A prospective study of suicidal behaviour in Sundarban delta, West Bengal, India.
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Date
2010-07
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Abstract
Background. Deliberate self-harm is a challenging public
health issue but there is a paucity of data on non-fatal
deliberate self-harm in the literature. We aimed to understand
the behaviour of deliberate self-harm, both fatal and nonfatal,
in a primary care setting.
Methods. A year-long prospective study of all admitted
patients of deliberate self-harm at 13 block primary health
centres of the Sundarban region was done to examine the
sociodemographic profile and clinical outcome of suicidal
behaviour. Data were collected by using an especially devised
deliberate self-harm register. Each subject was administered a
20-item case history sheet by trained medical officers and
nursing staff.
Results. A total of 1614 deliberate self-harm subjects
(619 men, 995 women) were admitted during the year, of
whom 143 (62 men, 81 women) died. Although women,
especially in the younger age groups, constituted the majority
of subjects (61.6%), the fatality trend was higher among men
than among women (10% v. 8.1%). Poisoning was the
commonest (98.4%) method of self-harm, particularly using
pesticide. Easy availability of pesticides was a risk factor.
Psychosocial stressors, such as conflict with spouse, guardian
or in-laws, failed love affairs and economic distress, were the
common underlying reasons. The majority of acts of deliberate
self-harm (92.6%) were committed inside the home, especially
by women. Only a small proportion of subjects had a past or
family history of attempt at deliberate self-harm. The overall
incidence of fatal and non-fatal deliberate self-harm was 5.98
and 61.51 per 100 000 population, respectively.
Conclusion. Both fatal and non-fatal pesticide-related
deliberate self-harm is a major public health issue in the Sundarban region. An intersectoral approach involving primary health, administration and agriculture may help in developing an effective preventive programme to reduce the morbidity
and mortality from deliberate self-harm.
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Chowdhury A N, Banerjee S, Brahma A, Das S, Sarker P, Biswas M K, Sanyal D, Hazra A. A prospective study of suicidal behaviour in Sundarban delta, West Bengal, India. National Medical Journal of India. 2010 Jul-Aug; 23(4): 201-205.