Socioeconomic Demographic Study of Suicide among the People in a Southern Town Berhampur of Odisha State (India)

Research Article

Austin J Forensic Sci Criminol. 2014;1(2): 6.

Socioeconomic Demographic Study of Suicide among the People in a Southern Town Berhampur of Odisha State (India)

Sachidananda Mohanty1*, Abarnita Sethi2, Kiran Kumar Patnaik1 and Asim Mishra1

1Department of Forensic medicine and Toxicology, M.K.C.G. Medical College, India

2Department of Forensic medicine & Toxicology, S.C.B Medical College, India

*Corresponding author: Sachidananda Mohanty, Post Graduate Department of Forensic medicine and Toxicology, M.K.C.G. Medical College, Berhampur-760004, Odisha, India

Received: October 10, 2014; Accepted: November 23, 2014; Published: December 01, 2014

Abstract

Suicide is a worldwide problem affecting mostly the Asian countries like India. The aim of the present study was to specify the risk factors. The study was carried out on 434 established cases of suicide out of 1701 cases of all medico legal autopsies. Our study revealed a suicide rate 11.42 per 100,000 populations with male to female ratio 1.18:1. All the victims were Hindu with highest number reported between 21 to 30 years of age (34.33%). The victims were mostly illiterate (34.56%) of rural areas (74.19 %), low socioeconomic status (79.72%), mentally sound (86.4%), married (76%), and from nuclear families (51.84%), Housewives (30.65%) among female followed by laborers (25.81%) among male were the major sufferers. Family history of suicide, psychiatric illness, and physical illness, previous attempt of suicide, suicidal notes and hesitation cuts appear to be insignificant factors. Most of the incidents occurred in indoor (72.81%) during day time (59.22%) of summer (39.40%). A history of addiction was encountered in 37.33% cases. Two important methods of suicide were, poisoning (70.97%) with mostly ingestion of insecticide or pesticide (53.25%) followed by hanging (20.97%), where 81.32% of cases have used broad and soft ligature. The major causes of suicide were marital disharmony (22.98%) and financial burden (17.97%). Vitreous alcohol was positive in 20.33% victims. Victims belonging to blood group “O” were slightly prone to commit suicide. To conclude, our study points out some potential risk factors and their remedial measures.

Keywords: Autopsy; Suicide; Victim; Financial burden; Marital disharmony

Introduction

Suicide is defined as the deliberate taking of one’s own life. Over 800,000 people die due to suicide every year and there are many more who attempts suicide. Suicide was the second leading cause of death among 15 to 29 year olds globally in 2012. In fact, 75% of global suicide occurred in low- and middle-income countries in 2012. Suicide accounted for 1.4% of all deaths worldwide, making it the 15th leading cause of death in 2012 [1]. The world suicide rate is 11.6 per 100,000 persons per year. Suicide rates differ significantly between countries and over time. Lithuania, Japan and Hungary have the highest rates. China and India, accounts for over half the total numbers of suicides [2]. According to the National Crime Records Bureau, India (2013) report on Suicides in India, the all-India rate of suicides is 11.0/100,000 and this rate has increased by 5.7% in 2013 over 2003 in which the rate was10.4/100,000. On an average, more than one hundred thousand persons committed suicides every year in the country during the decade periods (2003–2013). At par with national average the suicide rate in Odisha also has increased over the period to 12.6 in 2013 [3]. But this represents only the tip of the iceberg since the reported rates grossly underestimates the actual deaths of suicide because of non-reporting and under-reporting.

To love one’s self is the inherent quality of each individual. When that person determines to end his or her own life, it points to the high degree of demoralization and fragmentation of the sane mind. The reason for the increased rate of suicide is complex; there are predisposing risk factors which foster a vulnerability to suicide as well as precipitating factors and protective factors which exert a countervailing influence. These risk factors exist at the individual level, the level of family, community and geographic region, are often interdependent and interactive and can manifest as suicidal thoughts, gestures or attempts or even a completed act. These factors may range from age, sex, personality trait, biological and genetic factor to the religious and social milieu, economic background, and moreover the ready availability of means for committing suicide at that point of time.

