Prasad J, Abraham V J, Minz S, Abraham S, Joseph A, Muliyil J P, George K, Jacob K S
Department of Community Health, Christian Medical College, Vellore, India.
Int J Soc Psychiatry. 2006 Jan;52(1):65-71. doi: 10.1177/0020764006061253.
Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles to investigating suicide in the developing world.
The aim of this study was to prospectively determine the suicide rate in Kaniyambadi Block, Tamil Nadu, South India, for the years 2000-2002 using verbal autopsies.
The setting for the study was a comprehensive community health programme in a development block in rural South India. The main outcome measure was death by suicide, diagnosed by a detailed verbal autopsy and census, and birth and death data to identify the population base.
The average suicide rate was 92.1 per 100,000. The ratio of male to female suicides was 1:0.66. The age-specific suicide rate for men increased with age while that for women showed two peaks: 15-24 years and over 65 years of age. Hanging (49%) and poisoning with organo-phosphorus compounds (40.5%) were the commonest methods of committing suicide. Acute and/or chronic stress was elicited for nearly all subjects. More men suffered from chronic stress while more women had acute precipitating events (chi2 = 4.58; p < 0.04). People less than 44 years of age had more acute precipitating events before death while older subjects reported more chronic stress (chi2 = 17.38; p < 0.001).
The study replicates findings of an earlier study from the area. The suicide rate documented in this study is very high and is a major public health concern. There is a need for sentinel centres in India and in developing countries to monitor trends and to develop innovative strategies to reduce deaths by suicide.
在发展中国家，民事登记系统效率低下、死亡未上报、死亡认证标准不一以及自杀的法律和社会后果是调查自杀情况的主要障碍。
本研究旨在通过运用口头尸检法前瞻性地确定2000 - 2002年印度南部泰米尔纳德邦卡尼亚姆巴迪区的自杀率。
本研究的背景是印度南部农村一个发展区的综合社区健康项目。主要结局指标是自杀死亡，通过详细的口头尸检和人口普查进行诊断，并利用出生和死亡数据确定人口基数。
平均自杀率为每10万人92.1例。男性与女性自杀率之比为1:0.66。男性的年龄别自杀率随年龄增长而上升，而女性的年龄别自杀率有两个高峰：15 - 24岁和65岁以上。上吊（49%）和有机磷化合物中毒（40.5%）是最常见的自杀方式。几乎所有受试者都存在急性和/或慢性应激。男性更多地遭受慢性应激，而女性有更多急性诱发事件（卡方 = 4.58；p < 0.04）。44岁以下的人在死亡前有更多急性诱发事件，而年龄较大的受试者报告有更多慢性应激（卡方 = 17.38；p < 0.001）。
本研究重复了该地区早期一项研究的结果。本研究记录的自杀率非常高，是一个主要的公共卫生问题。印度和其他发展中国家需要设立监测中心来监测趋势，并制定创新策略以减少自杀死亡。
