Stressors of Suicide Among the Residents of Ilam, Eastern Nepal: an Investigation Into a Neglected Burden

Abstract

Suicide is increasingly being recognized as a global public health concern, but it is still treated as a neglected burden in Nepal. Case-control study on suicide from Nepal is very rare. Thus, a community-based matched case-control study was conducted at Ilam District to identify different stressors associated with Nepalese suicidal victims with appropriate samples of 64 cases which were matched for age group (± 2 years) and area of residence with 128 controls (1:2 ratio). Data was collected through suicide survivors and close neighbors of suicide victims. Intimate partner violence was an independent risk factor for committing suicide (OR (95% CI) = 5.33 (1.41–20.10), P = 0.013). A conditional logistic regression identified two strong stressors of suicide: depression (OR (95% CI) = 10.53 (3.11–35.66), P < 0.001) and substance dependence (OR (95% CI) = 16.38 (4.23–63.35), P < 0.001). This is the first community-based case-control study to report stressors of suicide from eastern Nepal. An integrated counseling and public awareness center needs to be established by the Nepal Government at Ilam District addressing those significant stressors. Furthermore, the findings also have implications for formulating national health policy to be implemented in vulnerable districts in order to decrease risks of suicide in Nepal.