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SUCIDE AMONG THE HIGH PREVELANCE

 

 

SUCIDE AMONG THE HIGH PREVELANCE GROUP

                                                Dr Samiksha Kaur,*Dr Jai Singh Yadav**

Introduction

 

Suicide as per definition it is an act of self harm, undertaken with conscious self- destructive intent, with a fatal outcome. The World Health Organization estimates that it is the 13th leading cause of death worldwide and National Safety Council rates are sixth in the United States.3, 4 Over one million people commit suicide every year.  Suicide is often committed mental disorder which includes depression, bipolar disorder, schizophrenia, alcoholism and drug abuse, neurological disorder, physical chronic illness, AIDS, neurochemistry and also socioeconomic causes like financial difficulties unemployment, troubles with interpersonal relationships, divorce, isolation and other undesirable situations play a significant role.1, 2

 

Suicide is a leading cause of death among teenagers and adults under 35 percentage.5, 6 Rates of suicide are higher in men than in women.7 There are an estimated 10 to 20 million non-fatal attempted suicides every year worldwide.5 Sati was a Hindu funeral practice in which the widow would immolate herself on her husband's funeral pyre, either willingly, or under pressure from the family and in-laws.6

 

Methods of Suicide

The methods of suicide are common hanging, pesticide poisoning, cutting and firearms. Hanging or jumping method is violent where as drug and other forms of poison is non violent. Males and mentally disordered persons tend violent methods; female toward non-violent. Worldwide methods of suicide are 30% from pesticides, 52% from firearms and 40% poisoning. 31 Other methods of suicide include blunt force trauma (jumping from a building or bridge, self-defenestrating, stepping in front of a train, or car collision, for example).  Bloodletting (slitting one's wrist or throat), intentional drowning, self-immolation, electrocution, and intentional starvation are other suicide methods. In a study 1996 was found that relationship between suicides among friends, 32 while a 1986 study found increased rates of suicide following by the television of news stories regarding suicide.33 A suicide attempt is sometimes interpreted as a "cry for help" and attention  and the wish to escape, rather than a genuine intent to die.37 Most people who attempt suicide do not complete suicide on a first attempt; those who later gain a history of repetitions have a significantly higher probability of eventual completion of suicide.38

 

Suicide and Mental disorder

 

Total 87% to 98% peoples those committed suicide were suffering from mental disorder. 7,8 The percentage of suicide in substance abuse is 18%, schizophrenia 14%, and  personality disorders is 13% .8 About 5% of people with schizophrenia die of suicide.9 Depression, is one of the most precipitating factor in suicide 10,11,12,13 so depression leading cause of disability worldwide in the United States alone affects 17.6 million. In approximately 75% of completed suicides the individuals had seen by physician within the prior year before their death, 45%-66% within the prior month. Approximately 33% - 41% of those who completed suicide had contact with mental health services in the prior year, 20% within the prior month.14, 15,16,17,18

 

Suicide and addiction

More than 50% those committed suicide were alcoholic and drug abuser. The chronic consumption of alcohol and benzodiazepine are second most common risk factor of suicide after mood disorder.19   In adolescents the figure of suicides is 70% due to misuse of alcohol and misuse of drugs, such as cocaine have a high correlation with suicide. Suicide is more common of chronic cocaine abusers with there withdrawal phase. It has been found that drinking 6 drinks or more per day results in a six fold increased risk of suicide.20

 

There have been various studies done showing a positive link between smoking, suicidal ideation and suicide attempts.24,25 In a study conducted among nurses, those smoking between 1-24 cigarettes per day had twice the suicide risk; 25 cigarettes or more, 4 times the suicide risk, than those who had never smoked.26,27 In a study of 300,000 male U.S. Army soldiers, a definitive link between suicide and smoking was observed with those smoking over a pack a day having twice the suicide rate of non-smokers.28

 

Suicide and Heritability

 

Genetics has also an effect on suicide risk 30-50%.29,30 Much of this relationship acts through the heritability of mental illness.30There is also evidence to suggest that if a parent has committed suicide, his/her offspring also attempts suicide.

 

Suicide and Legal view

.

Switzerland has recently taken steps to legalize assisted suicide for the chronically mentally ill. . In Singapore, assisting in the suicide of a mentally handicapped person is a capital offense. In India, abetting suicide of a minor or a mentally challenged person can result in a maximum 1 year prison term with a possible fine.40In some jurisdictions, an act or incomplete act of suicide is considered to be a crime. More commonly, a surviving party member who assisted in the suicide attempt will face criminal charges. In Brazil, if the help is directed to a minor, the penalty is applied in its double and not considered as homicide. In Italy and Canada, instigating another to suicide is also a criminal offense. In Germany, the following laws apply to cases of suicide41

 

Suicide rates have increased by 50% to 60% mainly in the developing countries.33 According to the World Health Organization, China, India and Japan may account for 40% of all worlds. According to NCRB 2009 there are 127151 lakes suicidal death in a year in India. The data of (2009) India suicidal deaths have been given below.

 

 

 

 

Distribution of Suicidal Death State, UT, City wise 2009. Total data was 28 state, 07 UT and 35 cities of India.

