</pub-id><pub-id pub-id-type="pmid">1599369</pub-id></element-citation></ref><ref id="CR68"><label>68.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Eddleston</surname><given-names>M</given-names></name><name><surname>Karalliedde</surname><given-names>L</given-names></name><name><surname>Buckley</surname><given-names>N</given-names></name><name><surname>Fernando</surname><given-names>R</given-names></name><name><surname>Hutchinson</surname><given-names>G</given-names></name><name><surname>Isbister</surname><given-names>G</given-names></name><etal></etal></person-group><article-title>Pesticide poisoning in the developing world—a minimum pesticides list</article-title><source>Lancet</source><year>2002</year><volume>360</volume><fpage>1163</fpage><lpage>1167</lpage><pub-id pub-id-type="doi">10.1016/S0140-6736(02)11204-9</pub-id><pub-id pub-id-type="pmid">12387969</pub-id></element-citation></ref><ref id="CR69"><label>69.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Nandi</surname><given-names>DN</given-names></name><name><surname>Mukherjee</surname><given-names>SP</given-names></name><name><surname>Banerjee</surname><given-names>G</given-names></name><name><surname>Ghosh</surname><given-names>A</given-names></name><name><surname>Boral</surname><given-names>GC</given-names></name><name><surname>Chowdhury</surname><given-names>A</given-names></name><etal></etal></person-group><article-title>Is suicide preventable by restricting the availability of lethal agents? A rural survey of West Bengal</article-title><source>Indian J Psychiatry</source><year>1979</year><volume>21</volume><fpage>251</fpage><lpage>255</lpage></element-citation></ref><ref id="CR70"><label>70.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rich</surname><given-names>CL</given-names></name><name><surname>Warstadt</surname><given-names>GM</given-names></name><name><surname>Nemiroff</surname><given-names>RA</given-names></name><name><surname>Fowler</surname><given-names>RC</given-names></name><name><surname>Young</surname><given-names>D</given-names></name></person-group><article-title>Suicide, stressors and the life cycle</article-title><source>Am J Psychiatry</source><year>1991</year><volume>148</volume><fpage>524</fpage><lpage>527</lpage><pub-id pub-id-type="doi">10.1176/ajp.148.4.524</pub-id><pub-id pub-id-type="pmid">2006700</pub-id></element-citation></ref><ref id="CR71"><label>71.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Latha</surname><given-names>KS</given-names></name><name><surname>Bhat</surname><given-names>SM</given-names></name><name><surname>D’Souza</surname><given-names>P</given-names></name></person-group><article-title>Attempted suicide and recent stressful life events: a report from India</article-title><source>Crisis</source><year>1994</year><volume>15</volume><fpage>136</fpage><pub-id pub-id-type="pmid">7859481</pub-id></element-citation></ref><ref id="CR72"><label>72.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Siwach</surname><given-names>SB</given-names></name><name><surname>Gupta</surname><given-names>A</given-names></name></person-group><article-title>The profile of acute poisonings in Haryana-Rohtak Study</article-title><source>J Assoc Physicians India</source><year>1995</year><volume>43</volume><fpage>756</fpage><lpage>759</lpage><pub-id pub-id-type="pmid">8773034</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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