Risk factors for suicide in rural south India

BACKGROUND: The relative contributions of psychosocial stress and psychiatric morbidity to suicide are a subject of debate. AIMS: To determine major risk factors for suicide in rural south India. METHOD: We used a matched case-control design and psychological autopsy to assess 100 consecutive suicides and 100 living controls matched for age, gender and neighbourhood. RESULTS: Thirty-seven (37%) of those who died by suicide had a DSM-III-R psychiatric diagnosis. Alcohol dependence (16%) and adjustment disorders (15%) were the most common categories. The prevalence rates for schizophrenia, major depressive episode and dysthymia were 2% each. Ongoing stress and chronic pain heightened the risk of suicide. Living alone and a break in a steady relationship within the past year were also significantly associated with suicide. CONCLUSIONS: Psychosocial stress and social isolation, rather than psychiatric morbidity, are risk factors for suicide in rural south India.