 

Category

No Of Suicidal death

State

124870

UT

2281

City

13503

                                                                              

 

Distribution of Suicidal Death categorized by Sex and Age Group-2009

 

Categories/Age

14 Year

15-29 Years

30-44 Years

 

Male

Female

Total

Male

Female

Total

Male

Female

Total

State

1483

1418

2901

23133

19659

42792

28865

13953

42815

UT

18

32

50

613

515

1128

470

203

673

All India

1501

1450

2951

23746

20174

43920

29355

14153

43488

City

234

255

499

2941

250

5441

2964

1308

4272

 

Continue above

45-49 Years

60 Years above

Total of Years

Male

Female

Total

Male

Female

Total

Male

Female

Total

19341

6940

26281

7215

2866

10081

80037

44833

124870

255

67

322

78

30

108

1434

847

2281

11596

7007

26603

7293

2896

10184

81471

45680

127151

1748

595

2343

673

285

958

8560

4943

13503

 

Distribution by Causes of Suicide-2009

 

Causes of  Suicide

Male

Female

Total

Bankruptcy

2781

381

3162

Suspected Relation

500

680

1130

Concealing marriage

475

528

1003

Not having Children

216

464

680

Illness

17387

9344

26731

a-Aids/STD

492

185

677

b- Cancer

591

250

841

c-Paralysis

517

199

716

d-Insanity/Mental illness

5416

3053

8469

e-Other Prolonged Illness

10371

5657

16028

Death of Dear Person

460

343

803

Dowry Dispute

74

2847

2921

divorce

152

179

331

Drug Abuse Addiction

2844

98

2942

Failure in Examination

1107

903

2010

Fall in Social Relation

672

451

1123

Family Problem

18441

11641

30082

Ideological Causes

116

12

128

Illegitimate Pregnancy

NA

141

141

Love affaires

1927

1784

3711

Physical Abuse

95

225

320

Poverty

2308

679

2987

Professional/Career Problem

1212

142

1354

Property dispute

1063

220

1283

Unemployment

2165

307

2472

Causes Not Known

14334

6979

21313

Others Causes

14334

7332

20474

Total

81471

45680

127151

 

 

 

Distribution of state UT, City wise High privilege rate of Suicidal Death in India 2009

 

Name of State

No Of suicidal Death

Percentage of Suicidal Death

West Bengal

14648

11.5%

Andhra Pradesh

14500

11.4%

Tamil Nadu

14424

11.3%

Maharrshtra

14300

11.2%

Karnataka

12195

9.6%

Kerala

8755

6.9%

Delhi  (UT)

1477

1.2%

Bengaluru (City wise)

2167

16.0%

Chennai

1412

10.5%

Delhi

1215

9.0%

Mumbai

1051

7.8%

Pune

648

4.8%

 

 

Distribution of Suicide by Profession Age and Sex wise-2009

 

 

14 Years

15-29 Years

30-44 Years

45-49 Years

Profession

Male

Female

Total

Male

Female

Total

Male

Female

Total

Male

Female

Total

House wife

NA

62

62

NA

11029

11029

NA

8613

8613

NA

3843

3843

Services

3

3

6

3771

1052

4823

5510

766

6276

3211

400

3611

1-Government

0

0

0

279

126

5-Apr

628

111

739

484

59

543

2-Privet

3

2

5

2770

750

3520

3625

510

4435

2067

241

2308

3-Public sector undertaking

0

1

1

722

176

898

957

145

1120

660

100

760

Student

649

629

1278

2934

22721

52/6

137

89

262

12

3

15

Unemployed

37

30

67

2931

693

3624

3435

433

3868

1540

277

1817

Self employed

307

326

633

10694

3122

13816

15914

2768

18682

11337

1512

12849

1-Business

24

2

26

1774

199

1973

2750

229

2970

2082

103

2185

2- professional Activity

20

0

20

871

156

27-Oct

1238

125

1363

954

55

1009

3-Forming

46

27

73

3464

931

4395

5820

808

6628

4045

482

4527

4-Others

217

297

514

4585

1836

6421

6106

1606

7712

4256

872

5128

Retired

1

0

1

17

10

27

29

28

75

109

31

140

Others

504

400

904

3399

1996

5395

4274

1438

5712

3307

941

4248

Total

1501

1450

2951

23746

20174

43290

29335

14153

43488

16596

7007

23603

 

 

 

 

60 Years above

Total

Male

Female

Total

Male

Female

Total

NA

1545

1545

NA

25092

25092

549

83

632

13044

2304

15348

25

2

27

1416

298

1714

388

64

452

9153

1567

10720

136

17

153

2475

439

2914

0

0

0

8768

2993

6761

445

95

540

8388

1528

9916

4085

554

4639

42337

8282

50619

566

19

585

7196

552

7748

199

16

215

3282

352

3634

1576

169

1745

14951

2417

17368

1744

350

2094

16908

4961

21869

600

108

708

836

195

1031

1614

511

2125

13098

5286

18384

7293

2896

10189

81471

45680

127151

 Conclusion

 

 

 

Suicide is more complicated social and mental problem of the world.  Suicide is a leading cause of death among teenagers and adults under 35 percentage...5, 6 Rates of suicide are higher in men than in women.7 There are an estimated 10 to 20 million non-fatal attempted suicides every year worldwide.5 Misuse of alcohol is associated with a number of mental health disorders, who occur in heavy drinkers and those who abuse alcohol commit suicide.22,23 In the United States 16.5% of suicides are related to alcohol.34 About 15% of alcoholics commit suicide, and about 33% of suicides in the under 35's have a primary diagnosis of alcohol or other substance misuse. In adolescent’s alcohol or drug misuse plays a role in up to 70% of suicides.35National suicide rates differ significantly between countries and amongst ethnic groups within countries.36There is many evidence, and causes of suicide due to drug abuse, physical and mental illness, failure in exam, love   businesses. Near about 87-98 percent of suicide due to mental illness world wide. In India family problem, (30082) poverty, (298) unemployment (2472,) mental and physical illness (260731) bankruptcy (3162) is one of the leading causes of suicidal death 2009.Suicide ratio of male and female was 64;36, boys and girls 51:49, married men and women it was45.5:24.6percentage respectively in 2009 in India.  There are high rate of suicidal death state wise Andhra Pradesh, Karnataka, West Bengal, Tamilnadu and Kerala .

 

 

 

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