关于安得拉邦维贾亚瓦达悉达多医学院和政府综合医院停尸房送检的自杀死亡病例模式的研究

Mohammad Ajas Khan, Nelapati Sushanth, M. D. V. Rajasekhar.
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When you look at suicide deaths, the highest suicide rates are in the south. In central India, including Maharashtra, Madhya Pradesh and Rajasthan, you have “middling suicide rates”, and the rate falls up north, in Uttar Pradesh and Bihar.Material & Methods: A five years retrospective and cross-sectional study was conducted in Forensic Medicineand Toxicology Department, Siddhartha Medical College, Vijayawada, Andhra Pradesh. All the autopsiesconducted on victims of suicidal deaths during the period from Jan, 2016 to Dec, 2020 were studied from theavailable data. Inclusion criteria includes all the suicidal deaths due to poisoning, hanging and self-immolation by burns. Exclusion criteria includes suicidal deaths from causes other than poisoning, hanging and suicidal burns like drowning, electrocution, fall from height etc.Results: It is clear that committing suicide by consuming poison accounts for major number of deaths followed by committing suicide by hanging and least followed by committing suicide by self-immolation. It is also clear that committing suicides has increased year by year from 2016 to 2020 irrespective of committing suicide by hanging, poisoning. Coming to sex pattern, suicide by hanging was observed more in males. Sex pattern in suicidal deaths due to poisoning clearly showed that females outnumbered males. Sex pattern in suicidal deaths due to self-immolation clearly showed that females outnumbered males with high margin. Coming to the age pattern in committing suicidal deaths by hanging, 30 – 45 years age group showed highest incidence year by year followed by 45 – 60 years and least among 15 – 25 years age group. Where as in case of suicidal deaths by poisoning and self-immolation, incidence was highest in 30 – 45 age group followed by 15 – 30 years age group and least among 45 – 60 years group. \nConclusion: According to the World Health Organization, in India, suicide is an emerging and serious publichealth issue. Suicide rates in India have been rising over the past five decades. India’s contribution to globalsuicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. In 2016, suicide was the most common cause of death in both the age groups of 15–29 years and 15–39 years in India. Factors such as frustration, family problems, love affairs, poverty, harassment, sexual violence, social boycott, chronic diseases and bankruptcy were studied as the main reasons leading to committing of suicides in people.The need for a strategy which will raise awareness and help make suicide prevention a national priority has to be recognized. 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引用次数: 0

