SUICIDAL HANGING: A FIVE-YEAR ANALYSIS AT A TERTIARY HEALTH CENTER IN SOUTH INDIA
DOI:
https://doi.org/10.48165/jfmt.2024.41.1.2Keywords:
Hanging, Autopsy, Ligature Material, Rural, India, NeckAbstract
Suicide is a global burden, accounting for more than seven lakh deaths annually, with a range of one suicide every 40 seconds. India reports the highest number of suicides in the world. Hanging is the most common method, followed by poisoning and burns. Records from a tertiary centre in Southern India were examined retrospectively for the study between 2010 and 2014. We studied 147 cases of hanging out of 3996 autopsies conducted in our tertiary health centre. Data was collected from the police inquest and postmortem examination reports from 2010 to 2014. Males (55%) are more commonly affected than females (45%). Around 45% of cases occurred during the third decade of life. The present study reveals that a higher proportion of cases (54%) were reported from rural regions, with family problems being the most prevalent reason among both genders. The second most common reason was financial problems in males. The leading cause of hanging in adult females was found to be dowry harassment, while academic pressure was the primary cause in minor females. The vast majority of cases (94%) occurred within the victim’s residence, with the most commonly used material being saree (37%), followed by rope (27%). Approximately 74% of cases were completed, and 81% were typical hanging. In 64% of cases, the internal structures beneath the ligature mark were found to be intact. Duration of survival analysis conducted between rural and urban regions revealed that a significant proportion of cases that survived for < 24 hours belonged to rural regions.
Downloads
References
Suicide. https://www.who.int/news-room/fact-sheets/ detail/suicide [Accessed 10th February 2023]. 2. Goal 3 | department of economic and social affairs. https://sdgs.un.org/goals/goal3 [Accessed 10th February 2023].
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258): 1204–1222. DOI: https://doi.org/10.1016/S0140-6736(20)30925-9.
Dandona R, Bertozzi-Villa A, Kumar GA, Dandona L. Lessons from a decade of suicide surveillance in India: who, why and how? Int J Epidemiol. 2017;46(3):983-993. DOI: 10.1093/ije/dyw113. PMID: 27255440.
Vijayakumar L, Chandra PS, Kumar MS, Pathare S, Banerjee D, Goswami T, et al. The national suicide prevention strategy in India: context and considerations for urgent action. The Lancet
Psychiatry. 2022;9(2):160-8. DOI:https://doi.org/ 10.1016/S2215-0366(21)00152-8
ADSI reports of previous years | national crime records bureau. https://ncrb.gov.in/en/adsi-reports-of previous-years [Accessed 10th February 2023].
Arafat SY, Ali SA, Menon V, Hussain F, Ansari DS, Baminiwatta A, et al. Suicide methods in South Asia over two decades (2001–2020). Int J Soc Psychiatry. 2021;67(7):920-34. DOI: https://doi.org/10.1177/ 00207640211015700
Arya V, Page A, Gunnell D, Dandona R, Mannan H, Eddleston M, et al. Suicide by hanging is a priority for suicide prevention: method specific suicide in India (2001–2014). J Affect Disord. 2019;257:1-9. DOI: https:/ /doi.org/10.1016/j.jad.2019.07.005
Rao D. An autopsy study of death due to Suicidal Hanging–264 cases. Egypt J Forensic Sci. 2016;6(3):248-54.
Hassan DA, Ghaleb SS, Kotb H, Agamy M, Kharoshah M. Suicidal hanging in Kuwait: retrospective analysis of cases from 2010 to 2012. J Forensic Leg Med. 2013;20(8):1118-21. DOI: https://doi.org/10.1016/ j.jflm.2013.09.021
Dean DE, Kohler LJ, Sterbenz GC, Gillespie PJ, Gonzaga NS, Bauer LJ, Looman K, Owens OD. Observed characteristics of suicidal hangings: An 11 year retrospective review. J For Sci. 2012;57(5):1226- 30.
