有关印度自杀的系统综述(英文)

Suicide in India: a systematic review

背景:自杀是印度重要的死亡原因之一,但基于印度国家犯罪统计局数据估算的自杀率并不可靠。目标:系统回顾现有的有关印度自杀及自杀相关因素的文献。方法:选择适当的检索词在PubMed,PsycINFO,EMBASE,全球健康,谷歌学术和IndMED数据库中查找文献。查找到的论文摘要由两位作者分别独立筛选是否符合纳入标准,再从筛选出的论文全文中摘录标准化数据。结果:本研究筛选出符合纳入标准的36篇论文进行分析。由于抽样过程和研究方法的异质性,荟萃分析的方法不可行。在印度部分农村地区的死因推断研究中报道的自杀率较高,每10万人口中有82至95人自杀,比官方报道的全国自杀率高出8倍。其中20至29岁人群的自杀率最高;30岁以下人群中女性自杀率高于男性,而30岁及以上的人群则正好相反。自缢和服用有机磷农药是最常见的自杀方式,自焚在女性较为常见。社会经济地位低、精神疾病(尤其是酒精滥用)和人际交往障碍是与自杀关系最为密切的因素。结论:有关印度自杀的数据质量非常有限。但显而易见,自杀是一个重要且日益严重的公共卫生问题。相对于高收入国家而言,印度自杀特点为:女性(尤其是年轻妇女)自杀率高于男性、较多选择服用农药的自杀方式、与贫穷因素关系更为紧密而与精神疾病因素相关性较低。

Background：Suicide is an important cause of death in India but esitmated suicide rates based on data from India’s Naitonal Crime Records Bureau are unreliable. Aim：Systemaitcally review exisitng literature on suicide and the factors associated with suicide in India. Methods：PubMed, PsycINFO, EMBASE, Global Health, Google Scholar and IndMED were searched using appropriate search terms. The abstracts of relevant papers were independently examined by both authors for possible inclusion. A standardized set of data items were abstracted from the full text of the selected papers. Results：Thirty-six papers met inclusion criteria for the analysis. The heterogeneity of sampling procedures and methods of the studies made meta-analysis of the results infeasible. Verbal autopsy studies in several rural locaitons in India report high suicide rates, from 82 to 95 per 100,000 populaiton-up to 8-fold higher than the offcial naitonal suicide rates. Suicide rates are highest in persons 20 to 29 years of age. Female suicide rates are higher than male rates in persons under 30 years of age but the opposite is true in those 30 years of age or older. Hanging and ingestion of organophosphate pesticides are the most common methods of suicide. Among women, self-immolaiton is also a relaitvely common method of suicide. Low socioeconomic status, mental illness （especially alcohol misuse） and inter-personal difficulties are the factors that are most closely associated with suicide. Conclusion：The quality of the information about suicide in India is quite limited, but it is clearly an important and growing public health problem. Compared to suicides in high-income countries, suicide in India is more prevalent in women （paritcularly young women）, is much more likely to involve ingesiton of pesitcides, is more closely associated with poverty, and is less closely associated with mental illness.