Epidemiological Profile of Complete Suicidal Poisoning Cases Autopsied at Autopsy Centre, RIMS, Ranchi

B Singh, K Kishore, A K Chaudhary

22

Abstract

Background: Suicidal behaviour is any deliberate action that has potentially life-threatening consequences, such as taking a drug overdose, deliberately consuming poison, hanging, drowning, burn etc. The aim of this study was to illustrate the epidemiological profile of complete suicidal poisoning cases autopsied at Department of Forensic Medicine and Toxicology, Rajendra Institute of Medical Sciences, Ranchi, India.

Methods: All cases autopsied at autopsy centre of department of forensic medicine and toxicology between April 2013 to October 2014 evaluated. Data obtained from the Information regarding the socio-demographic, mode of suicides, time of incidence, place of incidence, occupation, etc were gathered from the police papers like inquest report, dead body challan etc, and through detailed interviews of the relatives, neighbours, friends, and police officials accompanying the dead bodies.

Results: Total 3492 cases were autopsied, out of which only 180 cases were due to acute self-poisoning, suicidal in nature. This was 5.2% of the total cases autopsied at centre. The ratio of male and female suicide by poisoning was almost equal (M: F = 1.22: 1). The majority of victims were married, unemployed, from joint family and middle economic class. The most important agents of poisoning were agrochemical pesticides among these majorities were due to organophosphate.

Conclusion: More than 50% of victims from both male and female were in between 15 years to 30 years. The maximum victims were consumed poison at evening (between 4 PM to 8 PM) during summer season. The Agrochemicals were the preferred agents with organophosphates alone responsible for about 50% of suicidal mortalities followed by aluminium phosphide.

Keywords

Intentional Acute Poisoning, Suicide by poisoning, Time of Poison’s Consumption

Full Text:

PDF

References

Berman M, Ronald S, Mortan A. Comprehensive Textbook of Suicidology. 72 Spring Street, New York, NY 10012: The Guilford Press. 2000;3–144.

World Health Organization. Suicide rates per 100,000 by country, year and sex. (Last accessed on 2012 Mar 27). Available from:

http://www.who.int/mental_health/prevention/suicide_rates/en/index.html

Preventing suicide: a global imperative. World Health Organization. 2014;7-83.

Accidental Deaths and Suicides in India 2007. New Delhi: Ministry of Home Affairs, Government of India; 2009. National Crime Records Bureau.

Accidental Deaths and Suicides in India 2008. New Delhi: Ministry of Home Affairs, Government of India; 2010. National Crime Records Bureau. 26.

Singh, P.; Kumar, N. "Effect of Orography on Precipitation in the Western Himalayan Region", Journal of Hydrology. 1997;199(1):183–206.

World Health Organisation. The Global Burden of Disease: 2004 update. Geneva: WHO; 2008.

Hedge RS. Suicide in rural community. Indian J Psychiatry. 1980; 22: 368-70.

Banerjee S, Chowdhury AN, Schelling E, Brahma A, Biswas MK, Weiss MG. Deliberate self-harm and suicide by pesticide ingestion in the Sundarban region, India. Tropical Medicine & International Health. 2009;14:213-9.

Shukla G, Verma B, Mishra DN. Suicide in Jhansi City. Indian J Psychiatry. 1990;32:44-51.

Vijayakumar L, Rajkumar S. Are risk factors for suicide universal? A case-control study in India. Acta Psychiatr Scand. 1999;99:407-11.

Aaron R, Joseph A, Abraham S, Muliyil J, George K, Prasad J et al. Suicides in young people in rural southern India. Lancet. 2004;363:1117-8.

Gururaj G, Isaac MK, Subbakrishna DK, Ranjani R. Risk factors for completed suicides: a case-control study from Bangalore, India. Inj Control Saf Promot. 2004;11:183-91.

Kumar PNS. An analysis of suicide attempters versus completers in Kerala. Indian J Psychiatry. 2004;46:144-9.

Sharma BR, Singh VP, Sharma R, Sumedha. Unnatural deaths in northern India: a profile. Journal of Indian Academy of Forensic Medicine. 2004;26:140-6.

Abraham VJ, Abraham S, Jacob KS. Suicide in the elderly in Kaniyambadi block, Tamil Nadu, South India. Int J Geriatr Psychiatry. 2005;20:953-5.

Khan F, Anand B, Devi MG, Murthy KK. Psychological autopsy of suicide-a cross-sectional study. Indian J Psychiatry. 2005;47:73-8.

Bose A, Konradsen F, John J, Suganthy P, Muliyil J, Abraham S. Mortality rate and years of life lost from unintentional injury and suicide in South India. Tropical Medicine & International Health. 2006;11:1553-6.

Mohanty S, Sahu G, Mohanty MK, Patnaik M. Suicide in India: a four year retrospective study. J Forensic Leg Med. 2007;14:185-9.

Chavan B, Singh G, Kaur J, Kochar R. Psychological autopsy of 101 suicide cases from northwest region of India. Indian J Psychiatry. 2008;50:34-8.

