The British Journal of Psychiatry (2010) 196: 26-30. doi: 10.1192/bjp.bp.108.063347
© 2010 The Royal College of Psychiatrists
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Risk factors for suicide in rural south India

S. D. Manoranjitham, MSc

Department of Psychiatric Nursing

A. P. Rajkumar, MD, DNB

Department of Psychiatry

P. Thangadurai, DNB, DPM

Department of Psychiatry

J. Prasad, MD, MPH

Department of Community Health

R. Jayakaran, MSc

Department of Community Health Nursing

K. S. Jacob, MD, PhD, MRCPsych

Department of Psychiatry, Christian Medical College, Vellore, India

Correspondence: Correspondence: Professor K. S. Jacob, Department of Psychiatry, Christian Medical College, Vellore 632002, India. Email: ksjacob{at}cmcvellore.ac.in

Declaration of interest

None.

Background

The relative contributions of psychosocial stress and psychiatric morbidity to suicide are a subject of debate.

Aims

To determine major risk factors for suicide in rural south India.

Method

We used a matched case–control design and psychological autopsy to assess 100 consecutive suicides and 100 living controls matched for age, gender and neighbourhood.

Results

Thirty-seven (37%) of those who died by suicide had a DSM–III–R psychiatric diagnosis. Alcohol dependence (16%) and adjustment disorders (15%) were the most common categories. The prevalence rates for schizophrenia, major depressive episode and dysthymia were 2% each. Ongoing stress and chronic pain heightened the risk of suicide. Living alone and a break in a steady relationship within the past year were also significantly associated with suicide.

Conclusions

Psychosocial stress and social isolation, rather than psychiatric morbidity, are risk factors for suicide in rural south India.


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