Violence, psychological distress and the risk of suicidal behaviour in young people in India

Aravind Pillai, Teddy Andrews, Vikram Patel

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Background: Suicide among young people has emerged as a major public health issue in many low- and middle-income (LAMI) countries. Suicidal behaviour including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. The aim of this study is to estimate the prevalence and risk factors for suicidal behaviour in young people in India. Method and findings: Cross-sectional study of 3662 youth (16-24 years) from rural and urban communities in Goa, India. Suicidal behaviour during the recent 3 months and associated factors were assessed using a structured interview. Overall 144; 3.9% [95% confidence interval (CI) 3.3-4.6] youth reported any suicidal behaviour in the previous 3 months. Suicidal behaviour was found to be associated with female gender Odds ratio (OR) 6.5 (95% CI 3.9-10.8), not attending school or college OR 1.6 (95% CI, 1.01-2.6), independent decision making OR 2.5 (95% CI 1.5-4.3), premarital sex OR 3.2 (95% CI 1.6-6.3), physical abuse at home OR 3.3 (95% CI 1.8-6.1), life time experience of sexual abuse OR 3.3 (95% CI 1.8-6.0) and probable common mental disorders (CMD) OR 9.5 (95% CI 6.3-14.5). Gender segregated analysis found independent decision making (P = 0.68 for interaction), rural residence (P = 0.01 for interaction) and premarital sex (P = 0.41 for interaction) retained association with suicidal behaviour only among females (P = 0.05). The population attributable fraction estimates were largest for CMD (42.8% for females; 35.9% for males); physical abuse in one's home (12.5% for females; 12.4% for males); sexual abuse (12.1% in females; 22.3% in males); and making independent decisions (22.9% for females). Analyses of the risk factors for the relatively less common outcome of suicide attempts found a similar set of factors as for suicidal behaviour; in addition, alcohol use was also an independent risk factor. Conclusion: Violence and psychological distress are independently associated with suicidal behaviour; factors associated with gender disadvantage - in particular for rural women, may increase their vulnerabilities. Prevention programs for youth suicide in India need to address both the structural determinants of gender disadvantage, and the individual experiences of violence and poor mental health.

Original languageEnglish
Pages (from-to)459-469
Number of pages11
JournalInternational Journal of Epidemiology
Volume38
Issue number2
DOIs
Publication statusPublished - 17-04-2009

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Risk-Taking
Violence
India
Confidence Intervals
Psychology
Odds Ratio
Suicide
Decision Making
Sex Offenses
Mental Disorders
Life Change Events
Sex Ratio
Rural Population
Mental Health
Public Health
Cross-Sectional Studies
Alcohols
Interviews
Population

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

@article{cc3787faf1ef45d6ad8c8fae144cd342,
title = "Violence, psychological distress and the risk of suicidal behaviour in young people in India",
abstract = "Background: Suicide among young people has emerged as a major public health issue in many low- and middle-income (LAMI) countries. Suicidal behaviour including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. The aim of this study is to estimate the prevalence and risk factors for suicidal behaviour in young people in India. Method and findings: Cross-sectional study of 3662 youth (16-24 years) from rural and urban communities in Goa, India. Suicidal behaviour during the recent 3 months and associated factors were assessed using a structured interview. Overall 144; 3.9{\%} [95{\%} confidence interval (CI) 3.3-4.6] youth reported any suicidal behaviour in the previous 3 months. Suicidal behaviour was found to be associated with female gender Odds ratio (OR) 6.5 (95{\%} CI 3.9-10.8), not attending school or college OR 1.6 (95{\%} CI, 1.01-2.6), independent decision making OR 2.5 (95{\%} CI 1.5-4.3), premarital sex OR 3.2 (95{\%} CI 1.6-6.3), physical abuse at home OR 3.3 (95{\%} CI 1.8-6.1), life time experience of sexual abuse OR 3.3 (95{\%} CI 1.8-6.0) and probable common mental disorders (CMD) OR 9.5 (95{\%} CI 6.3-14.5). Gender segregated analysis found independent decision making (P = 0.68 for interaction), rural residence (P = 0.01 for interaction) and premarital sex (P = 0.41 for interaction) retained association with suicidal behaviour only among females (P = 0.05). The population attributable fraction estimates were largest for CMD (42.8{\%} for females; 35.9{\%} for males); physical abuse in one's home (12.5{\%} for females; 12.4{\%} for males); sexual abuse (12.1{\%} in females; 22.3{\%} in males); and making independent decisions (22.9{\%} for females). Analyses of the risk factors for the relatively less common outcome of suicide attempts found a similar set of factors as for suicidal behaviour; in addition, alcohol use was also an independent risk factor. Conclusion: Violence and psychological distress are independently associated with suicidal behaviour; factors associated with gender disadvantage - in particular for rural women, may increase their vulnerabilities. Prevention programs for youth suicide in India need to address both the structural determinants of gender disadvantage, and the individual experiences of violence and poor mental health.",
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Violence, psychological distress and the risk of suicidal behaviour in young people in India. / Pillai, Aravind; Andrews, Teddy; Patel, Vikram.

