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Table 1 Characteristics of original studies included in review

From: Suicide and deliberate self-harm in Pakistan: a scoping review

Author / Year

Study Design

Setting (City, Province)

Studies reporting on

Number of suicidal cases

Male to female ratio

Age of the study population

Method (three most common)

Psychiatric Diagnosis (% of sample)

Jamil et al. (1977) [56]

Retrospective case series (1976)

Karachi, Sindh

Unnatural deathsa

35 out of 53

N/A

N/A

Poisoning

N/A

Jamil et al. (1977) [40]

Retrospective case series (1976)

Karachi, Sindh

Unnatural deaths

96 out of 157

N/A

N/A

Poisoning

N/A

Ahmed et al. (1981) [57]

Retrospective case series (1974–1978)

Karachi, Sindh

Suicide & DSH

25 suicide

167 DSH

Suicide-1.27: 1

DSH- 5.8: 1

Suicide: 11–20 yrs.: 64%

DSH:

21–20 yrs.: 50%

Suicide: drugs, poisons, sharp instruments

DSH: drugs, poisons, sharp instruments

Suicide: 8%

DSH: 1%

Noor et al. (1988) [58]

Retrospective case series (1984–1987)

Multan, Punjab

Unnatural deaths

20 out of 112

N/A

N/A

Poisoning

N/A

Jamil et al. (1990) [59]

Retrospective case series (1976–1985)

Karachi, Sindh

Unnatural deaths

1330 out of 1900

N/A

N/A

Poisoning

N/A

Javed et al. (1996) [24]

Cross-sectional (1992)

Lahore, Punjab

Suicidal ideation

27 out of 60

0.66: 1

N/A

N/A

N/A

Khan et al. (1996) [60]

Retrospective case series (1989–1992)

Karachi, Sindh

DSH

314

0.69:1

<30 yrs.: 71%

Poisoning, hanging, wrist slashing

31% affective disorder

6% schizophrenia

Khan et al. (1996) [25]

Retrospective case series (1989–1993)

Karachi, Sindh

DSH

382

0.69:1

<30 yrs.: 69%

Poisoning

N/A

Waseem et al. (1997) [61]

Prospective case series (1996)

Lahore, Punjab

Suicide

20

1.85: 1

N/A

Poisoning

N/A

Khan et al. (1998) [39]

Retrospective case series (1989–1994)

Karachi, Sindh

DSH

447

0.69:1

<30 yrs.: 62%

Poisoning

14%

Aziz et al. (1999) [62]

Retrospective case series (1993 & 1995)

Lahore, Punjab

Suicide

96

1.43: 1

20–30 yrs.: 49%

Hanging, firearms, burning

15%

Malik et al. (1999) [26]

Retrospective case series (1984–1996)

Lahore, Punjab

Unnatural deaths

2 out of 837

1:1

N/A

Cutting

N/A

Bashir et al. (2000) [63]

Retrospective case series (1994–1999)

Lahore, Punjab

Unnatural deaths

45 out of 91

N/A

N/A

Hanging

N/A

Rana et al. (2000) [64]

Retrospective case series (1984–1988)

Lahore, Punjab

Unnatural deaths

21

N/A

N/A

Poisoning

N/A

Khalid et al. (2000) [65]

Retrospective case series (1997–2001)

Karachi, Sindh

Suicide

1230

2.19: 1

21–30 yrs.: 47.21%

Gunshot, hanging, poisoning

9% males

5% females

Khan et al. (2000) [66]

Retrospective case series (1996–1997)

Karachi, Sindh

Suicide

306

2.1: 1

<30 yrs.: 82%

Poisoning, hanging, firearms

3%

Bunggush et al. (2000) [67]

Retrospective case series

Pakistan

Unnatural deaths

243 out of 408

N/A

N/A

Poisoning

N/A

Haider et al. (2001) [30]

Cross-sectional (2000)

Lahore, Punjab

DSH

100

0.67:1

15–24 yrs.: 36%

Poisoning

34%

Agha et al. (2001) [68]

Case-control (1999)

Karachi, Sindh

DSH

Case: 72

Control: 72

Case: 1:1

Control: 1:1

Mean age in both: 20–29 yrs

Benzodiazepines

100% in case group

Khan et al. (2001) [69]

Case-control (1998)

Peshawar, KPK

Suicidal ideation

4 out of 50

N/A

N/A

N/A

N/A

Ghazanfar et al. (2001) [70]

Retrospective case series (2006–2008)

Rawalpindi, Punjab

Unnatural deaths

27 out of 91

1.7: 1

N/A

Organophosphorus poisoning

N/A

Haider et al. (2002) [31]

Cross-sectional (2000)

Lahore, Punjab

DSH

385

0.81: 1

15–35 yrs.: 66%

Poisoning, cutting, firearms

52%

Ahmad et al. (2002) [71]

Cross-sectional (1996–2000)

Multan, Punjab

Unnatural deaths

193 out of 370

N/A

N/A

Poisoning

N/A

Haider et al. (2002) [50]

Cross-sectional (2002)

Lahore, Punjab

DSH

147

0.88: 1

Mean age (males): 30.5 yrs.

