Factors associated with suicide methods among non-fatal suicide attempters in a general hospital
Keywords:
Drug overdose, Hanging, Poison consumption, Suicide method
Abstract
Background: Suicide is a major public health concern. A number of socio-demographic and clinical variables interplay in determining the chosen method and hence influence the outcome of suicidal behavior.
Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The socio-demographic details were recorded in the semi structured proforma. Detailed assessment of Psychiatric morbidity and attempted suicide was done by clinical interview and validated by M.I.N.I.-Plus 5.0 and Beck Suicide Intent Scale. Data was analyzed using SAS Version 9.2 & SPSS Version 17.0.
Results: In the present study, the three most common method of attempting suicide was by poison consumption (50.5%), followed by drug overdose (35%) and hanging (9.5%). Most of the study participants who attempted suicide by poison consumption and drug overdose were in the age group of 11-40 years (P= 0.010 and P=0.050) and female gender had the highest risk of attempting suicide by poison consumption (P=0.005). Most of the subjects in the drug overdose group belonged to urban domicile (P=0.023). Majority of the attempters were first time attempters with low intentionality, low lethality and high impulsivity. Psychosocial factors played an important precipitating role and the most common psychiatric morbidity was adjustment disorder followed by MDD. The influence of alcohol prior to the attempt was significant in the poison consumption group (P=0.040).
Conclusions: There are various demographic, clinical and psychosocial factors that play a determinantal role in the choice of method in non-fatal suicide attempters and understanding the interplay of these factors can help devising better preventive strategies in the future.
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References
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29. Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE Jr. The interpersonal theory of suicide. Psychol Rev. 2010 Apr;117(2):575-600. doi: 10.1037/a0018697. [PubMed]
30. Radhakrishnan R, Andrade C. Suicide: An Indian perspective. Indian J Psychiatry. 2012 Oct;54(4):304-19. doi: 10.4103/0019-5545.104793. [PubMed]
31. Michel K, Ballinari P, Bille-Brahe U, Bjerke T, Crepet P, De Leo D, Haring C, Hawton K, Kerkhof A, Lönnqvist J, Querejeta I, Salander-Renberg E, Schmidtke A, Temesvary B, Wasserman D. Methods used for parasuicide: results of the WHO/EURO Multicentre Study on Parasuicide. Soc Psychiatry Psychiatr Epidemiol. 2000 Apr;35(4):156-63.
32. Värnik A, Kõlves K, Allik J, Arensman E, Aromaa E, van Audenhove C, Bouleau JH, van der Feltz-Cornelis CM, Giupponi G, Gusmão R, Kopp M, Marusic A, Maxwell M, Oskarsson H, Palmer A, Pull C, Realo A, Reisch T, Schmidtke A, Pérez Sola V, Wittenburg L, Hegerl U. Gender issues in suicide rates, trends and methods among youths aged 15-24 in 15 European countries. [PubMed]
33. Tuan NV, Dalman C, Thiem NV, Nghi TV, Allebeck P. Suicide attempts by poisoning in Hanoi, Vietnam: methods used, mental problems, and history of mental health care. Arch Suicide Res. 2009;13(4):368-77. doi: 10.1080/13811110903266657. [PubMed]
34. Rajasuriar R, Awang R, Hashim SB, Rahmat HR. Profile of poisoning admissions in Malaysia. Hum Exp Toxicol. 2007 Feb;26(2):73-81. [PubMed]
35. Khan FA, Anand B, Devi MG, Murthy KK. Psychological autopsy of suicide-a cross-sectional study. Indian J Psychiatry. 2005 Apr;47(2):73-8. doi: 10.4103/0019-5545.55935.
2. National Crimes Records Bureau. Accidental Deaths and Suicides in India 2013. New Delhi: Ministry of Home Affairs, Government of India; 2014.
3. Ajdacic-Gross V, Weiss MG, Ring M, Hepp U, Bopp M, Gutzwiller F, et al. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization. 2008;86(9):726-32.
