Rates and factors associated with suicide in Kaniyambadi Block, Tamil Nadu, South India, 2000-2002

BACKGROUND: Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles to investigating suicide in the developing world. OBJECTIVE: The aim of this study was to prospectively determine the suicide rate in Kaniyambadi Block, Tamil Nadu, South India, for the years 2000-2002 using verbal autopsies. METHOD: The setting for the study was a comprehensive community health programme in a development block in rural South India. The main outcome measure was death by suicide, diagnosed by a detailed verbal autopsy and census, and birth and death data to identify the population base. RESULTS: The average suicide rate was 92.1 per 100,000. The ratio of male to female suicides was 1:0.66. The age-specific suicide rate for men increased with age while that for women showed two peaks: 15-24 years and over 65 years of age. Hanging (49%) and poisoning with organo-phosphorus compounds (40.5%) were the commonest methods of committing suicide. Acute and/or chronic stress was elicited for nearly all subjects. More men suffered from chronic stress while more women had acute precipitating events (chi2 = 4.58; p < 0.04). People less than 44 years of age had more acute precipitating events before death while older subjects reported more chronic stress (chi2 = 17.38; p < 0.001). CONCLUSION: The study replicates findings of an earlier study from the area. The suicide rate documented in this study is very high and is a major public health concern. There is a need for sentinel centres in India and in developing countries to monitor trends and to develop innovative strategies to reduce deaths by suicide.     

Suicide in India

The epidemiology of suicide in India from 1975–1994 was explored, with data on suicide rates by gender, the methods used for suicide, and the officially-recorded motives for suicide. In 1991, the Indian suicide rate was 9.2 per 100,000 per year, with a male rate of 10.6 and a female rate of 7.9. the most common methods for suicide are poisoning and hanging. The only predictor of the regional variation in Indian suicide rates was population density, while the time-series suicide rate was predicted by female participation in labor force and fertility.     

Psychosocial interventions after tsunami in Tamil Nadu, India

Any response to the mental health needs of the affected community following any disaster depends upon a number of factors, including disaster preparedness, existence of mental health services, resources in human and financial terms, along with the magnitude, cause and suddenness of the event. In India, groups of islands in the Bay of Bengal and the coast of Tamil Nadu were very badly hit. The survivors needed basic physical and emotional support. The response by two non-governmental organizations (NGOs) is described in this paper. Normalization was seen as an important first step. Using a number of training materials, volunteers were trained to deal with the mental health needs of the survivors. A consistent well resourced and accessible mental health network is necessary for appropriate intervention.     

Suicide among the elderly and associated factors in South Korea

With the population of the elderly increasing, suicides among elderly people present a serious problem for global societies. However, there are few studies on suicide among elderly subjects, especially in Asia. The study aimed to determine the relationship between physical health, mental health, social environmental condition, and the suicide behavior among elderly subjects in the city of Suwon, located southeast of Seoul. We analyzed 1548 Korean aged over 60 years from baseline data of a larger prospective study called the Suwon Project. The study protocol included sociodemographic variables, mental health factors, and physical health factors. In the interview, the subjects were asked about suicide ideation and history of suicide attempt. Of the total subjects, 7.42% reported suicide ideation and 1.42% reported a history of suicide attempt. A logistic regression analysis showed that physical illness, five stroke warning signs, anxiety and depression associated with suicide ideation, and depression strongly corresponded to the suicide ideation. Anxiety, depression, and stroke warning signs were associated with history of suicide attempt among the elderly. Additionally, stroke warning signs and depression are independently associated with history of suicide attempt. This study revealed that stroke warning signs have a high correlation with history of suicide attempt in the elderly, independent from the depression factors. This study suggests that there is an independent relationship between physical health status and suicide behavior in the case of elders.     

Suicide among the elderly in mainland China

Suicide in mainland China shows unique demographic patterns with age: the over-65 age group has the highest rate of completed suicide, reaching 44.3–200 per 100 000, which is four to five times higher than the Chinese general population. Rural suicide rates among the elderly are three to five times higher than the urban rates. The gender ratio of suicide in the elderly shows a reversal to those younger than 60 years of age in China. In addition, suicide methods and causes are different from those in Western countries. In the present paper, the profile of suicide among the elderly in China is delineated, including the prevalence, characteristics, underlying reasons and measures of preventing it.     

