Risk Factors Associated with Female Suicide Attempts: A Cross-sectional Study

Introduction: Attempted suicide, both fatal and non fatal, is a challenging public health issue. In India, suicide attempts are more frequent in females than in males. Gender-related vulnerability to psychopathology and psychosocial stressors pose women with increased vulnerability to suicidal behaviour. Studies suggest that each prior attempt among women increased risk of future suicide threefold. More is known about differences in males and females in conditions like depression and schizophrenia than suicide. Remarkably few studies have focused upon suicidal behaviour in women or attempted to explore the complex relationships between various risk factors and suicidal behaviour in women. Such studies can provide useful information for understanding the risk factors associated with female suicide attempts and can help in developing suicide prevention strategies catering to the needs of women. Aim: To study the risk factors associated with female suicide attempts in patients admitted in a medical college hospital in South India. Materials and Methods: This is a descriptive cross-sectional study conducted in the Department of Psychiatry, Stanley Medical College Hospital, Chennai, Tamil Nadu, India, from October 2021 to March 2022. Based on convenience sampling method, 170 female patients admitted for attempted suicide above 18 years of age who were referred for psychiatric counselling services to the Outpatient unit were considered for the study. Data on Socio-demographic details including age, education status, marital and employment status, type of family and socio-economic status was collected. In addition, data on clinical variables like suicide and mental illness in the family, mode of attempt, number of past suicide attempts, comorbid physical illness were collected from the participants. Beck’s suicide intent scale was used to assess the severity of suicide intent. Presumptive Stressful Life Events Scale (PSLES) was used to assess the stressful life events. For analysing the factors associated with severity of suicide intent, inferential statistics (Pearson’s Chi-square test) was used. Results: Of the 170 women who attempted suicide, 79 (46.5%) were between the ages of 18 and 25 years. A total of 71 (41.8%) participants were employed and 111 (65.3%) were married. A total of 48 (28.2%) participants had co-morbid physical illness. Suicide ideation in the past 30 days was reported by 43 participants. The most common method of suicide attempt was self-poisoning (91.8%). A total of 65 participants (38.2%) had a current diagnosis of depression, 25 (14.7%) participants had one or two suicide attempts in the past, 99 women who attempted suicide (58.2%) had medium suicidal intent and in 30 participants (17.6%), the severity of suicide was high. The most common stressful life event was marital conflict. The severity of suicide intent was associated with age, past history of suicide attempt, suicide ideation in the past 30 days and current psychiatric diagnosis. Suicide intent was high in older age group patients and in those who had suicide ideation in the previous 30 days. Among the psychiatric diagnosis patients with diagnosis of depressive disorder had higher suicide intent. The mean±Standard Deviation (SD) stressful life event score was 115.93±36.50 in patients with high suicide intent. Conclusion: The study highlights the various risk factors associated with female suicide attempts. The association between suicide intent and underlying psychiatric disorder in female suicide attempted patients insist the need for prompt diagnosis and management of psychiatric illness in preventing suicide behaviours in women. Suicide prevention programs should incorporate women-specific strategies. Multisectoral collaboration is needed to empower women with a good family, social support and foster socio-emotional life skills in women.