October 2007 - Volume 1, Issue 5

SOCIAL AND FAMILY FACTORS' EFFECT ON COMMITTING SUICIDE AMONG UNIVERSITY STUDENTS IN IRAN

Seyyed Hadi Motamedi, MD Asghar Dadkhah, PhD University of Social Welfare and Rehabilitation science, Tehran Abbas Tavallaee, MD Baghiatallah University of medical science, Tehran Fatemeh Nasirzadeh University of Social Welfare and Rehabilitation science Correspondence to: Dr Asghar Dadkhah, University of Social Welfare and Rehabilitation, Evin, Kudakyar Avenue, Tehran 19834, Iran E-mail: asgaredu@uswr.ac.ir

ABSTRACT Abstract: In all societies people of different ages and races commit suicide, and it is considered as one of the top ten causes of death. There may be several reasons for suicide and their recognition has always been of great importance for the authorities who are supposed to control it. In fact, committing suicide among young people, especially university students is a great social problem. It is also a matter of concern for mental health specialists. The aim of this study is to investigate the relationship between social and family factors and the idea of committing suicide among university students in Iran. 100 university students (50 male, 50 female) from University of Welfare and Rehabilitation sciences were randomly selected and participated in the study. A 59 question demographic questionnaire about family situation, personal features and the idea of committing suicide was constructed and also a Beck questionnaire about depression and disappointment. The questionnaires were filled out in a private interview. The samples were taken randomly. So it was found out that the singles were more inclined to commit suicide than the married ones. Divorce, failure in education, and family background also increase it. Among the other increasing factors, old age and female sex should be indicated.

Key words: Social and family factors, suicidal idea and attempt, university students

INTRODUCTION

The word suicide is a French word that consists of two parts: sui which means self and cide which means killing (Dorckhime, 1999). .Pierre Mourn indicates that suicide is an intentional work either consciously or subconsciously in order to destroy one's self (Moron, 1997). Aristotle believes that suicide is different from sacrifice (Azkia,1985). Freud believes that sexual relationships with others is an important factor (Roiters, 1994). According to Eric Frum the disintegration of social and traditional beliefs is an effective factor (Khosravi, 1960). This theory is confirmed by Halbwachs (Shabani Fard Jahromi). Dorkhime claims that economical welfare decreases suicide (Halbwachs, 1930). Henry and Short confirm this idea with and emphasis on aggression (Henry, 1965). Gibbs and Martin emphasize the contrast of roles (Gibbs, 1965). Some people believe that social isolation is the only cause of suicide (Alec Ray). Sometimes suicide finds an elevated value in the society (Heidary, 1997). Of course in this respect, the amount of suicides in society and the social position of the people should be considered as determining factors (Jahan Pajuhesh). There are even a lot of glorious examples of suicide in literature such as the examples in Shakespeare's Works including the suicide of Juliet in Romeo and Juliet, that of Ophelia in Hamlet and that of Cleopatra in Antony and Cleopatra, and also suicide in the works written by Victor Hugo.

We read of the suicide of some famous people, such as Ernest Hemingway.
It is estimated that 6% to 14% of people have the idea of suicide, and 10% to 14% of those with the idea finally committed suicide. Statistics show that it is increasing, especially among young people, all over the world (Mohseni , 1987). Research shows that the number of women who have to stay in hospital because of suicide is more than that of men (Burke,1978,7-11) and concerning the seasonal effects, it increases a bit in spring and autumn and decreases in Winter.

Suicide is a great social pathology and also a matter of concern for those who deal with mental health. This problem is worse especially when it is about young people and university students who are the hope of our future. (Shopfropfer 2001).

