Risk factors for completed suicides: a case-control study from Bangalore, India.
BACKGROUND
Suicides are a hidden and unrecognized epidemic in the Indian region, affecting predominantly younger age groups. Information on causative risk factors and mechanisms is not available in the country, which is crucial for designing intervention programmes.


OBJECTIVE
To identify and quantify risk factors for completed suicides in the city of Bangalore.


METHODS
A case-control study was conducted with the families of 269 completed suicides and 269 living controls within the broader population of the city using psychological autopsy methods.


RESULTS
The study has shown that several factors in the areas of family, marriage, education, occupation, general health, mental health and absence of protective factors contribute significantly for suicides. The cumulative and repetitive interaction of several factors in a complex manner results in suicides. The significant factors were presence of previous suicidal attempt in self (odds ratio (OR) = 42.62), interpersonal conflicts and marital disharmony with spouse (OR = 27.98), alcoholism in self (OR = 23.38), presence of a mental illness (OR = 11.07), sudden economic bankruptcy (OR = 7.1), domestic violence (OR = 6.82) and unemployment (OR = 6.15). Individuals completing suicides did not have a positive outlook towards life, problem-solving approaches and coping skills.


CONCLUSIONS
The observed findings are at variance with suicidal causation in the West in some areas operating in a different sociocultural and economic environment. The intervention strategies should include prioritized macro and micro level efforts aimed at individual, family and society.
Gururaj
G
G
Department of Epidemiology, WHO Collaborating Centre for Injury Prevention and Safety Promotion, National Institute of Mental Health and Neuro Sciences, Bangalore, India. guru@nimhans.kar.nic.in
Isaac
M K
MK
Subbakrishna
D K
DK
Ranjani
R
R
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015984:Causality; D017579:Domestic Violence / Q000523:psychology; D005195:Family Relations; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014478:Unemployment / Q000523:psychology; D000092864:Suicide Prevention