Suicide is one of the leading causes of death in many western countries, but in eastern countries this phenomenon was until recently extremely rare. Our study, performed during 2005-2012 comes to shed lights on the prevalence and the underlying reasons of the notable increase of suicide attempts in the conservative and religious Arab community of Nazareth, Israel. Extensive interviews, sociodemographic information, suicide risk factors in addition to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnoses were used in current retrospective study of 772 suicide attempters in the emergency room at the Nazareth Hospital. Statistical analysis using SPSS version 17, Pearson χ2 analysis and percentage distribution were used for the statistical analysis. We considered the differences to be significant at the level of p < 0.05. Three fold frequency of suicide attempts were observed among females (77%) compared to males (23%), (P = 0.0001). During the year 2009 the suicide attempts prevalence was the highest 118 (15.3%) and during 2005 it was the lowest 77 (10%). 76.5% of the attempters arrived to the emergency room within 1 - 6 hours. A single suicide attempt was observed among 60% of males compared to 70.5% among females [OR = 0.846 (CI: 0.742 - 0.966)] additionally, more than one suicide attempt was notified among 40% of males whereas 29.5% among females [OR = 1.367 (CI: 1.099 - 1.701), (P = 0.007)]. Psychiatric patients (59.3%) performed more than one suicide attempt compared to normal subjects (21.5%), [OR = 2.76;CI: 2.276 - 3.354, P-value = 0.0001]. Drugs was preferred for suicide attempts in both genders (87.7%), especially among females compared to males (90.6% vs. 78.8% respectively), [OR = 0.869;CI: 0.801 - 0.942, P = 0.001]. 38 of males (21.3%) committed suicide attempts by causing accidents and self harm compared to 56 females (9.4%);[OR = 2.261;CI: 1.552 - 3.294, (P = 0.0001)]. 40 psychiatric patients (18.7%) chose this method compared to 54 non-psychiatric patients (9.7%), [OR = 1.925;CI: 1.32 - 2.806, P-value = 0.001]. The underlying causes of suicide were as follows: 50% social causes, 26% adjustment reactions and 24% psychiatric diseases. Conclusion: Being the first unique study to shed lights on the increasing phenomenon of suicide in the Arab community, our findings unveiled a tragic transition in the rate of suicide attempts in a supposedly conservative and religious community. Even though the rate of suicide attempts is lower than other communities it should not divert focus away from efforts to develop effective strategies to prevent suicide attempts, especially among females.
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