Table 1.

Description of reviewed studies

Author (Year)	Design	Sample	Prevalence	Correlates of suicide	Method of suicide
Sathyawati[9] (1975)	CSS legal records	45 suicides in children (<14 years) in a large city from 1967-1973		Increase in suicide rate with age; 76% girls; 38% working as laborers, domestic servants or errand boys; 80% live with parents; 75% had clear social stressors.	Burning and drowning each accounted for 38%; poisoning 3%; and hanging 9%.
Nandi[10] (1978)	National mortality records, WHO reports	Comparison of registered suicides in 1872 and 1972 in Bengal.	Suicide rate was 2.4 per 100,000 in 1872 and 16.0 per 100,000 in 1972.	In 1872 most suicides occurred between ages 25 and 30, and in 1972 most suicides occurred in the 18 to 30 age group. Men had higher rates at both times.	Poisoning (44%) and hanging (41%) in 1872; poisoning (50%) and hanging (22%) in 1972.
Sharma[11] (1978)	CSS legal records	130 suicides reported in a single community from 1968 to 1970		Majority 25 to 44 years of age; 63% males; 88% living in joint families; 70% of males and 63% of females married; 15% had mental illness; 22% had prior domestic conflict.
Nandi[12] (1979)	CSS legal records	All suicide cases reported in two village police stations from January 1976 to September 1977.	Prevalence of suicide was 28.6 per 100,000 in one village and 5.1 per 100,000 in the other.	Most suicides were in the 15 to 24 age group. In one village male suicide was rare (none in 1976 and only 1 in 1977); in the other the male-to-female suicide ratio was 1 in 1976 and 0.4 in 1977. Chronic or incurable illnesses and domestic conflict were common precipitants of suicide.	In 1976 67% of suicides ingested Endrine and 22% died by hanging. In 1977 (after a ban on Endrine) 50% used Endrine and 32% die by hanging
Hedge[13] (1980)	CSS legal records	51 suicides recorded over 9 years in a cluster of villages with a population of 61,561.	9.3 suicides per 100,000 per year.	Most suicides were in the 10 to 29 age group. Males 67%. Marital and domestic problems 37.3%, incurable disease 29%, and financial problems 10%.	Drowning 39%, poisoning 33%, hanging 25%, other methods 2%.
Ponnudurai[14] (1980)	CSS legal records	87 suicides recorded at an urban police station in 1978.		Males 44.8%. Married women below 30 years of age at high risk; marriage in males not associated with suicide; mental illnesses in 7.6% males and 12.5% females.	Most common method was hanging followed by organophosphate pesticides in males and drowning in females.
Gupta[15] (1988)	CSS autopsy records	180 fatal burns cases reported to a district mortuary in a one-year period.	23.9% of fatal burns were suicides.	94% self-immolation suicides were female; 85% of females were married; among married females 73% of were married in last 5 years, 51% tortured by husband/in-laws for dowry, and 32.5% occurred following a quarrel or marital disharmony.
Banerjee[16] (1990)	CSS semi structured interview	58 suicides in one year based on police records in a cluster of villages with a population of 133,510	43.4 per 100,000 per year.	Quarrel with a spouse was a common cause for suicide in females (32%) and quarrel with parents in males (33%).	Insecticide poisoning was most common method (93%)
Shukla[17] (1990)	CSS legal records	187 urban suicides identified in police records from 1986 to 1987 in a city	Annual rate of suicide was 29 per 100,000.		Poisoning (22.6%), burning (21.4%), drowning (20.3%), hanging (18.7%) and getting run over by car/train (13.3%) were reported.
Ponnudurai[18] (1997)	CSSa, autopsy and legal records	144 consecutive suicide autopsies over one year in a tertiary care hospital.		34% of males preferred places outside their houses for suicide: hotel rooms (7.9%), rivers (6.7%) and work place (4.5%). Other sites were railway station, park and water tank.
Vijaykumar[19] (1999)	VA CCS legal records	100 urban suicides, 100 neighborhood age and sex matched controls		Factors with increased odds of suicide: presence of DSM-III-R Axis I disorder, family history of psychopathology and life events in the month before suicide.
Bhatia[20] (2000)	CSS	55 suicide cases referred for post mortem evaluation at a tertiary care center.		Majority married, high school educated; 18.2% had made prior attempt.	Hanging (43.6%), burning (38.3%), poisoning (12.7%)
Mayer[21] (2002)	Ecological study, analysis of data from NCRB	Suicide data released by the NCRB for the years 1991 to 1997	Suicide rates increased between 1991 and 1997 from 9.2 to 10.0 per 100,000	In India the classic suicide sex ratio is inverted for the ‘≤14’- and ’15 to 29’ year age groups. Peak for male suicides is in the 30 to 59 age group, for women is in the 15 to 29 age group.