Stulz N, Hepp U, Kupferschmid S, Raible-Destan N, Zwahlen M. Trends in suicide methods in Switzerland from 1969 to 2018: an observational study. Swiss Med Wkly. 2022 Dec 10;152:40007. DOI: 10.57187/ smw.2022.40007
Kanchan T, Menezes RG. Suicidal hanging in Manipal, South India–victim profile and gender differences. J Forensic Leg Med. 2008;15(8):493-6. PMID: 18926500 DOI: 10.1016/j.jflm.2008.05.004
Rao BS, Khan MI. A Post-mortem study of deaths due to hanging reported to RIMS, Adilabad. Eur J Mol Clin Med.2020;7(11).
Üzün Ý, Büyük Y, Gürpinar K. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases. J Forensic Leg Med. 2007;14(7):406-9. DOI: https://doi.org/10.1016/j.jflm.2007.01.002
Bennewith O, Gunnell D, Kapur N, Turnbull P, Simkin S, Sutton L, Hawton K. Suicide by hanging: multicentre study based on coroners’ records in England. Bri J Psy. 2005;186(3):260-1. DOI: https:// doi.org/10.1192/bjp.186.3.260
Eskin M, Ertekin K, Dereboy C, Demirkiran F. Risk factors for and protective factors against adolescent suicidal behavior in Turkey. Crisis. 2007;28(3):131-9.
DOI: https://doi.org/10.1027/0227-5910.28.3.131
Ambade VN, Kolpe D, Tumram N, Meshram S, Pawar M, Kukde H. Characteristic features of hanging: a study in rural district of Central India. J For Sci. 2015 ;60(5):1216-23. DOI: https://doi.org/10.1111/1556- 4029.12772
Shaw D, Fernandes JR, Rao C. Suicide in Children and adolescents: a 10-year retrospective review. Am J Forensic Med Pathol. 2005;26(4):309-15. DOI: 10.1097/ 01.paf.0000188169.41158.58
Ahmad M, Hossain M. Hanging as a Method of Suicide: Retrospective Analysis of Postmortem Cases. J. Armed Forces Med. Coll. [Internet]. 2011. 14 [cited 2023 May 18];6(2):37-9. Available from: https:// www.banglajol.info/index.php/JAFMC/article/view/ 7273
Meel BL. A study on the incidence of suicide by hanging in the sub-region of Transkei, South Africa. J Cli Forensic Med. 2003;10(3):153-7. DOI: https:// doi.org/10.1016/S1353-1131(03)00077-4
Sabrinskas R, Hamilton B, Daniel C, Oliffe J. Suicide by hanging: A scoping review. Int J Ment Health Nurs. 2022;31(2):278-94. DOI: https://doi.org/10.1111/ inm.12956
Cooke CT, Cadden GA, Margolius KA. Death by hanging in Western Australia. Pathology. 1995;27(3):268-72. DOI: https://doi.org/10.1080/ 00313029500169093
Biddle L, Donovan J, Owen-Smith A, Potokar J, Longson D, Hawton K, et al. Factors influencing the decision to use hanging as a method of suicide: qualitative study. Br J Psychiatry. 2010 Oct;197(4):320- 5. DOI: https://doi.org/10.1192/bjp.bp.109.076349
Nayak SR, Naik SK, Samanta AK, Jena MK. Analysis of Profile of Hanging Deaths in Coastal Odisha. J Indian Forensic Med. 2017;39(1):16-9. DOI : 10.5958/ 0974-0848.2017.00003.3
Debbarma S, Deka SJ. Study of delayed death in hanging. Ind J Forensic Community Med. 2016 Oct;3(4):283-6.
Taware AA, Jadhao VT, Tatiya HS. Delayed death in suicidal hanging: a case report. J For Med Sci Law. 2013;22(1):44-8.
Gandhi R, Taneja N, Mazumder P. Near hanging: Early intervention can save lives. Ind J Anaesth. 2011 Jul;55(4):388-91. doi: 10.4103/0019-5049.84863. PMID: 22013258; PMCID: PMC3190516.
Kao CL, Hsu IL. Predictors of functional outcome after hanging injury. Chin J Traumatol. 2018 Apr;21(2):84- 87. doi: 10.1016/j.cjtee.2017.04.013. Epub 2018 Jan 31. PMID: 29454810; PMCID: PMC5911731
