A Study of Suicidal Behaviour in Persons with Depressive Disorder

Author(s): Lalam Parameswari1, T.S.N. Raju2, V. Bodhi Sri Vidya3, S. Radha Rani4

Depression is a major public health problem. Irrespective of socio-economic status,
age, education, gender and it exists in every community. Suicidal risk is most
common life-threatening situation among depressed individuals. According to
World Health Organization (WHO), every year about 1 million people die from
suicide and 20 times more people attempt suicide. Up to 50 % of persons with
depressive disorder will make a suicide attempt at least once in their lifetime.
There is a wide disparity in the rates of suicide across different countries and
hence, a greater understanding of region-specific factors related to suicide would
enable prevention strategies to be more culturally sensitive. We intended to study
suicidal behaviour in depressive disorder in Indian population as understanding of
region-specific factors related to suicide helps to plan culturally sensitive
preventive strategies.
130 subjects diagnosed as suffering from depressive disorder according to
International Classification of Disease (ICD-10) diagnostic criteria for research,
who were having suicidal ideation were selected. The subjects were divided into
two groups as suicidal attempters and non-attempters, and analysed using the
Hamilton Depression Rating Scale (HAMD) to rate the severity of depression and
Hamilton Anxiety Rating Scale (HAMA) to assess severity of anxiety and Columbia
Suicide Severity Rating Scale (C-SSRS) was used to assess severity of suicidal
behaviour. Columbia risk assessment version was used to determine risk factors
and protective factors and a semi-structured proforma was used to collect the
socio-demographic details of the participants.
High HAMA and HAMD score, urban residence, unemployment and agitation were
found to be significantly associated with the presence of suicidal attempt.
Urban residence, unemployment, severity of depression and anxiety, and agitation
were found to be associated with increased risk of suicidal attempts. Responsibility
to family or living with family was found to be associated with decreased risk of
suicidal attempts.