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Background and Objective: Our understanding of homicide-suicide (H-S), a rare yet tragic event, is sparse. While the phenomenon has been studied in the West for many years, only limited literature is available from Asia and none to our knowledge from Pakistan. There is evidence of complexity of the interaction between cultural, societal, and psychological mechanisms underlying this phenomenon; therefore, research findings from the Western countries cannot be directly applied in non-Western societies. Our objective was to study homicide-suicides in Pakistan, describe the characteristics of offenders and victims, determine the types of H-S, and examine possible motives and any events prior to the offense. Methods: In the absence of any official data on homicide-suicides, we used newspaper surveillance approach of four most widely circulated Pakistani newspapers (one Urdu and three English Daily) for two years (1st January 2019 to 31st December 2020). Each case was categorized using the modified Marzuk et al., Tardiff, and Hirsch's classification of homicide-suicides. Descriptive statistics were used to analyze the data that was then compared with published literature. Results: There were 114 H-S incidents with 198 victims of homicide during the study period, reported in the newspapers. Familial H-S particularly filicide-suicide were predominant, followed by spousal/ consortial H-S. Forty-one (36%) H-S involved multiple victims. The perpetrators across all categories of H-S were predominantly male (67%); the victims were predominantly women and children. Firearms were used in most incidents. The primary motive for the majority of H-S cases was familial, financial, and social stressors. Conclusions: The study highlights several unique patterns (predominance of familicide, multiple victims including high proportion of children) and a series of vulnerabilities (incidents related mostly to familial/ financial and social stressors) that overlap each other and ultimately lead to this tragic end. There is need to increase our understanding and develop effective evidence-based prevention strategies for H-S in Pakistan. It is also very important to have a national surveillance network and national violent death reporting system in the country for studying H-S cases, and for evaluating the impact of prevention programs. [ABSTRACT FROM AUTHOR]

Background: In Pakistan, there is lack of official suicide data due to associated stigma and socio-cultural factors. Although, suicide incidents are regularly reported in newspapers there are no official suicide reporting guidelines. Aims: The aim was to study the quality of suicide reporting in Pakistani newspapers and compare it to international media guidelines. Method: Newspaper reports on suicide deaths were searched in four Pakistani national newspapers from 1st January 2019 to 31st December 2020. Data was extracted using templates based on World Health Organization and Reporting on Suicide media guidelines. Results: There were total 2,295 suicides reported in 2 years. The word 'suicide' was mentioned in title of 2,113 (92.06%) reports. In 70.37% news articles, motive for suicide was reduced to a single factor. Method was mentioned in 95.6% suicides. Pictures accompanied 103 (4.4%) news reports. Only 13 (0.57%) the news stories recognized the link between substance abuse and suicide. None of the reports provided education to public about suicide or mentioned resources to seek help. Conclusions: The articles reporting on suicide deaths were regularly featured in Pakistani newspapers with strikingly low level of adherence to suicide reporting guidelines. [ABSTRACT FROM AUTHOR]

Background and Objective: Suicide is a serious, yet preventable global mental health problem for people of all ages and countries. It is the third leading cause of death in 15-19-year-olds. There is paucity of systematic studies and official statistics on child & adolescent suicides in Pakistan. In the absence of other means, newspaper coverage of adolescent suicides may serve as a useful source to understand the phenomena. Our objective was to report pattern of suicide deaths in children and adolescents across Pakistan and to determine the predominant methods of suicide precipitating events and associated factors Methods: This study used content analysis to analyze newspaper reports of adolescent suicide in four leading newspapers of Pakistan from January 1st, 2019, through December 31st, 2020. Search yielded 289 child and adolescent (ages<18) suicide reports. Data about various sociodemographic characteristics, methods of suicide, possible motives, and associated features (e.g., any suicide notes) was extracted and analyzed. Results: Total 289 suicides in children and adolescents in Pakistan were reported in selected newspapers during two years among both genders (51.5 % boys and 48.5% girls) with high incidence in late adolescence (66%). The predominant method of suicide in this group was ingestion of poisonous substances (50%) followed by hanging (35%) and use of firearms (7%). The behavior usually takes place within or near the adolescent’s home environment. The act was often attributed to domestic conflicts including arguments with parents of the deceased and relationship problems. Conclusion: To develop effective suicide prevention strategies for a population, it must be studied within its own socio-cultural context. Study results emphasize adolescent suicide being a reality in Pakistan. There is urgent need for further culture specific research in this area in the country. [ABSTRACT FROM AUTHOR]

Background: Stressful situations are often linked with poor health and lifestyle behaviors (e.g., unhealthy diet, limited physical activity, poor sleep quality etc.). Subsequent to the nationwide lockdown in Pakistan due to COVID-19 pandemic, medical students experienced substantial lifestyle changes along with academic stresses. The goal of this study was to measure the impact that the COVID-19 lockdown had on lifestyle like sleep, physical activity and nutrition, substance abuse, dealing with finances, spirituality and family life, with respect to a sample of Pakistani medical students. Methods: This cross- sectional online study involving 1100 medical students (68.7% females) from five medical colleges in Pakistan, used self-administered questionnaire to evaluate the impact of pandemic related restrictions on lifestyle of medical students in Pakistan from August- September 2020. Parameters such as physical activity, sleep, nutrition, smoking and substance abuse, family life, finances, internet use and spirituality were studied. Results: Fifty-nine percent of medical students reported a significant effect of lockdown on their physical activity. Only 5.8% people clearly followed or adhered to a routine during the pandemic. About 54.6% students have found that physical activity and exercise significantly reduced their anxiety. More than half of respondents reported increase in screen time, weight gain and poor sleep with 3.1% of students stating an increased use of sleeping pills to fall asleep Another 18.3% students had an increased worry regarding COVID19 based on the information they received on internet. No significant increase in substance uses and alcohol use or family conflicts among students post pandemic was noted. Conclusion: Our findings underscore that COVID-19 pandemic has led to undesired changes in health and lifestyle habits of medical students, which may, to some extent, be responsible for higher negative impact. Hence it is important for medical colleges to start awareness campaigns to tackle challenges for medical students physical and emotional well-being. [ABSTRACT FROM AUTHOR]