Batra[22] (2003)	CSS autopsy and legal records	942 autopsies due to burns in a rural health district over 5 years	15.1 per 100,000 deaths by burns per year	48% of fatal burns are suicidal; 75% of cases from rural districts; 21 to 30 age group most affected; females accounted for 81%; torment by in-laws was common cause (32%).
Joseph[23] (2003)	CSS VA	Suicide registry in rural development block with a population of 108,000 from 1994 to 1999	Suicides accounted 8 to 12% of total deaths; mean suicide rate 95/100,000.	M:F ratio was 1.2:1; rates higher in older men than older women; but in 15-24 age range rate higher in women (102/278) than in men (58/331).	Poisoning (45%) and hanging (41%) were the most common methods.
Sharma[24] (2003)	CSS autopsy records	857 suicides in 2272 autopsy records from January 1994 to December 2001.	38% of autopsies were suicide deaths	Most common in the 15 to 30 age group; majority male; most from rural communities; 40% had social difficulties, 28% had guilt or shame, and 15% had a recent loss.	Poisoning (18%), self-immolation (16%) and hanging (3%) were most common methods.
Steen[25] (2003)	Ecological study	Data on suicide from NCRB		Human development factors did predict suicide rates in both genders but no significant relationship between suicide rates and economic factors.
Aaron[26] (2004)	CSS VA	154 male and 152 female suicide (10 to 19 year olds) in a rural development area with total population of 108,000.	Average suicide rate in young women 148 per 100,000 and in young men 58 per 100,000.	Family conflicts, domestic violence, academic failures, unfulfilled romantic ideals, and mental illness were main causes.	Hanging (44%), poisoning with insecticide (40%), self-immolation (9%), and drowning (7%).
Girdhar[27] (2004)	CSS suicide note study	Post-mortems of 50 suicidal deaths with suicide notes compared to 50 without notes from total of 320 suicide post-mortems done over 1.5 years at a tertiary center.		38 of 50 notes written by males; note writers had higher education but otherwise did not differ greatly from non-note writers; most frequent reported reasons were physical and psychiatric illness; 13 note-writers did not mention any difficulty.
Gururaj[28] (2004)	VA CCS	269 suicide cases identified from police records (over a 3-month period) and 269 age- and gender-matched controls from a city of 6 million		M:F ratio was 2:1; 75% in 16 to 49 age group; emotional abuse (OR=2.6), physical violence (OR=1.8), longstanding alcohol abuse (OR=4.8), absence of social support networks (OR=3.1), limited resources (OR=11.5) and presence of mental illness (OR=1.6) were significant factors.	Hanging (59%), poisoning (25%) and self-immolation (11.5%) were common methods; burns (self-immolation) twice more frequent among women than men.
Kumar[29] (2004)	CCS case records	689 autopsies of suicide victims during January to December 2001		61.8% males, older and likely to be employed.	Hanging (48.2%), poisoning (28.9%), and immolation (12.8%, 6 times more common in females than males).
Lalwani[30] (2004)	CSS autopsy records	222 autopsies of suicidal deaths in 10 to 18 year olds at a tertiary care center over 10 years	1.9% of all autopsies in 10 to 18 year olds were suicides.	Girls 55.4%; the most common age was 15 to 18 years.	Hanging (girls 57%, boys 50%); poisoning (girls 37%, boys 50%).
Sharma[31] (2004)	CSS autopsy records	2835 autopsies of unnatural deaths over 10 years from 1994 to 2003 at a tertiary care center.	39% of unnatural deaths were suicidal	Suicide was most common in the 21 to 30 age group; male-to-female ratio was 2:1; majority from rural background.	Poisoning (48%), burns (40%) and hanging (10%).
Steen[32] (2004)	Time series analysis, NCRB reports	Available data on completed suicides in all Indian states from 1967 to 1997.	The differences between male and female suicide rates were relatively stable over the 30 year period.	As modernization increases, there is little change in the male-to-female suicide ratio.
Abraham[33] (2005)	CSS VA	152 male and 100 female suicides in persons 55 years or older over 8 years in a rural development area with total population of 108,000.	Annual suicide rate for people over 55 years was 189 per 100,000.	Male-to-female ratio was 1.5:1; suicide rate increased with age.	Hanging (51.6%) and poisoning (38.9%) were most common methods; women more likely to use burning or drowning.
Khan[34] (2005)	CSS VA	50 suicide cases referred for autopsy at a tertiary center.		Urban 72%; low income 54%; 24% had consulted physician or psychiatrist, 94% had stressful life events; precipitating factors present in 84%.	Hanging common in males, self-immolation in females.
