%0 Journal Article
%T Sociocultural Context of Suicidal Behaviour in the Sundarban Region of India
%A A. N. Chowdhury
%A S. Banerjee
%A A. Brahma
%A A. Hazra
%A M. G. Weiss
%J Psychiatry Journal
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/486081
%X The role of mental illness in nonfatal deliberate self-harm (DSH) is controversial, especially in Asian countries. This prospective study examined the role of psychiatric disorders, underlying social and situational problems, and triggers of DSH in a sample of 89 patients hospitalised in primary care hospitals of the Sundarban Delta, India. Data were collected by using a specially designed DSH register, Explanatory Model Interview Catalogue (EMIC), and clinical interview. Psychiatric diagnosis was made following the DSM-IV guidelines. The majority of subjects were young females (74.2%) and married (65.2%). Most of them (69.7%) were uncertain about their ¡°intention to die,£¿ and pesticide poisoning was the commonest method (95.5%). Significant male-female differences were found with respect to education level, occupation, and venue of the DSH attempt. Typical stressors were conflict with spouse, guardians, or in-laws, extramarital affairs, chronic physical illness, and failed love affairs. The major depressive disorder (14.6%) was the commonest psychiatric diagnosis followed by adjustment disorder (6.7%); however 60.7% of the cases had no psychiatric illness. Stressful life situations coupled with easy access to lethal pesticides stood as the risk factor. The sociocultural dynamics behind suicidal behaviour and community-specific social stressors merit detailed assessment and timely psychosocial intervention. These findings will be helpful to design community-based mental health clinical services and community action in the region. 1. Introduction Presently both fatal and nonfatal deliberate self-harm (DSH) are major public health concerns globally. Fatal DSH (i.e., suicidal death) accounted for more than 900,000 lives lost in 1995 [1]. The rate of non-fatal DSH is 10 times more than fatal DSH [2]. In India, the suicide rate is approximately 11.6 per 100,000 populations [3]. Research has revealed that young age, female sex, low educational level [4], being married [5], and housewife status [6] are potential risk factors for both fatal and non-fatal DSH. Several studies also document psychiatric illness, especially major depression, as associated with DSH behaviour [7, 8]. However, the relationship between suicidal behaviour and designated psychiatric illnesses is a matter of great controversy. Unlike some western studies [9¨C11] in which psychiatric and personality disorders are referred to as predominant DSH antecedents, some Indian urban studies [12, 13] have pointed out that many people who come to clinical attention after DSH do not have any designated
%U http://www.hindawi.com/journals/psychiatry/2013/486081/