People of all different ages, races, and social classes may commit suicide. (Jilianeh and Jeifer 1993). When the number of young people increases in a society, the number of suicides increases too. For example after the second world war with the large number of children the problem was that a lot of young people committed suicide (Caplan and Sadud 2000, Merk 2002).
It seems that the increase of suicide is the result of different factors including social environment, a change in the way we look at suicide, and availability of its tools ( Hawthon and Kate 1997)

Among the other causes of suicide we can also refer to severe depression, misuse of drugs, and criminal behaviours ( Caplan and Saduk 2000, and Merk 2002) and (Sarason,1994). In this respect there are two groups of causes: those that make the victim inclined and those that make his tendency evident. In the first group we can refer to family background, mental disorders, physical problems, and also a family tendency toward suicide, especially the parents. In the second group the crises of conformity, quarrel with parents, friends, and classmates, joblessness, divorce or separation, bereavement, and other stressful events of life( Caplan , Saduk and Gereb, 1996). Men are more successful in suicide than women. In this respect China is an exception. Iran is the 58th country in the world in which out of each 100,000 people only 6 attempt suicide ( Table 1 shows the rate of suicide in some countries for the two sexes. )
It is reported that in 2001 there were 3,000 suicides in Iran (65% men, 35% women) which is about 1% of total deaths. In developed countries this rate changes to 1% to 2% of total deaths (Ganil, 2000). The number of suicidal attempts is more than successful suicides. For example in our country it is reported about 2 to 50 times more and this number changes in different provinces.

In different countries women usually attempt suicide 3 to 4 times more than men but men have successful suicides 3 times more than women (Caplan and Saduk, 2000).

In Iran men usually have successful suicides 2 times more than women. But in some provinces such as Ilam, Bushehr, Khuzestatn, Kohkiluye and Boyerahmad, Fars, and Kerman the number of women who commit suicide is more than men. It is reported that the highest rate of successful suicide is in Ilam (26 in 100,000) and in Kermanshah (23 in 100,000) and the lowest rate is in Tehran and Sistan and Baluchestan. The oldest statistics about suicide in Iran can be taken from an article written by Dr. Mirsepasi in 1970 and published in a magazine about psychology. Manoochehr Mohseni in 1884 announced 229 cases of suicide in Iran (1.3 in 100,000). In research made by Dr. Naghavi in 1994 it is reported that among the population of villagers, the rate of suicide is 5 in 100,000. Killing by fire is one of the most frequent ways of suicide among women in some provinces. According to the study of Kamalzadeh and his colleagues the rate of suicide in Tehran has gone up three times higher in comparison with the last decade. Based on research in Kerman it is observed that women attempting suicide is 1.5 times more than men, but successful suicide among men is 1.5 times more than women (Abbasizadeh, 1999). Studies about this matter are so expanded that it is not possible to deal with all different aspects and texts, so some of the outstanding points will be given as follows:

Although the rate of suicide normally increases among the middle-aged and elderly, (men after 45 and woman after 55), it is also increasing very rapidly among the young people especially boys between 15-24 years old (Tehran University, 1996). Depression and schizophrenia are the two main causes of suicide, and the background of its attempt shows how serious it might be (Caplan and Saduk,1999). The idea of suicide is more common among men, old people, and single or divorced people (Caplan and Saduk, 1999). Suicide is more common in urban and industrial areas in contrast with rural and non-industrial areas (Sheibani, 1973). The matter of suicide is rarely observed among children only in urban areas (Mohseni, 1967, 9-11). Higher social position and descending in social rank are two other causes of suicide (Caplan and Saduk, 1999). The other cause is social disorder that leads to personal disorder (Caran,1965). Suicide is very common among the medical doctors, especially female doctors, and its main causes are depression and addiction. Psychiatrists and then ophthalmologists and anesthetists in contrast with the other specialists have a greater tendency to commit suicide). The unemployed people have more tendency to do this work (Caplan and saduk,1999). And in general in high and low positions it is more popular than in average positions (Mohseni, 1987). The rate of suicide among whites is more then blacks (Caplan and Saduk, 1999). The acceptance of a person in the family is the basis of his physical and moral health and as a result decreases the danger of suicide (Mohagheghi, 1985). Marriage and having children decrease the rate of suicide enormously. It is observed that suicide among singles is twice that of married people and also among the divorced people is two times more than the singles (Caplan and Saduk, 1999). Disintegrated families increase the rate of suicide especially among girls (Ministry of the Interior, Iran, 1990). Jews and Protestants commit suicide more than Catholics and the Moslems less than the others (Mohseni, 1987). Porterfield believes that impiety is closely related to suicide (Caran, 1965). Regardless of ethical, religious, and philosophical matters, psychologists investigated the subject of suicide based on clinical cases and their attempt to understand the reality of suicide (Caplan and Saduk, 1999). There is a close relationship between physical health, sickness, and suicide (12% to 15% of suicides) (Mohseni, 1987). Women are more likely to commit suicide during their monthly period, especially on the first day (Hassanpur, Mashhad and Beca and colleaques, Spanish). But it rarely happens during pregnancy (Abbasizadeh, 1999). Having children is one of the factors that immunizes women more than men against suicide (31). Imitation is one of the increasing factors but for a limited time (Dorckhime, 1999).