In: International Journal of Epidemiology, Vol. 38, No. 2, 17.04.2009, p. 459-469.

Research output: Contribution to journalArticle

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N2 - Background: Suicide among young people has emerged as a major public health issue in many low- and middle-income (LAMI) countries. Suicidal behaviour including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. The aim of this study is to estimate the prevalence and risk factors for suicidal behaviour in young people in India. Method and findings: Cross-sectional study of 3662 youth (16-24 years) from rural and urban communities in Goa, India. Suicidal behaviour during the recent 3 months and associated factors were assessed using a structured interview. Overall 144; 3.9% [95% confidence interval (CI) 3.3-4.6] youth reported any suicidal behaviour in the previous 3 months. Suicidal behaviour was found to be associated with female gender Odds ratio (OR) 6.5 (95% CI 3.9-10.8), not attending school or college OR 1.6 (95% CI, 1.01-2.6), independent decision making OR 2.5 (95% CI 1.5-4.3), premarital sex OR 3.2 (95% CI 1.6-6.3), physical abuse at home OR 3.3 (95% CI 1.8-6.1), life time experience of sexual abuse OR 3.3 (95% CI 1.8-6.0) and probable common mental disorders (CMD) OR 9.5 (95% CI 6.3-14.5). Gender segregated analysis found independent decision making (P = 0.68 for interaction), rural residence (P = 0.01 for interaction) and premarital sex (P = 0.41 for interaction) retained association with suicidal behaviour only among females (P = 0.05). The population attributable fraction estimates were largest for CMD (42.8% for females; 35.9% for males); physical abuse in one's home (12.5% for females; 12.4% for males); sexual abuse (12.1% in females; 22.3% in males); and making independent decisions (22.9% for females). Analyses of the risk factors for the relatively less common outcome of suicide attempts found a similar set of factors as for suicidal behaviour; in addition, alcohol use was also an independent risk factor. Conclusion: Violence and psychological distress are independently associated with suicidal behaviour; factors associated with gender disadvantage - in particular for rural women, may increase their vulnerabilities. Prevention programs for youth suicide in India need to address both the structural determinants of gender disadvantage, and the individual experiences of violence and poor mental health.

AB - Background: Suicide among young people has emerged as a major public health issue in many low- and middle-income (LAMI) countries. Suicidal behaviour including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. The aim of this study is to estimate the prevalence and risk factors for suicidal behaviour in young people in India. Method and findings: Cross-sectional study of 3662 youth (16-24 years) from rural and urban communities in Goa, India. Suicidal behaviour during the recent 3 months and associated factors were assessed using a structured interview. Overall 144; 3.9% [95% confidence interval (CI) 3.3-4.6] youth reported any suicidal behaviour in the previous 3 months. Suicidal behaviour was found to be associated with female gender Odds ratio (OR) 6.5 (95% CI 3.9-10.8), not attending school or college OR 1.6 (95% CI, 1.01-2.6), independent decision making OR 2.5 (95% CI 1.5-4.3), premarital sex OR 3.2 (95% CI 1.6-6.3), physical abuse at home OR 3.3 (95% CI 1.8-6.1), life time experience of sexual abuse OR 3.3 (95% CI 1.8-6.0) and probable common mental disorders (CMD) OR 9.5 (95% CI 6.3-14.5). Gender segregated analysis found independent decision making (P = 0.68 for interaction), rural residence (P = 0.01 for interaction) and premarital sex (P = 0.41 for interaction) retained association with suicidal behaviour only among females (P = 0.05). The population attributable fraction estimates were largest for CMD (42.8% for females; 35.9% for males); physical abuse in one's home (12.5% for females; 12.4% for males); sexual abuse (12.1% in females; 22.3% in males); and making independent decisions (22.9% for females). Analyses of the risk factors for the relatively less common outcome of suicide attempts found a similar set of factors as for suicidal behaviour; in addition, alcohol use was also an independent risk factor. Conclusion: Violence and psychological distress are independently associated with suicidal behaviour; factors associated with gender disadvantage - in particular for rural women, may increase their vulnerabilities. Prevention programs for youth suicide in India need to address both the structural determinants of gender disadvantage, and the individual experiences of violence and poor mental health.

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