Mean age (females):

29.4 yrs

Poisoning

71%

Sultana et al. (2002) [72]

Retrospective case series

Karachi, Sindh

Unnatural deaths

51 out of 632

N/A

N/A

Hanging, drowning, cutting

N/A

Hasan et al. (2002) [73]

Retrospective case series (1998–2001)

Rawalpindi, Punjab

Unnatural deaths

101 out of 181

N/A

N/A

N/A

N/A

Saeed et al. (2002) [74]

Retrospective case series (1998–2001)

Faisalabad, Punjab

Suicide

95

2.44: 1

20–29 yrs.: 43.1%

Hanging, Firearms, poisoning

N/A

Khan et al. (2003) [75]

Retrospective case series (2001)

Quetta, Baluchistan

DSH

46

100% females

16–25 yrs.: 65.2%

Poisoning

78%

Ali et al. (2003) [76]

Retrospective case series (2001)

Peshawar, KPK

Unnatural deaths

2 out of 679

100% females

N/A

Firearms, sharp weapons,

N/A

Ali et al. (2003) [77]

Retrospective case series (1997–2001)

Peshawar, KPK

Unnatural deaths

9 out of 52

N/A

N/A

Poisoning

N/A

Ahmed et al. (2003) [21]

Retrospective case series (1995–2001)

Karachi, Sindh

Suicide

1379

1.7: 1

21–30 yrs.: highest

Poisoning, hanging, firearms

N/A

Bashir (2003) [22]

Retrospective case series (1991–2000)

Peshawar, KPK

Suicide

39

2.9: 1

20–29 yrs.: highest

Firearms, hanging

N/A

Safdar et al. (2003) [78]

Retrospective case series

Sukkur, Sindh

Unnatural deaths

14 out of 26

N/A

N/A

Poisoning

N/A

Farooqi (2004) [79]

Cross-sectional (2003)

Lahore, Punjab

Suicidal ideation

50 out of 100

1.5: 1

N/A

N/A

40% depression

24% schizophrenia

Valika et al. (2004) [80]

Cross-sectional (2003)

Pakistan

Suicidal behavior

19

1: 0.88

N/A

Poisoning

N/A

Farooqi et al. (2004) [81]

Cross-sectional (2003)

Karachi, Sindh

DSH

50

1.5: 1

11–20 yrs.: 40%

Poisoning

N/A

Waseem et al. (2004) [82]

Prospective case series (2003–2004)

Lahore, Punjab

Unnatural deaths

31 out of 70

N/A

N/A

Poisoning

N/A

Shoaib et al. (2005) [34]

Prospective case series (2004)

Lahore, Punjab

Suicide & DSH

107

1.22:1

21–30 yrs.: 49%

Poisoning

9%

Khoker et al. (2005) [83]

Cross-sectional (2004)

Karachi, Sindh

Suicidal ideation

68 out of 217

0.87:1

N/A

N/A

N/A

Hussain et al. (2005) [37]

Retrospective case series (1996–2002)

Karachi, Sindh

Unnatural deaths

40 out of 50

N/A

N/A

Poisoning

N/A

Asif et al. (2005) [32]

Cross-sectional (2004)

Lahore, Punjab

DSH

1390

2.22: 1

21–30 yrs.: 36%

Poisoning

N/A

Rasheed et al. (2005) [29]

Prospective case series (2004)

Rawalpindi, Punjab

Suicidal ideation

Under-trial prisoners: significant relationship with suicidal behavior

100% males

N/A

N/A

N/A

Kermani et al. (2006) [84]

Retrospective case series (2004)

Karachi, Sindh

DSH

150

0.75: 1

21–25 yrs.: 41%

Poisoning

N/A

Aziz (2006) et al. [85]

Cross-sectional (2002–2004)

Larkana, Sindh

Suicide

52

2.03: 1

30–39 yrs.: 44.2%

Firearms, hanging, burning

73%

Khan (2006) [10]