Suicide in South Africa

Nationally registered suicide mortality data for South Africa (1984–1986) were analysed. There were 5448 deaths (1.3%) due to suicide in this period. Proportional mortality and mean annual suicide mortality rates were highest for whites, followed by Asians and then coloureds. The proportional mortality for blacks was similar to that of coloureds. Suicide was relatively prominent as a cause of death for Asian females (15–24 years). For whites, the most commonly used method of suicide was firearms. Except for coloured females, hanging was the most common method used for the other population groups. Political, economic, and religious factors may account for some of the differences. Cultural factors may explain the findings for young Asian females. There is a need for strict gun control legislation.     

Deliberate self-harm in the elderly

This article reviews 145 patients over the age of 65 years seen at a district general hospital after deliberate self-harm between 1973 and 1985. There was no significant change in the numbers seen per year, and they comprised 5.4% of all the hospital's self-harm cases. The male to female ratio was 1:1·5 although the self-harm rates for males and females over 65 in the local population were identical. Fifty-five per cent widowed, over 90% of the patients had depressive conditions, only 3% had an established dementia, and 63% had significant physical illness. Half the patients received inpatient psychiatric treatment. Under 10% of the patients gave a history of earlier self-harm, while both the repetition and suicide rates were very low. These findings are discussed.     

Psychological Autopsy Interviews in Suicide Research: The Reactions of Informants

Psychological autopsy studies in which in-depth interviews are conducted with relatives or other informants are a key method of investigation in suicide research. These interviews are likely to be emotive and potentially stressful for informants. We followed up 68 informants approximately one month after they were interviewed in three recent studies of suicide in high risk groups (young people, farmers and doctors) to determine their reactions to the interviews. Nearly all the informants (96.9%) said they preferred being approached through a letter from a member of the research team rather than by someone else. While some relatives (22.1%) understandably reported being upset during the interview and/or immediately afterwards, a month later only one informant reported feeling worse than usual. A beneficial effect was suggested in at least a third. Although only 30 informants accepted the offer of a bereavement information pack, probably because in many cases the interviews were conducted rather a long time after the deaths, 90% of these found the pack helpful. It is suggested that such a pack be included in future psychological autopsy studies and that follow-up evaluations of the kind reported here be conducted in order to ensure that potential negative effects of such studies be identified and avoided in further studies.     

Determination of Suicide in South Africa: Medical Practitioner Perspectives

Decisional processes underlying the determination of a suicide in the largest injury surveillance system currently available in South Africa are assessed through face-to-face semi-structured interviews with 32 medical practitioners involved in the system. Focus is placed on their current work circumstances and practices, and views of operational and empirical criteria proposed by US experts. Common themes and discrepancies in opinions emerged regarding the quality of the data currently available for suicide determinations, and regarding the importance and difficulty in assessing the US-developed criteria in South Africa. A truly standard approach is unlikely without considerable changes to the medico-legal system.     

Suicide Letters in Singapore

The contents of suicide letters provide insight into the reasons for suicide and the mental states of victims. Coroner court records of 1,721 Singaporean suicides occurring between 2000 and 2004 were reviewed, 398 (23%) of whom left suicide letters. Letter writers tended to be younger, single, and less likely to have mental or physical illness. A reason for suicide was evident in 58%. Major reasons included school and relationship problems in the young, financial and marital problems in adults and physical illnesses in the elderly. Positive sentiment (care/concern) was expressed in 59%. Negative emotions in 45% of which despondency/agony (60%) was the most common, followed by emptiness (25%), guilt/shame (15%), hopelessness (10%), and anger (3%). The study of these letters suggests that there are combinations of social, psychological and physical factors that influence a person to suicide, all of which are important in the prevention, assessment, and management of suicide.     

Suicide in the Canary Islands, 1977-1983.

