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Why women attempt suicide: the role of mental illness and social disadvantage in a community cohort study in India
  1. J Maselko1,
  2. V Patel2
  1. 1
    Department of Public Health, Temple University, Philadelphia, Pennsylvania, USA
  2. 2
    London School of Hygiene & Tropical Medicine, London, UK and Sangath, Sangath Centre, Porvorim, Goa, India
  1. Dr J Maselko, Assistant Professor in Public Health, Department of Public Health, Temple University, 1700 N Broad Street, Suite 300B, Philadelphia, PA 19122, USA; maselko{at}


Context: The relative importance of illness (physical and mental) and social disadvantage as risk factors for suicide is controversial.

Objectives: To describe the risk for attempted suicide in women when it is associated with social disadvantage and physical and mental illness.

Methods: Data were analysed from a population-based cohort study of women aged 18–50, in Goa, India (n = 2494). Baseline information was collected on socioeconomic factors, gender disadvantage and physical and mental illness. The main outcome was self-report attempted suicide (AS) over a 12-month study period. ORs were calculated using exact logistic regression.

Results: One-year incidence of AS was 0.8% (n = 18+1 completed suicide) and seven of these women had baseline common mental disorders (CMDs) (37%). In unadjusted models, CMDs (OR 8.71, 95% CI 2.86 to 24.43), exposure to violence (OR 7.70, 95% CI 2.80 to 22.21) and recent hunger (OR 6.59, 95% CI 1.83 to 19.77) were the strongest predictors of incident AS cases. However, in a multivariate model, exposure to violence (OR 5.18, 95% CI 1.55 to 18.75) and physical illness (OR 3.77, 95% CI 1.05 to 12.37) emerged as independent predictors of AS.

Conclusions: Multi-pronged strategies to reduce domestic violence, provide poverty relief and improve treatment of mental and physical disorders are needed to reduce the population burden of attempted suicide.

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  • Funding: This study was funded by a Wellcome Trust Career Development Fellowship in Clinical Tropical Medicine to VP. JM was funded by grant MH17119 from the National Institutes of Health. JM and VP have had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests: None.

  • Ethics approval: The study received approval from the ethics review board of the London School of Hygiene & Tropical Medicine, and the Independent Ethics Commission, Mumbai (India).

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