A lot of studies worldwide has been undertaken on this subject like in the USA, [4] UK and Wales, [5] New York, [6] Kentucky, [7] France, [8] St. Louis, [9] Hong Kong, [10] Australia, [11] Egypt, [12] Arhus, [13] Baltimore, [14] Eric country [15] and in other Asian countries like Singapore, [16] Pakistan [17,18] Turkey, [19] etc. And their views varied on different variables. In the Indian subcontinent in addition to the aforesaid factors, the law is very strict on suicide and different from the legal system of other countries. According to Indian law, a successful suicide is no offense, but attempt to commit suicide (S.309 IPC) and abetment of suicide (S.306 IPC) are treated as offenses. Similar studies were undertaken by different researchers [20- 35] in many regions of India to postulate the important parameters responsible for suicide. In spite of all the steps taken against suicide in different countries, it appears that the rate is not substantially declining.

As it is a complex phenomenon the risk factors of suicide also vary according to the regional and other psychosocial problems. So far not much work has been undertaken either at the local level or at the Government level to point out the specific factors of suicide and to bring down the rate of suicide. Therefore present study has been undertaken to point out important risk factors responsible for suicidal and their remedial measures.

Materials and Methods

This prospective facility based study was conducted in 434 established cases of suicide out of 1701cases requested for postmortem examination in the Department of Forensic Medicine and Toxicology of M.K.C.G. Medical College, Berhampur, Odisha during a period of 2 years from Nov 2011 to Oct 2013. This is a referral center it receives dead bodies from the whole of the Berhampur city and adjacent areas comprising a population of 1.9 million approximately.

Few doubtful cases of alleged suicide where the cause of death could not be ascertained because of insufficient history, gross decomposition or inadequate findings excluded from the study. Information was obtained by interviewing accompanying persons and investigating officers, perusal of autopsy records and Bed head tickets and all the findings were noted down in a predesigned pro forma. This psychological autopsy was done in a very friendly environment, sometimes supplemented by visit to site of occurrence. In suspected poisoning samples of body tissues and fluid were collected, preserved and forwarded to the forensic science laboratory for Toxicological analysis. Blood grouping and qualitative estimation of alcohol in vitreous (dichromate test) was carried out in the Departmental laboratory except in decomposed bodies.

In the present study considering the educational status, the deceased has been classified as illiterate- who were not able to read or write, Primary- up to class V, higher Secondary -Class VI –X and College and above. Socioeconomic status was categorized as low for families having annual income of less than Rs 0.1 million, middle whose annual income falls between Rs 0.1 to Rs 0.3million and higher whose annual income exceeds Rs 0.3 million respectively. The season was divided into Winter (November to February), Summer (March to June) and Rainy (July to October) as per prevailing climatic condition of this locality The victims belonging to areas under Notified area council and Municipal Corporation were considered as an urban group while others reporting from Panchayat areas were considered as rural group The data so derived was analyzed and compared with the findings of other researchers.

Statistical analysis

Calculations were done using SPSS software in Microsoft excels. The data collected were analyzed by using the chi - square test. The p-value (p = 0.05) was considered as statistically significant.

Results

This study was carried out in 434 (25.51%) established cases of suicide. Our study indicates a suicide rate 11.42 per 100,000 populations. Males represent 235 cases and females represent 199 cases (p> 0.05) with male to female ratio 1.18:1. The peak incidence was observed in the age group 21-30 years (34.33%), followed by 11-20 years (24.65%) (Figure 1). Maximum victims were found to be married (76%), illiterate (34.56%), rural origin (74.19%) and from low socioeconomic status (79.72%) (Table 1). Housewives (30.65%) among females and laborers in males (25.81 %) were the bulk sufferers. The majority of the victims (87.79 %) do not reveal a positive history of psychiatric illness. Only 3 cases out of 434 cases give a positive family history of suicide. In 72.81% cases the incident took place within four walls of their house. Maximum cases were reported during the day (60.60%) and in summer (39.40%). In 37.33% cases the victims were found to be addicted to various substances. The nuclear family (51.84%) accounts for more suicidal deaths than joint family. Hesitation cut marks and suicidal note were detected in only 2 cases each out of 434. The major causes of suicide were marital disharmony (22.58%), financial burden (17.97%) and familial quarrel (16.36%) (Table 2). In 70.97% cases poisoning was the method of choice, followed by hanging (20.97%) (Table 3). In 164 (53.25%) cases of poisoning, insecticides / pesticides were used and in74 (81.32%) cases of hanging, broad and soft ligature material were used. The victims belonging to blood group O (45.87%) are prone to commit suicide.