Bose[35] (2006)	CSS VA	638 suicides over 7 years in a rural development area of 108,000	82.2 per 100,000 population, 11.3% of all deaths.		Hanging (47.8%), use of poison (40.4%), burning (7.2%), drowning (4%).
Prasad[36] (2006)	CSS VA	Suicides in a rural development block with population of 108,000 from 2000 to 2002	92 per 100,000; accounts for 9.8 to 11.4 % of all deaths; rates in men and women were 112 and 72 per 100,000, respectively.	Male-to-female ratio was 1.5:1; suicide rate for men increased with age; women peaks in young and old; more suicides in younger women than men; 77% had chronic stress; 23% had acute precipitating events; men and those 44 or older had more chronic stress whereas women and those under 44 had more acute precipitating events.	Organophosphate pesticides (40.5%) and hanging (49%) were the most common methods.
Mohanty[37] (2007)	CSS Interview, case records and autopsy findings	588 deaths diagnosed as suicidal among 2096 autopsies over 4 years at a tertiary center.	11.8 suicides per 100,000 population; 28% of autopsies were suicides.	Male-to-female ratio almost equal; 21-30 years was the most common age group; rural areas (50%); married (71%); unsound mind (6%); past suicidal tendency (14%); intake of alcohol (22%); financial burden (37%); and marital disharmony (35%).	Hanging (32.6%), poisoning (30.6%).
Chavan[38] (2008)	CSS VA	101 deaths by suicide in a city in 2003.		60% were between 20 to 29 years old; males (57.4%), unemployed (55.4%), unmarried (57.4%), urban residence (70.2%), and low income (50.4%); psychosocial stressors (60.3%), interpersonal stressors (47.5%), and financial stressors (8.9%); psychiatric illness (34%); alcohol or substance abuse in (24%).	Hanging (72%); poisoning (16%).
Gupta[39] (2008)	CSS legal records	8 cases of murder-suicide from 2000 to 2004.		All assailants were mothers and all victims were their children aged 6 months to 7 years; five incidents in rural areas, three in urban areas; all cases in low socio-economic families; main cause is family-related problems.	Methods either for killing or suicide were either burning or drowning.
Kanchan[40] (2008)	CSS legal and autopsy records	Retrospective 5 years post mortem studies of 137 suicidal poisonings at a tertiary center.	18% of all autopsies were deaths due to suicidal poisoning.	Male 74%; most in the 20 to 29 age group; highest female rates during 2nd, 3rd and 6th decade; highest male rates in 4th, 5th, and 7th decade; 28% of female and 11% of male suicides had depression.	Agrochemicals were the preferred agents, especially organophosphates.
Bastia[41] (2009)	CSS VA	104 consecutive autopsies of death by hanging over a 2-year period reported at a Medical College.		Marriage protective for men (OR=0.14, CI=0.06–0.36); risk factors included dowry dispute, unemployment, illicit relationship of spouse and prolonged illness.	Hanging (15.7%), insecticide-ingestion (37.2%), other substance use (13.4%); medication overdose (6.5%), jumping under train (9.2%) and, self-immolation 8.5%.
Parkar[42] (2009)	CSS EMIC Interview with family of suicide victim	76 families of suicide decedents identified from police record in an urban slum from 1997 to 2003.		Most common age group was 21 to 28 years old; more women in young age groups and more men in older age groups; women had less education; 36% had prior attempts; common stressors included substance use by self or others, failed expectations, financial loss, interpersonal conflict and verbal abuse.	Common methods were burning (56.6%), poisoning (18.4%) and hanging (15.8%).
Soman[43] (2009)	CSS VA	Deaths over 5 years in seven contiguous districts constituting a development block in a southern state (798,695 person years of observation).	6.6% of all deaths were suicidal; male rate was 45 per 100,000, accounting for 7.3% of all deaths; female rate 27 per 100,000, accounting for 5.8% of all deaths		Hanging (64%), poisoning (10%), drowning (9.3%), self-immolation/burning (6.4%), and jumping in front of train (6.4%).
Manoranjitham[44] (2010)	CSS VA	122 family members of suicide cases and 100 age and gender matched controls in a rural and suburban population.		Male-to-female ratio was 1.5:1; 37% of the suicides and 16% of controls had at least one Axis I diagnosis; among suicides a higher proportion lived alone, experienced termination of a steady relationship, felt on-going stress, had few confidants, were widowed or separated, or experienced chronic pain.

CSS, Cross-sectional study; VA, Verbal autopsy; CCA, Case-control study; NCRB, National crime-records bureaue