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Table 1 Main findings of the studies investigating the association between domestic violence and suicidal behaviour

From: Exposure to violence and the presence of suicidal and self-harm behaviour predominantly in Asian females: scoping review

Study

Type of study

Region of Asia

Country

Sample size

Specific demographic factors

Effect size/odds ratio/percentage

Main findings

Associated factors

Strengths and limitations

Peltzer et al., 2017 [33]

Cross-sectional survey

Southeast Asia

Indonesia

Cambodia

Malaysia

Thailand

Myanmar

Vietnam

N = 4,675

Undergraduate university students

Suicide ideation

Total 546

Male 227

Female 319

Suicide attempt

Total 116

Male 38

Female 78

Suicide ideation

Total 11.7%

Male 11.8%

Female 11.6%

Suicide attempt

Total 2.4%

Male 2.0%

Female 2.8%

Suicidal ideation and suicidal attempts

Childhood emotional abuse

Childhood physical abuse

Childhood sexual abuse

Strength

• Large sample

Limitations

• Self-reported variables

• Limited ability to establish causality

• Generalizability

Hagaman et al., 2017 [8]

Mixed psychological autopsy case-series method

(MPAC)

Southeast Asia

Nepal

Total (N = 39)

Religion: Hindu, Buddhist, other

Female n = 18

Male n = 21

Abuse and neglect

Females n = 11 (61.1%)

Interpersonal conflict M/F = 22 (56.4%)

Completed suicides

Physical abuse

Emotional abuse

Neglect

Interpersonal conflicts

Limitations

• Recall bias

• Generalizability

• The stigma associated with mental health

Dahmardehei et al., 2014 [28]

Cross-sectional and retrospective study

Middle East Asia

Iran

N = 750

Female/homemakers majority

Physical/verbal violence

N = 230 (73.25)

Self-immolation

Lack of training

Lack of supporting programmes

Poor economic status

Interpersonal disputes

Domestic violence

Limitations

• Loss to follow-up

• Lack of self-immolation reason study

Kim et al., 2021 [29]

Cross-sectional descriptive design

East Asia

South Korea

N = 5,154

Females

Pre/postmenopausal women

Suicidal ideation (premenopausal women)

N = 24

Suicidal ideation (postmenopausal women)

N = 22

Suicidal ideation

Mental problems, decreased happiness, anger, depression, stress, anxiety

Limitations

• Generalizability

• We need to identify factors that affect suicide in the long term

• Secondary data analysis

Bandara et al., 2020 [27]

Case-control study

Southeast Asia

Sri Lanka

N = 291

Buddhists, Muslims, Hindus females/males

Domestic violence in females

N = 77 (50.0%)

Domestic violence in males

N = 49 (35.8%)

Self-poisoning

Fear, mental problems

Strength

• Quantifies DV and self-poisoning

• Differentiates the types of violence

• Studies of DV in males

Limitations

• Selection bias

• Recall bias

Hagaman et al., 2017 [8]

Case-series study

Southeast Asia

Nepal

N = 39

Buddhists, Hindus, other females/males

Physical abuse

Females N = 11 (61.1%)

Males N = 1 (4.8%)

Suicide

 

Limitations

• Respondent bias

• Misclassification

• Recall bias

• Underreporting

Jewkes et al., 2019 [23]

Randomised controlled trial (RCT)

Southeast Asia

Afghanistan

N = 932

Married women, Muslim

Overall, 6.3%

Ranged from MIL/SIL = 9.6% to BOTH = 41.3%

Suicidal ideation

Depression, PTSD, poor health, beat their kids

Limitations

• Focused only on physical violence

• Underreporting possibility

Naved et al., 2008 [21]

Cross-sectional survey

Southeast Asia

Bangladesh

N = 2,702 (1329 rural, 1373 urban)

Bangladeshi women aged 15–49 years

Exposed to physical violence

-Moderate physical violence

• Rural = 2.9

• Urban = 4.1

-Severe physical violence

• Rural = 17.8

• Urban = 14.5

Exposed to sexual violence

• Rural = 8.7

• Urban = 9.7

Exposed to emotional violence

• Rural = 13.5

• Urban = 10.8

Suicidal ideation

 

Limitations

• Regional variation

• Suicidal ideation before the 4-week study period was excluded

Strengths

• Explored the association between three different forms of spousal violence against women and suicidal ideation

Paiman et al., 2019 [24]

Case-control study

Southeast Asia

Afghanistan

Cases N = 185

Control

N = 555

Muslim Afghans were aged 16–58 years

Domestic violence n = 135 (73%)

Deliberate self-harm

Anxiety

Depression

Limitations

• Possible underreporting

• Exclusion of other types of violence

• Exaggeration in ill patients with severe pain

Strengths

• Case-control study

• Large sample size

• Structured questionnaire

Indu et al., 2020 [19]