摘要

研究背景:本研究旨在研究安得拉邦维贾亚瓦达市及其周边地区的自杀死亡模式、人口概况(包括各种诱发因素),并分析死亡的严重程度,从而制定预防措施,避免此类情况的发生。自杀死亡的定义是故意终止生命。根据国家犯罪记录局的说法,自杀死亡应该是非自然死亡,死亡的欲望应该来自于个人,并且应该有结束自己生命的理由。虽然印度 2019 年的自杀率为 14.04/10万,在全球排名第 49 位,但印度每年报告的自杀人数最高这一严峻现实不容忽视。从自杀死亡人数来看,自杀率最高的是南部地区。在印度中部,包括马哈拉施特拉邦、中央邦和拉贾斯坦邦,自杀率处于 "中等水平",而北方邦和比哈尔邦的自杀率则有所下降:安得拉邦维贾亚瓦达悉达多医学院法医学和毒理学系开展了一项为期五年的回顾性横断面研究。根据现有数据,研究了 2016 年 1 月至 2020 年 12 月期间对自杀死亡受害者进行的所有尸检。纳入标准包括所有因中毒、上吊和烧伤自焚导致的自杀死亡。排除标准包括除中毒、上吊和烧伤自杀以外的其他原因导致的自杀死亡,如溺水、触电、高空坠落等:很明显,服毒自杀占死亡人数的大部分,其次是上吊自杀,自焚自杀占死亡人数的最小部分。同样明显的是,从 2016 年到 2020 年,无论是上吊自杀还是服毒自杀,自杀人数都在逐年增加。从性别模式来看,男性更多采用上吊自杀的方式。中毒自杀死亡的性别模式明显显示女性多于男性。自焚自杀死亡的性别模式清楚地表明,女性人数远远多于男性。关于上吊自杀死亡的年龄模式,30-45 岁年龄组的发生率逐年上升,其次是 45-60 岁年龄组,15-25 岁年龄组的发生率最低。至于投毒和自焚自杀死亡,30-45 岁年龄组的发生率最高,其次是 15-30 岁年龄组,45-60 岁年龄组的发生率最低。结论世界卫生组织指出,在印度,自杀是一个新出现的严重公共卫生问题。过去五十年来,印度的自杀率一直在上升。印度占全球自杀死亡人数的比例从1990年的25.3%上升到2016年的36.6%,其中女性占18.7%,男性占24.3%。2016 年,自杀是印度 15-29 岁年龄组和 15-39 岁年龄组最常见的死因。研究发现,挫折、家庭问题、恋爱、贫困、骚扰、性暴力、社会抵制、慢性疾病和破产等因素是导致人们自杀的主要原因。这样一项国家战略将需要一种全面的方法,包括在全国范围内,在国家、地区和地方各级促进、协调和支持各项活动的实施。
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A Study on Pattern of Suicidal Deaths Brought for Medicolegal Autopsy at Mortuary of Siddhartha Medical College and Govt. General Hospital, Vijayawada, Andhra Pradesh
Background: The aim is to study the pattern of suicidal deaths, demographic profile including various contributary factors of victims and analyze the magnitude of deaths in and around Vijayawada part of Andhra Pradesh so that preventive measures can be set up to avoid such situation. A death by suicide is defined as the deliberate termination of life. For a death to be a suicide, it should be an un-natural death, the desire to die should originate within the person, and there should be a reason for ending their life, according to the National Crime Records Bureau. While India’s suicide rate of 14.04/lakh population in 2019 puts it at 49th rank globally, the grim reality of the highest numbers of suicides being reported annually from India cannot be overlooked. When you look at suicide deaths, the highest suicide rates are in the south. In central India, including Maharashtra, Madhya Pradesh and Rajasthan, you have “middling suicide rates”, and the rate falls up north, in Uttar Pradesh and Bihar.Material & Methods: A five years retrospective and cross-sectional study was conducted in Forensic Medicineand Toxicology Department, Siddhartha Medical College, Vijayawada, Andhra Pradesh. All the autopsiesconducted on victims of suicidal deaths during the period from Jan, 2016 to Dec, 2020 were studied from theavailable data. Inclusion criteria includes all the suicidal deaths due to poisoning, hanging and self-immolation by burns. Exclusion criteria includes suicidal deaths from causes other than poisoning, hanging and suicidal burns like drowning, electrocution, fall from height etc.Results: It is clear that committing suicide by consuming poison accounts for major number of deaths followed by committing suicide by hanging and least followed by committing suicide by self-immolation. It is also clear that committing suicides has increased year by year from 2016 to 2020 irrespective of committing suicide by hanging, poisoning. Coming to sex pattern, suicide by hanging was observed more in males. Sex pattern in suicidal deaths due to poisoning clearly showed that females outnumbered males. Sex pattern in suicidal deaths due to self-immolation clearly showed that females outnumbered males with high margin. Coming to the age pattern in committing suicidal deaths by hanging, 30 – 45 years age group showed highest incidence year by year followed by 45 – 60 years and least among 15 – 25 years age group. Where as in case of suicidal deaths by poisoning and self-immolation, incidence was highest in 30 – 45 age group followed by 15 – 30 years age group and least among 45 – 60 years group. Conclusion: According to the World Health Organization, in India, suicide is an emerging and serious publichealth issue. Suicide rates in India have been rising over the past five decades. India’s contribution to globalsuicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. In 2016, suicide was the most common cause of death in both the age groups of 15–29 years and 15–39 years in India. Factors such as frustration, family problems, love affairs, poverty, harassment, sexual violence, social boycott, chronic diseases and bankruptcy were studied as the main reasons leading to committing of suicides in people.The need for a strategy which will raise awareness and help make suicide prevention a national priority has to be recognized. Such a national strategy will need a comprehensive approach that encompasses the promotion,coordination, and support of activities to be implemented across the country at national, regional, and local levels.The program would need to be tailored for populations at risk.
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