Back in 2000, the New York Times reported that a young Turkish woman had thrown herself from the roof of a building after her father forbade her to work and beat her for wearing a tight skirt.

This incident may have been far from isolated, a study by two Turkish psychiatrists published in the June Canadian Journal of Psychiatry suggests. The study found a 94 percent increase in suicide attempts in Turkey from 1998 through 2001, and an especially sharp increase in suicide attempts during 2000 and 2001 by Turkish women.

Since 1962 Turkey has collected and published rates of completed suicides. However, no official records have been kept of suicide attempts. So in 1998, Halise Devrimci-Ozguven, M.D., an attending psychiatrist at Ankara University School of Medicine, and Isik Sayil, M.D., a professor of psychiatry there, decided to conduct a study to assess the rates of attempted suicides in Turkey.

The researchers decided to focus on Mamak, a district of Ankara, which is Turkey’s capital and second-largest city. Some parts of Mamak are included in the old city, but most is newly settled. With many immigrants living there, it is fast becoming one of Ankara’s most diverse districts, mirroring, to some extent, the cultural diversity of Turkey as a whole.

Mamak has 22 Ministry of Health primary care units and two general hospitals. Between 1998 and 2001, the researchers screened all admissions to these facilities for attempted suicides. During these years they also checked Mamak police records for attempted suicides to make sure that they didn’t miss any reported cases.

The researchers found that there had been 737 suicide attempts during the four-year study period—514 by women and 223 by men, with a female-male ratio of 2.3. Women aged 15 to 19 were found to have been at the highest risk, followed by women aged 20 to 24.

The investigators also discovered that there had been a 94 percent increase in suicide attempts during the study period, and an especially sharp increase in suicide attempts by women during 2000 and 2001 (see chart). They speculated that that upward trend in suicide attempts "may be related to the intense economic difficulties, increasing unemployment, and rapid social change" experienced by the Turkish people, and especially by young Turkish women, during the past few years. For instance, the moral values of Western society have influenced social life in Turkey more during the past decade than ever before.

Whether the number of suicide attempts by Turks, and especially young Turkish women, has continued on an upward trajectory since 2001 remains to be seen. However, "we are continuing to collect data in our catchment area for monitoring suicidal behavior," Devrimci-Özguvén told Psychiatric News. "Besides, we are planning to monitor suicidal behavior in other catchment areas in Turkey as well."

She added, "Our results will be used for [developing] the national guidelines for suicide prevention in Turkey. In addition, we hope that this kind of research will be helpful for professionals in their practice with suicidal patients."

The study, "Suicide Attempts in Turkey: Results of the WHO-EURO Multicenter Study on Suicidal Behavior," is posted on the Web at www.cpa-apc.org/Publications/CJP/current/ozguven.asp. ▪