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Stressors of Suicide Among the Residents of Ilam, Eastern Nepal: an Investigation Into a Neglected Burden

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Abstract

Suicide is increasingly being recognized as a global public health concern, but it is still treated as a neglected burden in Nepal. Case-control study on suicide from Nepal is very rare. Thus, a community-based matched case-control study was conducted at Ilam District to identify different stressors associated with Nepalese suicidal victims with appropriate samples of 64 cases which were matched for age group (± 2 years) and area of residence with 128 controls (1:2 ratio). Data was collected through suicide survivors and close neighbors of suicide victims. Intimate partner violence was an independent risk factor for committing suicide (OR (95% CI) = 5.33 (1.41–20.10), P = 0.013). A conditional logistic regression identified two strong stressors of suicide: depression (OR (95% CI) = 10.53 (3.11–35.66), P < 0.001) and substance dependence (OR (95% CI) = 16.38 (4.23–63.35), P < 0.001). This is the first community-based case-control study to report stressors of suicide from eastern Nepal. An integrated counseling and public awareness center needs to be established by the Nepal Government at Ilam District addressing those significant stressors. Furthermore, the findings also have implications for formulating national health policy to be implemented in vulnerable districts in order to decrease risks of suicide in Nepal.

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Acknowledgments

We thank the School of Public Health and Community Medicine, BPKIHS, Dharan, for providing an opportunity to conduct this study. We are thankful to Ilam group MBBS year students: Sabin Acharya, Sabin Kumar Ghimire, Saksham Agrawal, Sandeep Shrestha, Saniya Amna Ansari, Santosh Adhikari, Santosh Pant, Santosh Parajuli, Santosh Prasad Rauniyar, Shreya Dhungana, and Smriti Jha. We would like to acknowledge DSP Mr. Prakash Ranabhat and Mr. Rohan Acharya for their remarkable cooperation during data collection, and Mr. Dharma Gautam and Mr. Benup Raj Prasai for the logistic support. And we are very much grateful to all those who had directly or indirectly contributed to the study.

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  1. School of Public Health and Community Medicine, B P Koirala Institute of Health Sciences, P.O. Box: 7053, Dharan, Sunsari, Nepal

    Surya Raj Niraula, Nisha Manandhar, Sagar Pandey & Nilambar Jha

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  1. Surya Raj Niraula
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Correspondence to Surya Raj Niraula.

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The study was approved by the Ethical Review Board of the Research Committee of B.P. Koirala Institute of Health Sciences, Dharan, an institution authorized by the Nepal Health Research Council.

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Niraula, S.R., Manandhar, N., Pandey, S. et al. Stressors of Suicide Among the Residents of Ilam, Eastern Nepal: an Investigation Into a Neglected Burden. Int J Ment Health Addiction 20, 1793–1805 (2022). https://doi.org/10.1007/s11469-020-00480-0

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