Suicidal poisoning in Southern India: Gender differences

Abstract

Poisoning is an important health hazard and one of the leading causes of morbidity and mortality worldwide. Poisoning is one of the preferred means of committing suicide among males and females in India. A five year retrospective study from January 2000 to December 2004 was conducted at the Department of Forensic Medicine & Toxicology, Kasturba Medical College, Manipal, to understand the magnitude and pattern of suicidal poisoning deaths among males and females in Southern India. During this period, a total of 137 cases of suicidal poisoning related deaths were autopsied. Males were predominantly affected (male:female 2.8:1).

Maximum victims of suicidal poisoning mortalities were in their 3rd decade. Mean age for males and females was 40.5 years and 34.4 years, respectively. 27.8% of females and 10.9% males were suffering from depression. Preference for organophosphates was relatively more in males when compared to females, who preferred zinc phosphide, carbamates and medicinal agents. Suicidal poisoning was commonly encountered during afternoon hours in females. Males usually consumed poison during evening and late night hours. Maximum male mortalities were noted during second quarter of the year in contrast to first quarter in females. This paper examines the difference in pattern of suicidal poisoning among males and females to identify population at risk, and understand the problem status among both genders.

Introduction

The pattern of suicidal deaths can reflect the prevailing social set up and psychological mindset of the inhabitants of a region. Self harm (intentional self-injury) is a complex behaviour that can be thought as a maladaptive response to acute and chronic stress at a time when an individual fails to get out of the stress. Suicide behaviour, pattern and rates differ in various populations and culture. India ranks 10th in world with a suicide rate of 9.74 per lakh population.¹ The choice of method used to commit suicide depends on availability of means, knowledge about lethal effectiveness, victim’s motivation and intent. A number of chemical substances have been developed to save and improve the agricultural yield. These agrochemicals agents meant for the benefit of man sadly have grown in reputation as a popular means of self-destruction all over the world. India is predominantly an agricultural nation, where these agrochemicals are available in plenty. Poisoning is the preferred means of committing suicide among males and females in India.[2], [3], [4]

Males and females differ from each other in their genetic make up, physical characteristics, and also the psychological mindset. They react to different circumstances differently, have different priorities, and make different choices in life. Although gender based differences in suicidal poisoning are well known, the issue has rarely, if ever, been addressed. Target population identification has always been the mainstay of preventive measures. This paper examines the difference in pattern of suicidal poisoning among males and females to understand the problem status separately for both sexes in this part of rural India.

Manipal is a rural township situated in the Udupi district of coastal Karnataka, Southern India, and Kasturba Hospital is the apex teaching hospital of Kasturba Medical College, Manipal. The aims of the study are to describe the gender differences with regard to pattern and trends of suicidal poisonings and identify population at risk in this part of the country, so that probable preventive measures can be suggested and taken up accordingly.