Suicide Incidence and Epidemiology

Byline: M. Reddy Indian union health ministry estimates state that 1.2 lakh people commit suicide every year in India. Also, over 4 lakh people attempt suicide.On World Suicide Prevention Day 2008, WHO claimed that Japan, China and India might account for about 40% of the world suicides. Most people who commit suicide in India (37.8%) are below 30 years of age. The percentage of suicides committed by those below 44 years is 71% [Figure 1]. Experts opine that 60% of suicides may not have occurred if proper intervention was undertaken. Ministry officials state that majority of those commiting suicide suffer from depression or other emotional disorders. Over 7.5% of Indians are facing some sort of emotional disorder. Out of these, more than 1.75% (16 million) need institutional intervention. Out of every three cases of suicide reported every 15 minutes in India, one is committed by a youth in the age group of 15-29 years. Kerala, the country's first fully literate state, has the highest number of suicides. Some 32 people commit suicide in Kerala every day. In the United States, the overall rate is approximately 20 suicidal deaths per 100,000 persons, which is almost twice as much as the 10.5 reported in India [Table 1]. {Table 1}{Figure 1} According to the WHO, every year, almost 1 million people die from suicide, a "global" mortality rate of 16 per 100,000, or one death every 40 seconds. Suicide is among the three leading causes of death among those aged 15-44 years in some countries and the second leading cause of death in the 10-24 years age group; these figures do not include suicide attempts which are up to 20 times more frequent than completed suicide. Although traditionally, suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries. Mental disorders (particularly depression and alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries, impulsiveness plays an important role. Suicide is complex with psychological, social, biological, cultural and environmental factors involved. Although global rates are shown in [Figure 2], there are marked differences between individual countries with Belarus and Lithuania topping the list, while India ranks 43 [sup]rd , thus having a much lower suicide rate than many developed countries [Figure 3]. Within the country, suicide rates vary between 8.1 and 58.3/100,000 population for different parts of India. {Figure 2}{Figure 3} S. Mohanty and colleagues found that in India, the largest number of victims were found in the age group of 21-30 years. Majority of the victims were mentally sound, married and were from rural background. Victims were mostly drawn from low socioeconomic status (48%). Less educated or illiterates were usually the victims. Suicidal note was detected in 5% of cases. Suicidal tendency and alcohol intake could not be encountered in most of the cases. Financial burden (37%) and marital disharmony (35%) were some of the main reasons for the suicide. Andhra Pradesh, the fourth largest state in India, is responsible for more than 11% of these. Unfortunately, most suicides are under-reported and there are scant data on attempted suicides. Using Patient Care Record (PCR) forms of all emergencies serviced by 108 (Emergency Ambulance Service), an analysis of all cases was done in one study which found that a total of 1007 cases were recorded as confirmed suicides in the year 2007. Hanging and insecticide poisoning (72%) were the most common methods used. Males preferred hanging and insecticide poisoning, while females preferred self-immolation and hanging as the common methods. Self-immolation and insecticide poisoning had the highest mortality (41.6%). Estimates of attempted suicides for the year 2008 revealed a mean of 3. …