Educational basis: Collegians and students, according to the studies of Dr. Mohseni in 1973-76 in Tehran, observed that 17.5% of suicides were related to collegians and students. Failure in educational matters, especially in exams, increases the rate of suicide among university students (Alishiri, 1991). Revolution doesn't affect the rate of suicide, but war decreases it (Eslami Nasab, 1992). Social complications increase it (Eslami Nasab, 1992).When the rate of homicide increases in a country, the rate of suicide decreases consequently (Eslami Nasab, 1992). Availability of the device is very important in determining the type of suicide, for example in America gun is a very common device. In winter, suffocation by gas, and in summer drowning in water are very common (Elahi, 1987). There are some other factors that increase the danger of suicide including social forces, sudden strong stresses, family problems and crises, death of a close relative, dismissal, the sense of failure, and also strong criticism by others (Ghaem Magham, 1985). Addiction to alcohol and drugs can be added to the list (Oryan, 1998). The common people suppose that poverty increases the risk of suicide, but the fact is exactly in contrast (Dorckhime, 1999). Of course in some countries such as India and Uzbekistan, it is observed that there is a close relationship between economic crisis and poverty with suicide (Sotudeh, 1994). Studies confirm the same point even in Iran (The Entekhab newspaper). Although the relationship between modernity and suicide has not been proved (Sotudeh ,1994), old studies and statistics express the point that the movement of society toward modernity increases the rate of suicide (Shabani Fard Jahromi). In Iran increasing immigration of villagers to cities is considered as another cause (Hesamian, 1984).

Finally we are going to have a look at different causes of suicide in Iran: in Lorestan, addiction and poverty ; in Ilam, depression, poverty, and accusation of someone's chastity; in Gilangharb, sexual privation, limitations, and chastity affairs (Hesamian,1994); in Kermanshah, family problems, and psychological and mental problems (Province council of Kermanshah, 1997); in Mazandaran, family conflicts (Province council of Mazandaran, 1997); and in Kerman, family problems, and cultural poverty (Province council of Kerman, 1997).

Based on the studies about women, we can classify some of the causes of suicide among women in this way : husband's addiction, great difference between the ages, maladjustment, the existence of several wives for a man, lack of ability to make a decision, the interference of others in the family affairs, marriage in the early ages, and also considering divorce as a very undesirable work (Asgari ,1997). It is interesting to know that in Iran suicide is very popular among young married women while in western countries it is popular among the old unmarried men. (Asgari, 1997). There are several researches about different causes of suicide in Iran: according to research conducted in 1994, the causes are mentioned respectively as loneliness, age, irremediable disease, and failure in life and love (Gudarzi, 1994). In another research, the causes are pointed out as marital problems, undesirable condition of family life, psychological problems, failure in love, mental and personal disorders, poverty, joblessness, addiction, urban and industrial life and disintegration of social groups (Sotudeh, 1994). Based on another research the factors are mentioned respectively as marital problems, undesirable condition of family life, poverty, joblessness, addiction, psychological problems, personal and mental disorders, failure in love, and urban and industrial life (Mohseni, 1987).

The students of bachelor level at the university of Welfare and Rehabilitation in Tehran made up the society of statistical research. A sample group of 100 people (50 male, 50 female) was taken randomly from the same society.

The device of measurement:
a demographic questionnaire about information and two Beck questionnaires about hopelessness and depression, which were filled out respectively in a private and face-to-face situation. At the same time all the questions of the samples were answered.

The type of research:
This is a kind of retrospective research
The variables of research:
The independent variables are social and family factors and the dependant variable is suicide.

Statistical methods:
The software SPSS (9.5) is used in this research and then the method of one sample T test is used in which the relationship between the main variables and those that affect the number and rate of depression (which determines the rate of suicidal thought) is considered. The important point is the meaningful level that is about 0.0005 in the four cases of divorce, failure in education, marital status, and family background.

