title: Suicide in India: a systematic review.
abstract: BACKGROUND
  Suicide is an important cause of death in India but estimated suicide rates based on data from India's National Crime Records Bureau are unreliable.
  
  
  OBJECTIVE
  Systematically review existing literature on suicide and the factors associated with suicide in India.
  
  
  METHODS
  PubMed, PsycINFO, EMBASE, Global Health, Google Scholar and IndMED were searched using appropriate search terms. The abstracts of relevant papers were independently examined by both authors for possible inclusion. A standardized set of data items were abstracted from the full text of the selected papers.
  
  
  RESULTS
  Thirty-six papers met inclusion criteria for the analysis. The heterogeneity of sampling procedures and methods of the studies made meta-analysis of the results infeasible. Verbal autopsy studies in several rural locations in India report high suicide rates, from 82 to 95 per 100,000 population - up to 8-fold higher than the official national suicide rates. Suicide rates are highest in persons 20 to 29 years of age. Female suicide rates are higher than male rates in persons under 30 years of age but the opposite is true in those 30 years of age or older. Hanging and ingestion of organophosphate pesticides are the most common methods of suicide. Among women, self-immolation is also a relatively common method of suicide. Low socioeconomic status, mental illness (especially alcohol misuse) and inter-personal difficulties are the factors that are most closely associated with suicide.
  
  
  CONCLUSIONS
  The quality of the information about suicide in India is quite limited, but it is clearly an important and growing public health problem. Compared to suicides in high-income countries, suicide in India is more prevalent in women (particularly young women), is much more likely to involve ingestion of pesticides, is more closely associated with poverty, and is less closely associated with mental illness.
authors.affiliation: Institute of Psychiatry & Human Behaviour, Goa, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Rane
authors.affiliation: London School of Hygiene & Tropical Medicine, London, United Kingdom ; Sangath, Goa, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Nadkarni
keywords: India; mental illness; organophosphate pesticide; suicide; systematic review
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