Temporal Trend in methods of suicide in Kathmandu District

Abstract

BACKGROUND Suicide is a global health issue with methods varying widely based on cultural and regional factors. It is one of the leading cause of death in Nepal. This study analyzes suicide methods among autopsy cases at Department of Forensic Medicine (DoFM), Maharajgunj Medical Campus (MMC), Kathmandu, Nepal, that helps to provide a comprehensive understanding of how suicide methods have changed over time within this specific population. Understanding these trends is crucial for enhancing suicide prevention efforts at regional and national level. METHODOLOGY This study is retrospective descriptive study using autopsy data from the DoFM at MMC, Kathmandu, Nepal, from 2013 to 2022. Population data was projected using census figures, and crude suicide rates were calculated. Linear regression analyzed changes in suicide rates by gender and method over time while Chi-square tests assessed monthly frequency deviations. Data was stratified by age groups and sex to identify any potential correlations between these variables and the methods of suicide used. RESULTS There was overall annual increase in the suicide rate of 0.173% per year. Among males, the most common method was hanging (64.98%), followed by self-poisoning (32.07%), with falls and self-immolation each at 1.31%, and drowning, gunshots, and stabbing being rare. For females, hanging was also the most prevalent method (63.77%), followed by self-poisoning (32.65%), with falls (0.57%) and self-immolation (2.78%) being less common, and drowning, gunshots, and stabbing being negligible. The study depicted the mean age for female suicide to be 30.94 and 37.15 for male showing difference of 6.21. Suicide rates showed seasonal variations, peaking in Shrawan (July-August) and decreasing in Poush (December-January) and Magh (January-February). CONCLUSION Hanging remains the most common method across all age groups which decreased with the age, followed by self-poisoning, which increased with the age. The study depicted that females tend to commit suicide at relatively younger age than males. Significant seasonal variations in suicide rates were observed. The findings highlight the need for targeted public health interventions, including mental health awareness, improved counseling access, pesticide control, and drug regulation, particularly during high-risk seasons.