title: Sociocultural context of suicidal behaviour in the sundarban region of India.
abstract: The role of mental illness in nonfatal deliberate self-harm (DSH) is controversial, especially in Asian countries. This prospective study examined the role of psychiatric disorders, underlying social and situational problems, and triggers of DSH in a sample of 89 patients hospitalised in primary care hospitals of the Sundarban Delta, India. Data were collected by using a specially designed DSH register, Explanatory Model Interview Catalogue (EMIC), and clinical interview. Psychiatric diagnosis was made following the DSM-IV guidelines. The majority of subjects were young females (74.2%) and married (65.2%). Most of them (69.7%) were uncertain about their "intention to die," and pesticide poisoning was the commonest method (95.5%). Significant male-female differences were found with respect to education level, occupation, and venue of the DSH attempt. Typical stressors were conflict with spouse, guardians, or in-laws, extramarital affairs, chronic physical illness, and failed love affairs. The major depressive disorder (14.6%) was the commonest psychiatric diagnosis followed by adjustment disorder (6.7%); however 60.7% of the cases had no psychiatric illness. Stressful life situations coupled with easy access to lethal pesticides stood as the risk factor. The sociocultural dynamics behind suicidal behaviour and community-specific social stressors merit detailed assessment and timely psychosocial intervention. These findings will be helpful to design community-based mental health clinical services and community action in the region.
authors.affiliation: Institute of Psychiatry, 7 D. L. Khan Road, Kolkata 700025, India ; Northamptonshire Healthcare NHS Foundation Trust, Stuart Road Resource Centre, Corby, Northants NN17 1RJ, UK.
authors.forename: A N
authors.initials: AN
authors.lastname: Chowdhury
authors.forename: S
authors.initials: S
authors.lastname: Banerjee
authors.forename: A
authors.initials: A
authors.lastname: Brahma
authors.forename: A
authors.initials: A
authors.lastname: Hazra
authors.forename: M G
authors.initials: MG
authors.lastname: Weiss