4. Kar N. Profile of risk factors associated with suicide attempts: A study from Orissa, India. Indian J Psychiatry. 2010 Jan;52(1):48-56. doi: 10.4103/0019-5545.58895. [PubMed]
5. Mishra D, Singh HP. Kuppuswamy's socioeconomic status scale--a revision. Indian J Pediatr. 2003 Mar;70(3):273-4. [PubMed]
6. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57.
7. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol. 1979 Apr;47(2):343-52.
8. Schmidtke A, Bille-Brahe U, DeLeo D, Kerkhof A, Bjerke T, Crepet P et al. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1996;93:327-38. [PubMed]
9. Reddy MS. Suicide incidence and epidemiology. Indian J Psychol Med. 2010 Jul;32(2):77-82. doi: 10.4103/0253-7176.78501. [PubMed]
10. Bumbrah GS, Krishan K, Kanchan T, Sharma M, Sodhi GS. Phosphide poisoning: a review of literature. Forensic Sci Int. 2012 Jan 10;214(1-3):1-6. doi: 10.1016/j.forsciint.2011.06.018. Epub 2011 Jul 16. [PubMed]
11. Suicide Prevention Australia, 2015, Suicide and suicidal behaviour in women-issues and prevention, Suicide Prevention Australia. Available from: http://apo.org.au/node/56174. [Last accessed on 2016 March 15].
12. Vijayakumar L. Suicide in women. Indian J Psychiatry. 2015 Jul;57(Suppl 2):S233-8. doi: 10.4103/0019-5545.161484. [PubMed]
13. Sharma RC. Attempted suicide in himachal pradesh. Indian J Psychiatry. 1998 Jan;40(1):50-4. [PubMed]
14. Srivastava MK, Sahoo RN, Ghotekar LH, Dutta S, Danabalan M, Dutta TK, Das AK. Risk factors associated with attempted suicide : a case control study. Indian J Psychiatry. 2004 Jan;46(1):33-8. [PubMed]
15. Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med. 2002 Jul;55(1):125-39. [PubMed]
16. Pires MC, Silva Tde P, Passos MP, Sougey EB2, Bastos Filho OC. Risk factors of suicide attempts by poisoning: review. Trends Psychiatry Psychother. 2014 Jun;36(2):63-74. doi: 10.1590/2237-6089-2013-0044. [PubMed]
17. Keyvanara M, Mousavi SG, Karami Z. Social Class Status and Suicide Characteristics: A Survey among Patients Who Attempted Suicide in Isfahan. Mater Sociomed. 2013;25(1):56-9. doi: 10.5455/msm.2013.25.56-59.
18. Pompili M, Innamorati M, Szanto K, Di Vittorio C, Conwell Y, Lester D, Tatarelli R, Girardi P, Amore M.Life events as precipitants of suicide attempts among first-time suicide attempters, repeaters, and non-attempters. Psychiatry Res. 2011 Apr 30;186(2-3):300-5. doi: 10.1016/j.psychres.2010.09.003. [PubMed]
19. Haw C, Hawton K, Houston K, Townsend E. Correlates of relative lethality and suicidal intent among deliberate self-harm patients. Suicide Life Threat Behav. 2003 Winter;33(4):353-64. [PubMed]
20. Hepp U, Stulz N, Unger-Köppel J, Ajdacic-Gross V. Methods of suicide used by children and adolescents. Eur Child Adolesc Psychiatry. 2012 Feb;21(2):67-73. doi: 10.1007/s00787-011-0232-y. Epub 2011 Dec 1. [PubMed]
21. Flensborg-Madsen T, Knop J, Mortensen EL, Becker U, Sher L, Grønbaek M. Alcohol use disorders increase the risk of completed suicide--irrespective of other psychiatric disorders. A longitudinal cohort study. Psychiatry Res. 2009 May 15;167(1-2):123-30. doi: 10.1016/j.psychres.2008.01.008. Epub 2009 Apr 9.