Parkar SR, Dawani V, Weiss MG. Clinical diagnostic and sociocultural dimensions of deliberate self-harm in Mumbai, India. Suicide LifeThreat Behav. 2006;36:223-8.

Soman C, Vijayakumar K, Ajayan K, Safraj S, Kutty V. Suicide in South India: a community-based study in Kerala. Indian J Psychiatry. 2009;51:261-4.

Kumar TS, Kanchan T, Yoganarasimha K, Kumar GP. Profile of unnatural deaths in Manipal, Southern India 1994–2004. J Clin Forensic Med 2006;13(3):117–20.

Aggarwal NK, Aggarwal BBL. Trends of poisoning in Delhi. J Indian Acad Forensic Med, 1998; 20:32-36.

Dhattarawl SK, Singh H. Profile of deaths due to poisoning in Rohtak, Haryana. J Forensic Med Toxicol. 2001;18:28-9.

Kumar Shetty S, Kanchan T, G Menezes R, Shetty M, Raj V P, Preetham R. et al. Poisoning fatalities in Mangalore, South India: A three year snapshot. International Journal of A J Institute of Medical Sciences. 2012;1:104-111.

Singh B, Unikrishnan B. A Profile of Acute Poisoning at Mangalore (South India). Journal of Clinical Forensic Medicine. 2006;13(3):112-6.

Zine K. U. Pattern of acute poisoning at Indira Gandhi Medical College and Hospital, Nagpur, JIAFM. 1998;20(2):37–9.

Dalal JS, Goria RK, Aggrwal AK. Poisoning Trends – a post mortem study, JIAFM.1998;20(2):27-31.

Dhattarwal SK. Profile of death due to poisoning in Rohtak, Haryana, Journal of Forensic Medicine and Toxicology. 2001;14(1):51.

Gupta S, Sheikh M I. Study and changing trends of poisoning in year 2004-05 at Surat, India. International Journal of Medical Toxicology and legal Medicine. 2007;10(1):16-9.

Singh K, Oberoi S S, Bhullar D S. Poisoning Trends in the Malwa Region of Punjab, Journal of Punjab Academy of Forensic Medicine And Toxicology. 2003;3:26-9.

Sharma BR, Harish D, Sharma V. Poisoning in Northern India: changing trends, causes and prevention thereof. Med Sci Law. 2002;42(3):251–7.

Vaghela P C. Study of prevalence of fatal poisoning in Jamnagar region. 2005.

Navinkumar M S. Kalele D. Study of Profile of Deaths due to Poisoning in Bhavnagar Region. Indian Acad Forensic Med. 2011;33(4):313-8.

Shetty V, Pawar S G. Profile of poisoning cases in district and Medical College Hospital of North Karnataka. Indian Journal of Forensic Medicine and Toxicology. 2008;2(2).

Kumar S, Pathak A, Mangal H M.Trends of Fatal Poisoning in Saurashtra Region of Gujarat (A Prospective Study) . J Indian Acad Forensic Med. 2011;33(3):197-9.

Taruni NG, Bijoy TH, Moomonchand. A. profile of poisoning cases admitted in RIMS hospital, India. J Forensic Med. Toxicol. 2001;18:31-3.

A.K. Kapoor. An epidemiological study of Aluminium Phosphide poisoning at Allahabad.” IIJFMT. 2006;4(1).

Nigam M, Jain A K, Dubey B P. Trends of organophosphorus poisoning in Bhopal region – An autopsy based study, JIAFM. 2004;26(2):62-5.

Sharma B R, Dasari H, Vij K. The epidemiology of poisoning – An Indian view point, Journal of Forensic Medicine and Toxicology. 2002;19(2):5-11.

Islam MN, Islam N. Retrospective study of 273 deaths due to poisoning at Sir Salimullah Medical College from 1988 to 1997. Leg Med (Tokyo). 2003;5(1):S129-31.

Kambiz S, Faryadi M, Sardari F. Acute pesticide poisoning related deaths in Teheran during the period 2003-2004. J Forensic Leg Med. 2007;14:352-4.

Meel BL. Fatalities by poisoning in Mthatha area of South Africa. SA Fam Pract. 2007;49(7):683.

Abdullat EM, Hadidi MS, Alhadidi N, Al-Nsour TS, Hadidi KA. Agricultural and horticultural pesticides fatal poisoning; the Jordanian experience 1999-2002. J Clin Forensic Med. 2006;13(6e8):304-7

Shin SD, Suh GJ, Rhee JE, Sung J, Kim J. Epidemiologic characteristics of death by poisoning in 1991-2001 in Korea. J Korean Med Sci. 2004;19(2):186-94.

Tufekci IB, Curgunlu A, Sirin F. Characteristics of acute adult poisoning cases admitted to a university hospital in Istanbul. Hum Exp Toxicol. 2004;23(7):347–51.

Bertolote JM, Fleishmann A. A global perspective in the epidemiology of suicide. Suicidologi. 2002;7(2):6–8.

