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.