Suicidal Behaviors among Patients Attending for Psychiatric Care in a Tertiary Care Hospital of Bangladesh.

Suicide is a major preventable public health problem globally however, under attended in Bangladesh. It happens because of multi-factorial involvement; nevertheless, past suicidal attempt is a significant predictor of future suicidal behavior. We aimed to assess the suicidal behaviors among the patients visiting for psychiatric care in a tertiary care hospital of Bangladesh. This cross-sectional study was conducted among the patients attending at department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, from March 2018 to February 2019. A total of 379 patients were interviewed with pre-tested semi structured questionnaire. Non probability purposive sampling was used to collect data. Data were entered into Statistical Package for the Social Sciences 16.0 software and analyzed Among the 379 respondents, 197(52%) were male, 52.5% were married. Mean±SD age of the respondents was 29.94±11.32 year ranging from 18 to 75 years. About 24% percent of the respondents had family history of mental illness, 4% had family history of completed suicides. Prevalence of life time suicidal ideation among the patients was found as 32.5%, one-year prevalence rate 26.4%, one month 17.2% and within last two days it was found as 11.3%. The rate of suicidal plan was 14.0%, preparation 10.0% and attempt was 7.4%. Mean±SD age of onset of suicidal ideation was 24.33±8.9 year ranging from 14 to 57 years. About one in three psychiatric patients had life time suicidal ideation. Third decade of life was found to be vulnerable for onset of suicidal thoughts.

Cultural Variations in Symptom Presentations of Depression: A Cross-sectional Observation in a Tertiary Care Hospital of Bangladesh.

Depression is a normally occurring, severe, repeated disorder associated to diminished role functioning and quality of life, medical morbidity, and mortality. But presentation of depression differs culture to culture. We aimed to see the proportion of depressed patients presented spontaneously with the somatic complaints at department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. This descriptive, cross sectional study was conducted within the time period of June 2016 to December 2017 among the outdoor patients of the university. Purposive consecutive sampling was used to collect data from 105 depressed patients. The diagnosis was confirmed by the psychiatrist based on the DSM-5 criteria of depression. Data were collected through face to face interview with semi structured preformed pretested questionnaire. All data were entered into SPSS 16.0 software and were analyzed. The mean±SD age was 32.09±12.13 years, ranging from 18 to 70 years. Among the 105 respondents 36% of the depressive patients had complaints of somatic symptoms spontaneously. Headache (34.21%), weakness (2%), body ache (5%), hearing problem, heaviness of the body, restlessness, chest pain, palpitation, dizziness, vertigo, breathlessness, abdominal discomfort and burning sensation were the mentionable symptoms. Fear (11), anger (2), undue suspiciousness (2) & sexual dysfunction were the mentionable psychological symptoms. Due to multiple factors depressed patients can spontaneously present with somatic complaints, but after questioning on depression they can be diagnosed as depression. So, unexplained somatic symptoms should be attended and addressed properly in any stage of care.

Psychiatric Morbidities among Male Juvenile Offenders: A Cross Sectional Comparison in Bangladesh.

Inmates of Juvenile Developmental Centers are the special group of youth population who are in conflict with law and are vulnerable to psychiatric disorders. It was aimed to see the variation of prevalence and type of psychiatric disorders in institutionalized male juvenile offenders and non-offenders of same age, sex and socioeconomic group in the community. The association of mental disorders was examined in 138 male inmates of Juvenile Development Centers and 138 randomly selected comparison subjects in community. One stage-structured assessment of psychopathology was carried out by using a structured and valid Bangla version of the Development and Well-Being Assessment (DAWBA). Psychiatric diagnosis was established after scoring from DAWBA that is actually corresponds to diagnosis of ICD-10 for research. It was revealed that, of those who were in conflict with law, 57.2% had mental disorder, whereas 9.4% of non-offenders had psychiatric disorder. Among the offenders with psychiatric disorders, most of them (16.7%) suffered from Conduct Disorder (CD), followed by Major Depressive Disorder (MDD). On the other hand, among the non-offenders with psychiatric disorder 2.2% suffered from CD. Study revealed that psychiatric disorders are more prevalent among the male juvenile offenders with comparison to non-offenders. Broad-based multi centered and cross cultural replication study can generalize the findings.

Prevalence of Psychiatric Disorders among Female Juvenile Offenders.

Inmates of Juvenile Developmental Centers are the special group of youth population who are in conflict with law. They are vulnerable to psychiatric illness. The objective of this study was to see the prevalence and type of psychiatric disorders in institutionalized female juvenile offenders and non-offenders of same age, sex and socioeconomic group in the community. The association of mental disorders was examined in 43 female inmates of Juvenile Development Centers and 43 randomly selected comparison subjects in community. One stage-structured assessment of psychopathology was carried out by using a structured and valid Bangla version of the Development and Well-Being Assessment (DAWBA). Development and Well-Being Assessment generated psychiatric diagnosis was assigned based on ICD-10 diagnostic criteria for research. The result revealed that, of those who were in conflict with law, 93% had mental disorder, whereas 14% of non-offenders had psychiatric disorder. Among the offenders with psychiatric disorders, most of them (32.6%) suffered from Major Depressive Disorder (MDD), followed by combined MDD & Post Traumatic Stress Disorder (PTSD). On the other hand, among the non-offenders with psychiatric disorder 9.3% suffered from MDD. It can be concluded that considerable psychiatric disorders are prevalent among the female juvenile offenders with comparison to non-offenders. Broad-based replication study could confirm these findings.