Suicide related to the COVID-19 pandemic in India: A systematic review

Abstract

Background The suicide rate has increased during the pandemic in India. Moreover, several studies, especially press-media reporting suicide studies have been conducted but no systematic review has been attempted in this context. Therefore, the present study systematically investigated the risk factors associated with suicidal behaviors, and the method of suicide during the COVID-19 pandemic in India. Methods Following the PRISMA guidelines, a systematic search was performed to include papers published up until September 30, 2022. From an initial 144 papers, 18 studies which met the inclusion criteria were included in the present review. The Pierson’s method was used for quality assessment of the included studies in the present review. Results The risk factors associated with suicide comprised: (i) socio-demographic factors (e.g., being aged between 31 and 50 years, male, married, unemployed), (ii) behavior and health-related factors (e.g., unavailability of alcohol and alcohol withdrawal symptoms, poor state of physical health and health issues, family disputes, relationship complexities, and sexual harassment), (iii) COVID-19-related factors (e.g., fear of COVID-19, COVID-19 test results, quarantine or isolation, financial hardship due to the pandemic, having influenza-like symptoms, experiencing stigmatization and ostracism despite testing negative, separation from family due to transport restrictions, misinterpreting other illness symptoms as COVID-19, saving the village from infection, watching COVID-19 videos on social media, online schooling, perceived stigma toward COVID-19, and being suspected of having COVID-19), and (iv) psychopathological stressors (depression, loneliness, stress, TikTok addiction, and poor mental health, suicidal tendencies, helplessness, and worrying). Hanging was the most common method of suicide. In addition, jumping from high buildings, poisoning, drowning, burning, cutting or slitting throat or wrists, self-immolation, medication overdose, electrocution, pesticide, and gun-shot were also used to carry out the suicide. Conclusions Findings from this research suggest multiple reasons for suicide during the COVID-19 pandemic and knowledge of such factors could aid in developing suicide prevention strategies focusing the most vulnerable cohorts inside and outside India.

The Psychological Impact and Suicidal Behaviour in the Context of the COVID-19 Pandemic: Four Case Reports From Oman

“…A few case reports have been published in the US, the UK, Bangladesh, and India. Those cases presented findings based on the number of people who had committed suicide due to the combined factors of xenophobia, COVID-19, and negative media coverage [ 16 ]. The reports illustrated the use of different terminologies about the chosen method of suicide: gunshot [ 16 ], hanging [ 6 ], and knife [ 7 ].…”

“…Those cases presented findings based on the number of people who had committed suicide due to the combined factors of xenophobia, COVID-19, and negative media coverage [ 16 ]. The reports illustrated the use of different terminologies about the chosen method of suicide: gunshot [ 16 ], hanging [ 6 ], and knife [ 7 ]. In our series, hanging was used in one case, and the others used knives.…”

Suicidal Behavior and Its Association With Psychological Distress, Coping Mechanisms, and Resilience: A Cross-Sectional Study

“…A significant proportion of suicides in India happen secondary to stressful life events, including family conflict, financial hardships, unemployment, reduced economic growth, relationship issues, chronic pain, and illness-related issues [1,[21][22][23]. Social isolation during the COVID-19 pandemic has been highlighted to be associated with increased suicidal behavior [24]. The consequent higher levels of perceived distress were associated with "intent to die" by suicide [25,26].…”

Building systemic resilience, productivity and well-being: a Mental Wealth perspective

“…Studies dating back to the 1930s highlight the relationship between labour market status and well-being, demonstrating both the positive impacts of being engaged in productive work and the negative effects of unemployment 13. Unemployment and underemployment are associated with significant increases in psychological distress, mental ill-health and suicidal behaviour 14–24. With increasing duration of unemployment, perceived helplessness is theorised to reduce a person’s motivation to search for employment or acquire new skills due to the belief that actions will have little or no effect on their circumstances 13 25.…”

“…13 Unemployment and underemployment are associated with significant increases in psychological distress, mental ill-health and suicidal behaviour. [14][15][16][17][18][19][20][21][22][23][24] With increasing duration of unemployment, perceived helplessness is theorised to reduce a person's motivation to search for employment or acquire new skills due to the belief that actions will have little or no effect on their circumstances. 13 25 Well-being impacts can also occur when workers experience a reduction in wages, conditions and job security on reemployment.…”