Retrospective case series (1985–1999)

Karachi, Sindh

Suicide

2568

2.78: 1

N/A

Poisoning, hanging & drowning

N/A

Suliman et al. (2006) [86]

Prospective case series (2002–2003)

Bahawalpur, Punjab

Unnatural deaths

111 out of 143

N/A

N/A

Poisoning

N/A

Tahir et al. (2006) [54]

Prospective case series (2003–2004)

Sukkar, Sindh

Unnatural deaths

17 out of 24

N/A

N/A

Poisoning

N/A

Rathore et al. (2007) [87]

Prospective case series (2006–2007)

Lahore, Punjab

Suicide & DSH

50

1.27: 1

21–30 yrs.: 44%

Poisoning

N/A

Ahmad et al. (2007) [88]

Prospective case series (2002–2003)

Islamabad, Punjab

Unnatural deaths

9 out of 142

N/A

N/A

Burns

N/A

Shaikh et al. (2008) [23]

Retrospective case series

Hyderabad, Sindh

Unnatural deaths

99 out of 111

N/A

N/A

Poisoning

N/A

Raja et al. (2008) [48]

Cross-sectional (2007)

Karachi, Sindh

Unnatural deaths

9539 out of 27,254

N/A

N/A

Poisoning

N/A

Babar et al. (2008) [35]

Retrospective case series (2002)

Islamabad, Punjab

Suicide

227

2.3: 1

25–45 yrs.: 63%

Poisoning, shooting

3%

Syed et al. (2008) [49]

Retrospective case series (1990–2006)

Karachi, Sindh

DSH

69

0.59: 1

> 14 yrs.: 89.9%

Poisoning, hanging, firearms

5.8%

Shahid et al. (2008) [89]

Retrospective case series (2004)

Karachi, Sindh

DSH

98

0.58: 1

Mean age: 23.5 yrs

Drug ingestion, organophosphate poisoning

N/A

Karamaliani et al. (2008) [90]

Cohort study

Hyderabad, Sindh

DSH

2 out of 2324

N/A

N/A

N/A

N/A

Patel et al. (2008) [91]

Retrospective case series (2002–2006)

Karachi, Sindh

DSH

202

0.69:1

Mean age: 17 yrs

Benzodiazepines, anti-depressants

58.4% depression, 10.9% bipolar disorder

Khan et al. (2008) [28]

Case-control (2003)

Karachi, Sindh

Suicide

100 cases

100 controls

4.88: 1

N/A

Hanging, poisoning & firearms

96%

Khurram et al. (2008) [33]

Cross-sectional (2006)

Rawalpindi, Punjab

DSH

60

0.72: 1

N/A

Poisoning

% not mentioned

Shaikh et al. (2008)

Retrospective case series (2004–2006)

Karachi, Sindh

Unnatural deaths

99 out of 111

N/A

N/A

Poisoning

N/A

Zakiullah et al. (2008) [92]

Retrospective case series (1997–2002)

Karachi, Sindh

DSH

283

0.66: 1

12–15 yrs.: 22.2%

Poisoning, cutting, burning

50.3%

Khan (n.d) [93]

Cross-sectional

Chitral, KPK

Completed Suicides

32

100% females

16–20 yrs.: 59%

N/A

0%

Farooq et al. (2009) [94]

Retrospective case series (1999–2008)

Rawalpindi, Punjab

Unnatural deaths: 5.06% suicidal

9

N/A

N/A

Burns

N/A

Ayub (2009) [95]

Cross-sectional

Pakistan

Suicidal ideation

N/A

N/A

N/A

N/A

Hopelessness linked to suicidal ideation

Khan et al. (2009) [27]

Cross-sectional (2000–2004)

Ghizer, KPK

Suicide

49

100% females

18–25 yrs.: 59%

Drowning, Poison, hanging

N/A

Shahid et al. (2009)

Retrospective case series (2008)

Karachi, Sindh

DSH

98

0.59: 1

Mean age: 23.5 yrs

Benzodiazepines, organophosphate poisoning, alcohol poisoning

24.2%

Asad et al. (2010) [117]

Cross-sectional

Hyderabad, Sindh

Suicidal ideation & attempts

41 attempted suicide

150 suicidal thoughts

100% females

N/A

N/A

18%

Farooq et al., (2010) [42]

Retrospective case series (2007–2008)

Rawalpindi, Punjab

DSH

Police reports: 7

ED: 33

Police reports: 13.2: 1

ED: 5.6:1

ED: 15–56 yrs.: 77.3%

Poisoning

N/A

Rizwan (2010) [97]

Case-control

Karachi, Sindh

Suicidal ideation

120 in case, 120 in control

Case: 2.15: 1

Control: 1:1

Mean age in case: 22 yrs.