Case-control study

Southeast Asia

(South) India

Cases N = 77

Control N = 153

Married women aged 15–45 years

Domestic violence n = 28 (36.4%)

Attempted suicide

 

Limitations

• Limited to women of reproductive age group

• Generalizability

• Measurement bias

Strengths

• Case-control study

• Steps to decrease selection/measurement bias

• Multivariant analysis

• Exclusion of MDD

Antai et al., 2014 [30]

Cross-sectional survey

Southeast Asia

Philippines

N = 2433

Women aged 15–49 years

Physical abuse = 93 (47%)

Psychological abuse = 96 (49%)

Sexual assault = 49 (25%)

Attempted suicide

Psychological distress

Limitation

• Recall bias

• Underreporting

Strengths

• Found a strong association between economic, physical, and psychological abuse and suicide attempts as well as psychological distress

Chowdhury et al., 2009 [17]

Prospective study

Southeast Asia

India (West Bengal)

N = 89

23 males

66 females

Verbal abuse

• Abuse/slang words N = 53

• Defaming N = 15

Physical abuse

• Beating n = 25

• Burn n = 4

• Suffocation n = 2

• Restraint n = 2

Psychological abuse

• Threat n = 22

• Humiliation n = 25

• Mock execution n = 5

Deliberate self-harm

Depression

Psychosomatic dysfunctions.

Limitation

• Unwilling participation

• Underreporting

• Generalizability

Wu et al., 2018 [34]

Cross-sectional online survey

East Asia

China

N = 78

Female, the average age was 32.63 years

Suicidal ideation (rs = −0.43, p < .01)

Suicide attempts (rs = −0.23, p < .01)

Suicidal ideation and attempted suicide

 

Limitation

• Small sample size

• Generalizability

• A limited number of suicide predictors

Strengths

• New strategies to prevent suicide

• Study shows higher suicide ideations and attempts in IVP

Shah et al., 2017 [22]

Cross-sectional study

Southeast Asia

Bangladesh

N = 271

Majority of females aged < 30 years

N = 6 (2.2%)

Suicide

 

Limitations

• Small sample size

Strengths

• First paper content analysis on suicide in Bangladesh

Gururaj et al., 2010 [18]

Case-control study

Southeast Asia

India

N = case 269 + control 269

Male to female ratio 2:1

Age 11–70

Cases = 97

Control + 21 (OR 6.82)

Suicide

  

Yanqiu et al., 2011 [26]

Cross-sectional study

East Asia

China

N = 1771

Poorly educated women

Mean age 42.1 years (SD = 10.2)

Physical assault n = 34%

Psychological aggression n = 68%

Sexual coercion = 4%

Lifetime suicidal ideation N = 15.9%

Suicidal ideation preceding week n = 3.3%

Suicidal ideation

 

Limitations

• Generalizability

• Underreporting

Sharma et al., 2019 [20]

Cross-sectional study (quantitative and qualitative)

Southeast Asia

India

N = 827

Ever-married women from Delhi

The average age of the women was 37.1 ± 9.72 (15–60) years

Exposure to violence lifetime and past 12 months: psychological 43.4% and 37.6%, physical 27.2% and 19.3%, sexual 26.4% and 20.3%, any form of violence 43.4% and 37.8%

Suicidal thoughts 21 (2.5%) in the past 4 weeks

8.2% ever in life

Attempted suicide 7 (0.8%)

Suicidal thoughts and attempted suicide

A quarter of the women (25.3%) reported unhealthy mental status in the past 4 weeks

Limitations

• Self-reporting may have led to recall bias and underreporting

Devries et al., 2011 [9]

Cross-sectional household survey

South America

Africa

Asia

Oceania

Europe

Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia, Thailand, and Tanzania

N = 20967

Women aged 15–49 years

Thailand province n = 1140

IPV = 2.16 with CI 95% (1.15, 4.06)

Thailand city IPV = 2.30 with CI 95% (1.29, 4.10)

Suicidal thoughts and attempted suicide

 

Limitations

• Underreporting possibility

• Completed suicide excluded

• Limited statistical power

• Universal vs site-specific models

Asian communities outside Asia

 Chew-Graham et al., 2002 [31]

Qualitative study

Europe

UK

Four groups (5 + 7 + 7 + 12)

N = 31

Religion: Muslim

Females of Southeast Asian origin

 

Self-harm and attempted suicide

Gender and racial discrimination, increased isolation

Mental distress

Strength

• Concordant ethnicity of the worker and group

Limitations

• Generalizability

  1. DV domestic violence, COR crude odds ratio, DSH deliberate self-harm