印度的自杀死亡率：一项全国代表性调查。
Suicide mortality in India: a nationally representative survey.
机构信息
The London School of Hygiene and Tropical Medicine, UK.
出版信息
Lancet. 2012 Jun 23;379(9834):2343-51. doi: 10.1016/S0140-6736(12)60606-0.
BACKGROUND
WHO estimates that about 170,000 deaths by suicide occur in India every year, but few epidemiological studies of suicide have been done in the country. We aimed to quantify suicide mortality in India in 2010.
METHODS
The Registrar General of India implemented a nationally representative mortality survey to determine the cause of deaths occurring between 2001 and 2003 in 1·1 million homes in 6671 small areas chosen randomly from all parts of India. As part of this survey, fieldworkers obtained information about cause of death and risk factors for suicide from close associates or relatives of the deceased individual. Two of 140 trained physicians were randomly allocated (stratified only by their ability to read the local language in which each survey was done) to independently and anonymously assign a cause to each death on the basis of electronic field reports. We then applied the age-specific and sex-specific proportion of suicide deaths in this survey to the 2010 UN estimates of absolute numbers of deaths in India to estimate the number of suicide deaths in India in 2010.
FINDINGS
About 3% of the surveyed deaths (2684 of 95,335) in individuals aged 15 years or older were due to suicide, corresponding to about 187,000 suicide deaths in India in 2010 at these ages (115,000 men and 72,000 women; age-standardised rates per 100,000 people aged 15 years or older of 26·3 for men and 17·5 for women). For suicide deaths at ages 15 years or older, 40% of suicide deaths in men (45,100 of 114,800) and 56% of suicide deaths in women (40,500 of 72,100) occurred at ages 15-29 years. A 15-year-old individual in India had a cumulative risk of about 1·3% of dying before the age of 80 years by suicide; men had a higher risk (1·7%) than did women (1·0%), with especially high risks in south India (3·5% in men and 1·8% in women). About half of suicide deaths were due to poisoning (mainly ingestions of pesticides).
INTERPRETATION
Suicide death rates in India are among the highest in the world. A large proportion of adult suicide deaths occur between the ages of 15 years and 29 years, especially in women. Public health interventions such as restrictions in access to pesticides might prevent many suicide deaths in India.
FUNDING
US National Institutes of Health.
背景
世卫组织估计，印度每年约有 17 万人死于自杀，但该国很少有关于自杀的流行病学研究。我们旨在量化 2010 年印度的自杀死亡率。
方法
印度登记总署实施了一项全国代表性的死亡率调查，以确定 2001 年至 2003 年间在印度各地随机选择的 6671 个小地区的 110 万个家庭中发生的死亡原因。作为该调查的一部分，实地工作人员从死者的近亲或亲属那里获得了关于自杀原因和自杀风险因素的信息。140 名受过培训的医生中的两名（仅按阅读每种调查所用语言的能力分层）被随机分配，根据电子现场报告独立和匿名地为每个死亡原因分配一个死因。然后，我们将调查中这一年龄段和性别特定的自杀死亡比例应用于 2010 年联合国对印度绝对死亡人数的估计，以估计 2010 年印度的自杀死亡人数。
发现
在年龄在 15 岁及以上的调查死亡者中，约有 3%（95335 人中有 2684 人）是自杀导致的，相当于 2010 年印度这个年龄段约有 18.7 万人自杀（11.5 万男性和 7.2 万女性；标准化年龄别率，每 10 万 15 岁及以上人群中男性为 26.3，女性为 17.5）。在年龄在 15 岁及以上的自杀死亡者中，40%的男性（114800 人中的 45100 人）和 56%的女性（72100 人中的 40500 人）自杀死亡发生在 15-29 岁之间。印度 15 岁的个体在 80 岁之前死于自杀的累积风险约为 1.3%；男性的风险（1.7%）高于女性（1.0%），尤其是在印度南部，男性（3.5%）和女性（1.8%）的风险尤其高。约一半的自杀死亡是由于中毒（主要是吞食农药）造成的。
解释
印度的自杀死亡率是世界上最高的之一。很大一部分成年自杀死亡发生在 15 岁至 29 岁之间，尤其是女性。限制接触农药等公共卫生干预措施可能会防止印度发生许多自杀死亡。
资金来源
美国国立卫生研究院。
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