Mean age in control: 21 yrs

N/A

100% in case group

Tahir et al. (2010) [55]

Retrospective case series (2001–2008)

Jamshoro, Sindh

DSH

154

0.55: 1

Mean age: 31.21 yrs

Burning

67%

Faruqui et al. (2011) [98]

Cross-sectional (2009)

Islamabad, Punjab

Suicidal ideation

15 out of 50

N/A

N/A

N/A

N/A

Naz (2012) [99]

Retrospective case series (2010)

Karachi, Sindh

Suicide

10

N/A

N/A

N/A

N/A

Ali et al. (2012) [100]

Cross-sectional

Karachi, Sindh

Suicidal Ideation

28

100% females

Not mentioned

N/A

% not mentioned

Kumar et al. (2012) [101]

Retrospective case series (2010–2012)

Larkana, Sindh

Unnatural deaths

91 out of 10,130

N/A

N/A

N/A

N/A

Lakhair et al. (2012) [102]

Prospective case series

Hyderabad, Sindh

Unnatural deaths

58 out of 70

N/A

N/A

N/A

N/A

Mirza et al. (2012) [103]

Retrospective case series (2005–2010)

Karachi, Sindh

Unnatural deaths

7 out of 61

N/A

N/A

N/A

N/A

Ali (2012) et al. [104]

Prospective case series (2008)

Karachi, Sindh

Unnatural deaths

65 out of 100

N/A

N/A

Organophosphorous poisoning

N/A

Kehtran et al. (2012) [105]

Retrospective case series (1998–2000)

Barkhan, Baluchistan

Unnatural deaths

2 out of 268

N/A

N/A

Firearms

N/A

Riaz et al. (2012) [106]

Cross-sectional (2012)

Karachi, Sindh

DSH

9

N/A

N/A

Cutting

 

Tahir et al. (2013) [107]

Cross-sectional (2011)

Mianwalli, Punjab

DSH

108

3.54: 1

21–30 yrs.: 50.5%

Poisoning & firearms

33%

Khalil et al. (2013) [96]

Retrospective case series (2009–2012)

Peshawar, KPK

Unnatural deaths

66 out of 2365

12.2: 1

20–40 yrs

Firearm, blunt trauma

N/A

Ali (2013) et al. [108]

Cross-sectional

Karachi, Sindh

Suicidal ideation

759: 58.8% had suicidal thoughts

100% females

N/A

N/A

% not mentioned

Ayub et al. (2013) [109]

Cross-sectional (2012)

Lahore, Punjab

Suicidal ideation

636 out of 650

100% females

N/A

N/A

93%

Raza et al. (2014) [110]

Retrospective case series (2009–2013)

Lahore, Punjab

Unnatural deaths

3 out of 31

N/A

N/A

Knife, razor blade

N/A

Shaikh et al. (2014) [111]

Prospective case series

Karachi, Sindh

Suicidal ideation

171

N/A

N/A

N/A

Anxiety statistically significant with suicidal ideation

Salman et al. (2014) [112]

Prospective case series (2012)

Peshawar, KPK

DSH

45

0.8: 1

N/A

N/A

N/A

Saiq et al. (2014) [113]

Prospective case series (2010–2012)

Islamabad, Punjab

DSH

93

0.24: 1

<35 yrs.: 96%

Burning

1.07%

Osama et al. (2014) [114]

Cross-sectional (2013)

Karachi, Sindh

Suicidal ideation

118 out of 331

0.70: 1

Mean age: 20.73 yrs

N/A

N/A

Husain et al. (2014) [36]

Randomized control trial (2010–2012)

Karachi, Sindh

DSH

221

0.45: 1

Mean age: 23.1 yrs

Poisoning

N/A

Shagufta et al. (2015) [115]

Prospective case series (2014)

Peshawar, KPK

Suicidal ideation

91 out of 415

100% males

11–18 yrs.: 100%

N/A

0.24%

Rao et al. (2015) [116]

Cross-sectional (2009)

Pakistan

Suicidal ideation

334 out of 4583

N/A

N/A

N/A

N/A

Shahid et al. (2015) [46]

Case-control study (2011–2012)

Karachi, Sindh

DSH

201 cases 201 controls

0.7: 1

N/A

N/A

9% depression

  1. aUnnatural deaths (homicidal, accidental & suicidal)
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