22. Koller G, Preuss UW, Bottlender M, Wenzel K, Soyka M. Impulsivity and aggression as predictors of suicide attempts in alcoholics. Eur Arch Psychiatry Clin Neurosci. 2002 Aug;252(4):155-60. [PubMed]
23. Pompili M, Serafini G, Innamorati M, Dominici G, Ferracuti S, Kotzalidis GD, Serra G, Girardi P, Janiri L, Tatarelli R, Sher L, Lester D. Suicidal behavior and alcohol abuse.Int J Environ Res Public Health. 2010 Apr;7(4):1392-431. doi: 10.3390/ijerph7041392. Epub 2010 Mar 29. [PubMed]
24. Rao A. Attempted suicide. Indian J Psychiatry 1965;7:253-64. [PubMed]
25. Ponnudurai R, Jeyakar J, Saraswathy M. Attempted suicides in Madras.Indian J Psychiatry. 1986 Jan;28(1):59-62. [PubMed]
26. Gradus JL, Qin P, Lincoln AK, Miller M, Lawler E, Lash TL. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide. Clin Epidemiol. 2010 Aug 9;2:23-8. [PubMed]
27. Portzky G, Audenaert K, van Heeringen K. Adjustment disorder and the course of the suicidal process in adolescents. J Affect Disord. 2005 Aug;87(2-3):265-70. [PubMed]
28. Srivastava AS, Kumar R. Suicidal ideation and attempts in patients with major depression: Sociodemographic and clinical variables. Indian J Psychiatry. 2005 Oct;47(4):225-8. doi: 10.4103/0019-5545.43059.
29. Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE Jr. The interpersonal theory of suicide. Psychol Rev. 2010 Apr;117(2):575-600. doi: 10.1037/a0018697. [PubMed]
30. Radhakrishnan R, Andrade C. Suicide: An Indian perspective. Indian J Psychiatry. 2012 Oct;54(4):304-19. doi: 10.4103/0019-5545.104793. [PubMed]
31. Michel K, Ballinari P, Bille-Brahe U, Bjerke T, Crepet P, De Leo D, Haring C, Hawton K, Kerkhof A, Lönnqvist J, Querejeta I, Salander-Renberg E, Schmidtke A, Temesvary B, Wasserman D. Methods used for parasuicide: results of the WHO/EURO Multicentre Study on Parasuicide. Soc Psychiatry Psychiatr Epidemiol. 2000 Apr;35(4):156-63.
32. Värnik A, Kõlves K, Allik J, Arensman E, Aromaa E, van Audenhove C, Bouleau JH, van der Feltz-Cornelis CM, Giupponi G, Gusmão R, Kopp M, Marusic A, Maxwell M, Oskarsson H, Palmer A, Pull C, Realo A, Reisch T, Schmidtke A, Pérez Sola V, Wittenburg L, Hegerl U. Gender issues in suicide rates, trends and methods among youths aged 15-24 in 15 European countries. [PubMed]
33. Tuan NV, Dalman C, Thiem NV, Nghi TV, Allebeck P. Suicide attempts by poisoning in Hanoi, Vietnam: methods used, mental problems, and history of mental health care. Arch Suicide Res. 2009;13(4):368-77. doi: 10.1080/13811110903266657. [PubMed]
34. Rajasuriar R, Awang R, Hashim SB, Rahmat HR. Profile of poisoning admissions in Malaysia. Hum Exp Toxicol. 2007 Feb;26(2):73-81. [PubMed]
35. Khan FA, Anand B, Devi MG, Murthy KK. Psychological autopsy of suicide-a cross-sectional study. Indian J Psychiatry. 2005 Apr;47(2):73-8. doi: 10.4103/0019-5545.55935.
CITATION
DOI: 10.17511/ijmrr.2016.i04.05
Published: 2016-04-30
How to Cite
1.
Kumar. K. K, Ahmed Sattar F, Bondade S, Ballur S, Hussain P D. Factors associated with suicide methods among non-fatal suicide attempters in a general hospital. Int J Med Res Rev [Internet]. 2016Apr.30 [cited 2024Apr.27];4(4):491-05. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/508
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