Reviewer's report
Title:Evaluation of the Female Suicidal Deaths Between 2005-2011 in Van City
of Turkey
Version:2Date:15 July 2014
Reviewer: Annette Beautrais
Reviewer's report:
Re: 'Evaluation of the Female Suicidal Deaths Between 2005-2011 in Van City of
Turkey'
Yavuz Hekimoglu, Ipek Esen Melez, Nergis Canturk, Zerrin Erkol, Mustafa
Gokhan Dizdar, Gurol Canturk, Deniz Oguzhan Melez and Ziya Kir
Submitted to: BMC Women's Health
Research article
This paper addresses an important issue, describing the nature and
characteristics of female suicide deaths in Turkey and highlighting the
contribution to those deaths of interpersonal violence. The paper is significant
because current views of female suicide tend to be ‘Westernised’ and tend not to
fully cover issues relating to the relationship between violence and female
suicidal behaviour that are seen in developing and non-Western countries. I have
the following specific comments:
1. The goal of the authors is to draw attention to the contribution to suicidal
behaviour in Turkey of the social, marital and cultural status of females, and the
contribution of interpersonal violence. The research issue could be a little more
clearly spelt out and defined. English editing may help clarify the major issue.
(Does not require a response from the authors)
2. The approach adopted was a review of autopsy reports for female suicides
from one town (‘Generalship’ needs to be defined for the journal audience – is it
a town or a hospital region?) over the period from 2005-2011. More information is
needed, including: how are suicides defined, and by whom and by what process
is the verdict of suicide assigned. How accurate is the ascertainment of suicide or
considered to be? (The authors raise this issue when they refer to ‘hidden’
suicides). What fraction of all female suicides over this time period (2005-11) do
these 66 constitute – that ie, how representative are they of all female suicides?
What fraction of total suicides in the region (male and female) are accounted for
by female suicides? What fraction of suicides receive autopsies? Who conducted
the autopsies and who conducted the reviews of the autopsy reports for this
paper? How systematically were data such as psychiatric diagnoses determined
and/or recorded? Responses to these questions are needed to expand the
methodology section so reviewers and the journal audience can gain an
appreciation of the of the quality of the data. (Major required revision)
3. Analysis is by simple descriptive statistics. Some data could be summarised in
tabular format, rather than iterated in text. (Discretionary revision)
4. The discussion is lengthy and could be abbreviated. The content of the
discussion ranges widely and covers demographic issues, seasonality and moon
phases, and post-mortem issues – the site of the entrance would, nature of
fractures and tissue damage, as well addressing issue of violence, status, and
abuse. In addition, there are comparisons with other countries and other studies.
The major interesting issue is the role of female status, marital issues, lack of
education and professional roles, and violence, and it might be useful to consider
whether focussing solely on these latter issues and highlighting their potential
role in female suicide in developing and non-westernised countries might convey
the central message in a more succinct way, with a discussion focussed on these
issues of status, violence and abuse and the fact that they are under-researched.
At present that message is lost in the wide-ranging discussion. (Discretionary
revisions)
5. On this matter, a title which more clearly conveyed that the issue of interest is
female status as a contributor to suicide in some parts of the world might be
more compelling. (Discretionary revision)
6. The authors need to review their methodology and note any limitations to their
data, their methodology and their paper. A brief paragraph would suffice.
(Required revision)
7. The paper would benefit from English editing. (Required revision)
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests