title: The impact of migration and culture on suicide attempts of children and adolescents living in Istanbul.
abstract: BACKGROUND
  Suicidal attempts are steadily increasing in societies with rapid urbanisation and dramatic social changes in places like Istanbul. Stress related to internal migration may increase suicidal behaviour.
  
  
  OBJECTIVE
  We investigated the impact of internal migration and culture on suicide attempts among youth in Istanbul.
  
  
  METHODS
  We retrospectively analysed the records of 210 children and adolescents, aged 6-18 years, who presented at the Emergency Outpatient Clinic of the Department of Pediatrics at Cerrahpaşa Medical School in Istanbul because of suicide attempts between January 2008 and December 2010.
  
  
  RESULTS
  The majority of patients (78.95%, N = 165) had a background of internal migration, mostly (65%, N = 136) originating from regions with large cultural differences compared with that of Istanbul. Noticeably, more migrants than non-migrants (18.8% vs. 6.8%) and more patients originating from regions with large cultural differences chose high-risk methods for suicide attempts (20.7% vs. 8.1%).
  
  
  CONCLUSIONS
  Internal migration can be considered a serious risk factor for suicidal behaviour. Furthermore, the degree of cultural differences between the area of origin and the new environment can be of vital importance. Healthcare measures should, therefore, focus on internal migration as a risk factor for youth suicidal behaviour and provide assistance for appropriate resettlement and integration in countries with increased mobility.
authors.affiliation: Department of Child and Adolescent Psychiatry, Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Medical University of Vienna , Vienna , Austria.
authors.forename: Türkan
authors.initials: T
authors.lastname: Akkaya-Kalayci
authors.forename: Christian
authors.initials: C
authors.lastname: Popow
authors.forename: Dietmar
authors.initials: D
authors.lastname: Winkler
authors.forename: R Hülya
authors.initials: RH
authors.lastname: Bingöl
authors.forename: Türkay
authors.initials: T
authors.lastname: Demir
authors.forename: Zeliha
authors.initials: Z
authors.lastname: Özlü
mesh_terms: D000293:Adolescent; D002648:Child; D003469:Culture; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D013406:Suicide, Attempted / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data*; D014171:Transients and Migrants / Q000523:psychology*; D014421:Turkey / Q000453:epidemiology
keywords: Suicide attempts; adjustment problems; children and adolescents; culture; migration