Case-control study of suicide in Karachi, Pakistan.
BACKGROUND
In recent years suicide has become a major public health problem in Pakistan.


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


METHODS
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.
Khan
Murad Moosa
MM
Department of Psychiatry, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. murad.khan@aku.edu
Mahmud
Sadia
S
Karim
Mehtab S
MS
Zaman
Mohammad
M
Prince
Martin
M
D016022:Case-Control Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D010154:Pakistan / Q000453:epidemiology; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D014478:Unemployment / Q000523:psychology*