We studied suicide in the Canary Islands between 1977 and 1983 and found 775 cases, twice the official number of 381. This indicates the lack of validity and reliability of official figures for suicide in Spain today. The figures reveal an upward trend in the Canary Islands, with the annual rate of 6.81 per 100,000 in 1977 having increased to 10.64 per 100,000 in 1983. There were no significant differences in the frequency of suicide according to season, month or day of the week.     

The General Public's Views on Suicide and Suicide Prevention,and their Perception of Participating in a Study on Attitudes towards Suicide

The aim of the presented study was to investigate whether common myths about suicide still prevail, what people in general think are the most common causes for suicide, whether suicide can be prevented, and if so, how. How subjects perceived their participation in a study on attitudes towards suicidal behavior, was also investigated. The Attitudes Towards Suicide questionnaire was sent to a random sample of 1,000 Norwegians. The data were analyzed both quantitatively and qualitatively. The results showed that the common myths still prevail, that people in general mainly assign intrapersonal causes to suicide, with the belief that suicide can be prevented, and that they perceived their participation in the study positively. The value of the general public in suicide prevention and the need for increased openness and competence building were emphasized.     

Predicting Suicide in Nations

ABSTRACT

Theory and research on suicide were used to derive variables for a regression equation to predict the suicide rate in 17 industrialized nations. This regression equation was found to be quite accurate in predicting the relative suicide rates of other European nations (not in the original sample) but not of non-European nations. Blood type was the strongest predictor of national suicide rates.     

The Effects of Publicized Suicide Deaths on Subsequent Suicide Counts in Israel

This study investigated associations between indiscriminate media reporting of suicides and later inflated suicide counts among Israel's general population between the years 2008 and 2012. Self-inflicted deaths that received post-suicide media exposure (referred to as “publicized suicides”) were selected via Google news search-hit appraisals. Distributions of suicides were inspected and risk ratios (RRs) estimated by comparing population suicide rates 4 weeks before and 4 weeks after each publicized suicide (“reference” vs. “affected” periods, respectively). Poisson time series regression was employed to account also for secular trends and seasonality. A total of 2,119 people died by suicide, 13 of whom received noticeable media attention throughout the study. No meaningful impact following the 13 deaths on subsequent suicide counts during the observation window (affected vs. reference phase) was found. Poisson regression confirmed that suicide counts following publicized suicides were independent of media coverage. Given the pronounced search hits following the publicized suicides developing regulation practices that constrain indiscreet media reporting should officially be included as part of suicide prevention practices. Future research should focus on imitation suicide effects as a function of post-suicide media exposure, while including both risk and protective factors.     

Suicide trends in Canada, 1956-1981

Using official suicide statistics, this study examined suicide rates in Canada over a 25-year span (1956 to 1981) as a function of age, gender, and geographical region. The analysis revealed that, for both sexes, the risk of suicide among the 15-24 year-olds increased at a faster rate than in any other age group. Male and female age-standardized suicide rates demonstrated an overall increase between 1956 and 1981. The trend for males was one of continuous increase, whereas female rates reached a maximum in 1976 and then decreased. Regional differences in suicide rates were also apparent. Although not strictly observed, a trend toward increasing risk of suicide in males as one proceeds westward across Canada was found. For females, a pattern of increasing suicide with more westerly location was also found, except that Ontario and the Prairie Provinces were in reverse order. Several possible explanations for these findings are presented.     

Suicide and attempted suicide in general practice, 1979-1986

Using data from the Continuous Morbidity Registration Sentinel Stations over the period 1979-1986, the authors tried to determine the incidence and the characteristics of patients in general practice who attempted or committed suicide. Almost half of the suicide attempts and suicides had contacted their general practitioner (GP) shortly before the suicidal act. A minority of these cases were recognized by the GP as having a high suicide risk. In almost 70% of the suicides and 58% of the suicide attempters the GPs reported the existence, currently or previously, of a depressive episode. About half of both the suicides and the suicide attempters had been treated or seen by mental health professionals or social workers. Given the fact that suicide and suicide attempt are relatively rare events in general practice, and given the fact that for the patients who contact their GP shortly before the suicidal act, it is not at all certain whether they present clearly recognizable signs of suicide risk at that time, the authors conclude that GPs cannot play an important role in the prevention of suicidal behaviour.