Sauvaget C, Ramadas K, Fayette J M, Thomas G, Thara S, Sankaranarayanan R
Screening Group, International Agency for Research on Cancer, 150 cours Albert, Thomas, 69372 Lyon cedex 08, France.
Natl Med J India. 2009 Sep-Oct;22(5):228-33.
India has witnessed a dramatic increase in suicide rates during the past few decades. The southern state of Kerala has been reporting the highest rates of suicide. Since suicide rates are estimated from death registries, they are likely to be under-reported because the civil registration system is incomplete and suicide deaths are poorly reported.
A cohort of 132 000 participants (age 35 years and above) in Thiruvananthapuram (erstwhile Trivandrum) district, Kerala was followed up for mortality from 1996 to 2005, after having filled-in a lifestyle questionnaire at baseline. The cause of death was based on verbal autopsy. Suicide methods were recorded and rates were estimated, and suicide risks were calculated according to several socioeconomic factors.
During the follow up period, a total of 11 608 deaths, of which 385 were suicides (3.3% of total deaths), were registered. The overall suicide rate was 39.3/100 000 person-years among adults 35-90 years of age (men: 78/ 100000; women: 16.5/100000). The predominant methods of suicide were hanging, followed by poisoning and drowning. The suicide determinants were male gender, middle-age (40-60 years), Hindu, alcohol drinkers and secondary education level (< or = 7 years). Neither low socioeconomic level, living alone, nor being a married woman was associated with suicide risk.
Suicide rates were consistent with the official rates of Thiruvananthapuram district (37/100 000). However, our study population did not include the 14-34-year-old age-group which represents more than 37% of all suicides and hence it is more likely that the official rates are under-reported. Determinants of suicide were in line with previous studies.
在过去几十年间，印度的自杀率急剧上升。印度南部的喀拉拉邦一直报告着最高的自杀率。由于自杀率是根据死亡登记处的数据估算得出的，而民事登记系统并不完善，自杀死亡报告情况不佳，所以这些数据很可能存在漏报。
对喀拉拉邦特里凡得琅（旧称特拉凡哥尔）地区的132000名参与者（年龄35岁及以上）进行队列研究，这些参与者在基线时填写了一份生活方式问卷，之后于1996年至2005年期间对其进行死亡率随访。死因基于口头尸检。记录自杀方式并估算自杀率，同时根据多种社会经济因素计算自杀风险。
在随访期间，共登记了11608例死亡，其中385例为自杀（占总死亡人数的3.3%）。35至90岁成年人的总体自杀率为39.3/10万人口年（男性：78/10万；女性：16.5/10万）。自杀的主要方式是上吊，其次是中毒和溺水。自杀的决定因素为男性、中年（40至60岁）、印度教徒、饮酒者以及中等教育水平（≤7年）。社会经济水平低、独居以及已婚女性均与自杀风险无关。
自杀率与特里凡得琅地区的官方数据（37/10万）一致。然而，我们的研究人群未包括14至34岁年龄组，而该年龄组占所有自杀人数的比例超过37%，因此官方数据更有可能存在漏报情况。自杀的决定因素与先前的研究一致。
