Suicide in India: a systematic review.

Anil Rane · Abhijit Nadkarni

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Suicide and Self-Harm Studies Mental Health Treatment and Access Homicide, Infanticide, and Child Abuse

Abstract

BACKGROUND: Suicide is an important cause of death in India but estimated suicide rates based on data from India's National Crime Records Bureau are unreliable. AIM: Systematically review existing literature on suicide and the factors associated with suicide in India. METHODS: PubMed, PsycINFO, EMBASE, Global Health, Google Scholar and IndMED were searched using appropriate search terms. The abstracts of relevant papers were independently examined by both authors for possible inclusion. A standardized set of data items were abstracted from the full text of the selected papers. RESULTS: Thirty-six papers met inclusion criteria for the analysis. The heterogeneity of sampling procedures and methods of the studies made meta-analysis of the results infeasible. Verbal autopsy studies in several rural locations in India report high suicide rates, from 82 to 95 per 100,000 population - up to 8-fold higher than the official national suicide rates. Suicide rates are highest in persons 20 to 29 years of age. Female suicide rates are higher than male rates in persons under 30 years of age but the opposite is true in those 30 years of age or older. Hanging and ingestion of organophosphate pesticides are the most common methods of suicide. Among women, self-immolation is also a relatively common method of suicide. Low socioeconomic status, mental illness (especially alcohol misuse) and inter-personal difficulties are the factors that are most closely associated with suicide. CONCLUSION: The quality of the information about suicide in India is quite limited, but it is clearly an important and growing public health problem. Compared to suicides in high-income countries, suicide in India is more prevalent in women (particularly young women), is much more likely to involve ingestion of pesticides, is more closely associated with poverty, and is less closely associated with mental illness.

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References

2012Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 2008Cross-national prevalence and risk factors for suicidal ideation, plans and attempts 2003Psychological autopsy studies of suicide: a systematic review 1998Excess mortality of mental disorder 2012Suicide mortality in India: a nationally representative survey 2000The International Handbook of Suicide and Attempted Suicide 2002Suicide rates in China, 1995–99 2004Self poisoning with pesticides

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