Bansal P, Gupta A, Kumar R. The Psychopathology and the Socio-demographic Determinants of Attempted Suicide Patients. Journal of Clinical and Diagnostic Research. 2011;5(5):917-20.

Ramdurg S, Goyal S, Goyal P, Sagar R, Sharan P. Sociodemographic profile,clinical factors, and mode of attempt in suicide attempters. Industrial Psychiatry Journal. 2011;20(1):11-6.

Adityanjee DR. Suicide attempts and suicides in India: cross-cultural aspects. Int J Soc Psychiatry. 1986;32(2):64-73.

Subhash C, Joshi A, Nigam P, Joshi G, Prakash Ch. Pattern of poisoning cases admitted at a tertiary care centre in the Kumoan region of Uttarakhand. Indian Journal of Forensic Medicine and Toxicology. 2010;4(1):4-5.

Bharati S, Mallik Sh, Pratim Datta P, Mukhopadhyay A, Datta D, Haq S. Socio-Demographic Profile and Suicidal Intent of Attempted Suicide Cases: A Hospital Based Study in West Bengal, India. National Journal of Medical Research. 2013;3(2):122-5.

Guptha B D, Vagehela P C. Profile of fatal poisoning in and around Jamnagar; J I A F M. 2005;27(3):145-8.

Eddleston M., Philips R. Self poisoning with pesticides. B M J. 2004;328(3):42-4.

Gouda MR, Rao S M. Factors related to attempted suicide in Davanagere. Indian J of Community Medicine.2008;33(1):15-8.

Guntheti K B, Singh U. The Pattern of Poisoning in Khammam. J Indian Acad Forensic Med. 2011. 33(4):296-300.

Naveen N, Madhuvardhana T, Arun M, Balakrishna Rao A J, Kagne R N. Profile of suicidal poisoning in Puducherry area. International Journal of Recent Trends in Science And Technology. 2015;14(1):76-9.

Narang RL, Mishra BP, Mohan N. Attempted suicide in Ludhiana. Indian J Psychiatry. 2000;42:83-7.

Arun M, Yoganarasimha, Palimar V, Kar N, Mohanty M. Para suicide: An approach to the profile of victims. J Indian Assoc Forensic Med. 2004;26:58.

Ahmad MDZ, Hussain T, Kumar M. Pattern of poisoning reported at BC Roy hospital, Haldia Purba Midnapur, West Bengal. Medicolegal update. 2012;12(2):228-30.

Navinkumar M, Kalele. Study of profile of deaths due to poisoning in Bhavnagar. JIAFM. 2011;33(4):311-6.

Haloi M, Haloi MD, Patowary A. Death due to poisoning in district of Kamrup, Assam a Medicolegal study. IJAFM 2013; 35(1) :17-20.

Guntheti B K, Khaja Sh. A study of serum cholinesterase levels in organo phosphorus poisoning cases. , Journal of Indian Academy of Forensic Medicine. 2010;3(4):332-5.

Karamjit S, Oberoi S S, Bhullar D S. Poisoning trends in the Malwa region of Punjab AFMAT. 2003;3:26-9.

Shreemanta Kumar dash. Sociodemo-graphic profile of poisoning cases; J I A FM. 2005;27(3):133-8.

Chew KS, Mc Cleary R. The spring peak in suicides: a cross-national analysis. Soc Sci Med. 1995;40(2) :223–30.

Preti A. Seasonal variation and meteotropism in suicide. Curr Opin Psych. 2000;13:655–60.

Preti A, Miotto P. Seasonality in suicides: the influence of suicide method, gender and age on suicide distribution in Italy. Psych Res. 1998;81(2):219–31.

Saeed A, Bashir MZ, Khan D, Iqbal J, Raja KS, Rehmon A. Epidemiology of suicides in Faisalabad. J Ayub Med Coll Abbottabad. 2002;14(4):34–7.

Senanayake N, Peiris H. Mortality due to poisoning in a developing and agricultural country: trends over 20 years. Hum Exp Toxic. 1995;14(10):808–11.

Sinha US, Kapoor AK, Agnihotri AK, Srivastava PC. A Profile of poisoning cases admitted in SRN Hospital, Allahabad with special reference to aluminium phosphide poisoning. J Forensic Med Toxic. 1999;16(1):40–3.

Preti A, Miotto P. Diurnal variations in suicide by age and gender in Italy. J Affect Disord. 2001;65(3):253–61.

Sahin HA, Sahin I, Arabaci F. Sociodemographic factors in organophos-phosphate poisoning; a prospective study. Hum Exp Toxicol. 2003;22(7):349-53.

Singh S, Sharma BK, Wahi PL. Spectrum of acute poisoning in adults (10 years experience). J Assoc Physicians India. 1984;32:561–3.

Singh S, Wig N, Chaudhary D, Sood N, Sharma B. Changing pattern of acute poisoning in adults: experience of a large North West Indian hospital (1970–1989). J Assoc Physicians India. 1997;45(3):194–7.

Singh Bhoopendra, Sinha A, Dogra TD, et al. Present status of poisoning in India. Indian Medical Guzette. 1998;CXXX(II):364–8.