50 men and 50 women took part in this research. Their ages were between 17 and 26 and the highest percent belonged to the age of 22 that was 23% of the whole. 15% of the samples were married, 58% stayed at the dormitories and 42% lived at home. 8% of the samples had experienced failure during their education. 32% of the samples had the idea of suicide and 6% attempted unsuccessful suicides. 28% had experienced the loss of a close relative in the last 6 months. In the family of two of them there was a background of suicide. Among the samples, there was a significant relationship between depression and divorce, failure in education, marital status, and family background. Of course the relationship between depression and family background was stronger than the others (Table 2). About the marks of hopelessness we can conclude that they took from 1 to 15. Most of them were between 2 and 8. The highest percents were for mark 3 by 17%, mark 2 by 16%, and mark 5 by 10%.

For many years in Iran nobody paid attention to comprehensive research about suicide (Mohseni, 1987) and little research has been done about. Studies about educational matters in America and especially at some universities such as Yale, Kernel, and Harvard support the fact that in these cities the university students commit suicide more than the other groups of people. According to the research of Dr. Mohseni about suicide in Tehran (1973-74), it is observed that 17.5% of suicides were related to collegians and students, which supports the above- mentioned point. In this research, some factors such as failure in exams, lack of educational success, and family conditions are considered as the main causes of suicide (Alishiri, 1991). Based on research in Kermanshah (97-98) 3% of suicides were because of failure in education (Province council of Kermanshah, 1997). In our sample test 8 people had experienced some failure and two of them had thought of suicide. Separation from family is another cause of the same thought, especially among girls. The reason is that they are dependent on their families for social, economical, and emotional matters (Ministry of the Interior, Iran, 1990). Research in Tabriz (1978-79) shows that the death of close relatives is the main cause of suicide (Karbasi) and another research made in 1994 supports the same point in the whole country (Gudarzi, 1994). In our research, 28 people had experienced the separation of a close relative in the last 6 months and 19 of them had thought of suicide and 3 of them committed suicide. Among the samples there were also 58 students who lived in the dormitories far from their families, from which 21 students had thought of suicide. Research shows that the rate of suicide among unmarried people is two times that of married people (Caplan and Saduk, 1999). In our research there were 85 singles and 15 married, and 30 of the singles (35%) and 2 of the married (13%) had thought of suicide. Also from the 6 students who committed suicide 5 were single. Of course in Iran marriage can be considered as a controlling factor especially for men (Asgari, 1997) and as a result, marriage decreases the amount of suicide (Mohagheghi, 1985). Research shows that suicide has increased in extended families in comparison with the nuclear families (Ministry of the Interior, Iran, 1990). In our research, there was a background of suicide only in the family of 2 samples, but neither of them had tendency to the same. Of course the problem is that our statistical society is limited. Most of the research confirms that family problems are the main causes in Iran (between 54% and 80%) (Mohseni, 1987, Province council of Kermanshah, 1997, Malek, 1994). The immunity of women against suicide is more than men (Malek, 1978). According to old research women committed suicide more than men in Iran (Asgari, 1997) but new research shows the opposite situation (Asgari, 2004). In our recent study 32 people out of 100 had thought of suicide (19 women and 13 men) and of course 6 of them committed suicide (4 women and 2 men). Increasing age is also an important factor (Tehran University, 1996). Suicide is increasing very fast among the men of 15 to 24 years of age (Tehran University, 1996). In our recent study we observed that there is a direct relationship between increasing age and suicidal thought. The results of this study proved all our hypotheses: there is a significant relationship between suicide (thought and attempt) and divorce, failure in education, marital status, and family background. Age and sex also have a significant relationship with suicide (thought and attempt).

Limitations:

1. Lack of ability to apply this research to the whole society because the selected people may not represent the society.
   
2. Limitation and small size of the selected group that is considered as a pilot study.
   

Source: the report of human expansion 1999 (undp)

In this table the variables are considered in pair and there is a significant relationship between depression and the four hypotheses. The important point in this table is the positive correlation between depression and family.
1- The relationship is significant.
2- The relationship is significant.
3- The relationship is significant.
4- The relationship is significant.

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