The British Journal of Psychiatry (2008) 193: 402-405. doi: 10.1192/bjp.bp.107.042069
© 2008 The Royal College of Psychiatrists
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Case–control study of suicide in Karachi, Pakistan*

Murad Moosa Khan, MRCPsych

Department of Psychiatry, Aga Khan University, Pakistan

Sadia Mahmud, PhD and Mehtab S. Karim, PhD

Department of Community Health Sciences, Aga Khan University, Pakistan

Mohammad Zaman, MA

Department of Psychiatry, Aga Khan University, Pakistan

Martin Prince, MRCPsych

Kings College, Institute of Psychiatry, London, UK

Correspondence: Dr Murad M. Khan, Department of Psychiatry, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. Email: murad.khan{at}aku.edu

Declaration of interest

None. Funding detailed in Acknowledgements.

* Presented in part at the XXIII World Congress of International Association of Suicide Prevention, Durban, South Africa, 12–16 September 2005.

Background

In recent years suicide has become a major public health problem in Pakistan.

Aims

To identify major risk factors associated with suicides in Karachi, Pakistan.

Method

A matched case–control psychological autopsy study. Interviews were conducted for 100 consecutive suicides, which were matched for age, gender and area of residence with 100 living controls.

Results

Both univariate analysis and conditional logistic regression model results indicate that predictors of suicides in Pakistan are psychiatric disorders (especially depression), marital status (being married), unemployment, and negative and stressful life events. Only a few individuals were receiving treatment at the time of suicide. None of the victims had been in contact with a health professional in the month before suicide.

Conclusions

Suicide in Pakistan is strongly associated with depression, which is under-recognised and under-treated. The absence of an effective primary healthcare system in which mental health could be integrated poses unique challenges for suicide prevention in Pakistan.


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