Risk factors for suicide in Bali: a psychological autopsy study

Toshiyuki Kurihara,Motoichiro Kato,Robert Reverger,I Gusti Rai Tirta

doi:10.1186/1471-2458-9-327

Toshiyuki Kurihara, Motoichiro Kato + Show 2 more

Open Access

https://doi.org/10.1186/1471-2458-9-327

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Abstract

BackgroundThe suicide rate in Bali has significantly increased in recent years. However, to date, there have been no case-control studies investigating risk factors for suicide.MethodsA psychological autopsy study was conducted comparing 60 suicide cases and 120 living controls matched in age, sex, and area of residence.ResultsMultiple logistic regression analysis identified the following risk factors for suicide: at least one diagnosis of axis-I mental disorder (OR: 14.84 CI: 6.12 - 35.94); low level of religious involvement (OR: 7.24 CI: 2.28 - 22.95); and severe interpersonal problems (OR: 3.86 CI: 1.36 - 11.01). Forty-eight (80.0%) of the suicide cases were diagnosed with mental disorders; however, only 16.7% visited a primary care health professional and none received psychiatric treatment during the 1 month prior to death.ConclusionClinical, religious, and psychosocial factors were associated with suicide. These results highlight the significance of early recognition and treatment of mental disorders, religious activities, and interpersonal problem-solving strategies for suicide prevention in Bali.

Highlights

The suicide rate in Bali has significantly increased in recent years
The suicide rate is lower than the world average, these results suggest that suicide should be recognized as a major health problem in Bali
The aim of the present study is to examine socio-demographic, clinical, and psychosocial correlates for suicide in Bali using a case-control psychological autopsy approach

Summary

Introduction

The suicide rate in Bali has significantly increased in recent years. to date, there have been no case-control studies investigating risk factors for suicide. In Bali, Suryani et al [2] demonstrated that the suicide rate in the period following the 2002 Bali bombings was 8.10 for males and 3.68 for females per 100,000 population. Suicide rates increased nearly four-fold in males and three-fold in females [2]. The suicide rate is lower than the world average, these results suggest that suicide should be recognized as a major health problem in Bali. Given that this figure is probably underestimated due to underreporting of suicides, the actual impact of suicide on mortality in Bali is most likely much higher.

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