1. Suicide Rate Computation - Methodological
Inexactitude
Article
Gopala Sarma Poduri
Consultant Psychiatrist, Department of Psychiatry, Yashoda Super Specialty Hospital, Malakpet, Hyderabad, India
Original *Corresponding Author:
Dr. Gopala Sarma Poduri, 501, Highlight Haveli, Street No.6, Habsiguda, Hyderabad - 500 007, India. Mobile: +91 944 099 4416.
E-mail: gopalasarmapoduri@yahoo.com ABSTRACT
Introduction: Suicide rates are computed on the basis of whole population without taking into consideration the cognitive capacity
of children to appreciate death. This study was undertaken to find out the variability in suicide rate if children of various ages are
excluded from computation of suicide rate Method: Suicide rates were computed taking the at risk population of India-above 6 yrs,
7 yrs, 8 yrs, and 9 yrs for the period 1991-2013, suicide data from the National Crimes Bureau statistics on Accidental Deaths and
Suicides of Ministry of Home Affairs, Govt. of India. The data was analyzed for percentage increase for various ages. Results: Depending
upon the cut-off age the rate increase over a twenty-three year period was from 11.2 to 14.6 and the percent increase was 16.1-33.7.
Conclusion: A standardized definition of suicide and a thorough debate on child’s concept of death and ability to decide to decide
on death across various cultures and regions is needed to understand the enormity of suicide.
Keywords: Child, Cognition, Intent-Suicide-India
view death in different ways depending on their age.
They do not have the cognitive capacity to appreciate
death, finality, all the implications and consequences
of it.2 This is needed to label the death as suicide. So
including such a population which does not have the
capacity, i.e., children, will give diluted suicide rates.
If that population is more, the dilution factor will be
more. As the age at which children acquire the capacity
of intention was not definite a simple exercise was
undertaken to see the change in suicide rate by excluding
different age population-six to nine.
METHODS
Year-wise rates for various at risk population in India-above
6 yrs, 7 yrs, 8 yrs, and 9 yrs, were taken from the
mid-year population projections of US Census Bureau
data on international Population for the years 1991-2013.3
This data was equalised by taking into consideration the
total population as mentioned in Indian suicide rate.
This was done as there were differences in the projected
population by various agencies. Suicide details from
National Crimes Bureau statistics on Accidental Deaths
and Suicides of Ministry of Home Affairs, Govt. of India
were collected for the same years4. Then suicide rate was
calculated basing on the above computed population
for various years. The data was analyzed for percentage
increase for various years and ages. Average rate for
various years was computed with and without exclusion
of various age groups. The same was done for percentage
increase over whole populations rates.
INTRODUCTION
Any measurement to be meaningful should be valid
and reliable. This depends on various factors-one
of the main factors being definition of what is being
measured. The same is the case with suicides. The
reliability of suicide statistics is suspect for a variety of
reasons. The quality and quantity of suicide statistics is
far from satisfactory for many reasons. These include
definition of suicide followed, reporting practices,
recording practices, misclassification of death, etc.
There are various definitions of suicide.1 Another
notable cause could be inclusion of whole population
in computing the rate. Suicide by definition involves
intention, execution by self that culminates in death.
Suicide rates are expressed as number of suicides per
lakh population. This is to adjust for the underlying
population, otherwise just stating the number of
suicides will be meaningless and does not convey any
information except the number. For any human deviant
behavior to be probed, the magnitude of the problem
must be clear. In this way, suicide is handicapped.
For a variety of reasons as mentioned above, it is
grossly under reported. The nearer the accuracy of the
magnitude of the problem of suicide is known, better
will be the assessment of the trends of suicides or in
comparison with other populations, groups, etc. and
for finding out environmental and social influences
in the long run. Apart from gross under-reporting,
suicide rate suffers from inclusion of persons who do
not have the cognitive capacity to indulge in it. Children
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2. Poduri: Inexactitude in Suicide Rate Computation
RESULTS
Computation of such data for twenty-three years
excluding different age population yielded rates ranging
from 11.2 to 14.6 against rate 9.2 to 11.4 for whole
population, depending on the age and year of exclusion.
The average rate over the computed period of twenty-three
years was 10.4 increasing to 12.4 (>6 yrs), 12.8
(>7 yrs), 13(>8 yrs) and 13.5 (>9 yrs). Figure-1 shows year-wise
suicide rate without and with different exclusion age
groups-6, 7, 8 and 9 Yrs.
The increase ranged from minimum of 16.1% to a maximum
of 33.7%, depending on the age and year of exclusion. The
average increased percentage for different age groups
were 19.3, 22.6, 26.0, and 29.4 for >6 yrs, >7 yrs, >8 Yrs, and
>9 Yrs respectively. Figure-2 shows year-wise incremental
percentage over suicide rate with different exclusion ages-
6, 7, 8 and 9 Yrs.
DISCUSSION
Obviously, when the denominator is reduced-population
in this case, the rate will go up. As observed there was a
progressive increase when children of various age groups
are excluded. The rate curves for different populations
were almost running parallel. When it came to computation
of percentage increase, the increase became comparatively
less as the mortality between each year between 6-9 yrs
is not much different. Traditionally children below ten
years cannot comprehend the significance of death.
They do not have the cognitive capacity to appreciate
the permanency and irreversibility of death.5 Children’s
understanding of death and suicide is immature.6 With
increasing intelligence, exploding knowledge spread, the
child is exposed to various knowledge sources, which
may bring down the age at which the child can cognate
death. But the moot point is whether such acquired
knowledge regarding death is real. When a majority of
adults, including those on death bed or nearer to death,
know the inevitability and irreversibility of death are in
denial mode and think it will not touch them, how can
children with their immaturity, cognate death? What was
noted about capacity for assisted dying (a form of suicide)7
holds good for suicide also. Legally also children are not
considered to be mature enough to understand the nature
and consequence of the crime. According to IPC (Indian
Penal Code)-sections 82, 83 a child below seven is not
considered to have committed a crime and a child between
seven and twelve is considered incapable of committing
a crime.8 Even though there were reports of suicide in
children, they were debatable. Most of the reported and
analyzed suicides in the literature were above ten years
of age. One such example of 678 cases the age range was
12-94 yrs.9 It is unusual to find official records of various
countries where children below ten were mentioned. With
increasing detection of depression and other psychiatric
disorders in children and rampant use of psychotropic
including antidepressants, suicide is a possibility. At
the same time one should keep in mind the cognitive
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Figure 1: Year-Wise Suicide Rates for Total Population and After Excluding Different Age Groups-6, 7, 8 and 9 Yrs
83 Acta Medica International | Jul - Dec 2014 | Vol 1 | Issue 2 |

3. Poduri: Inexactitude in Suicide Rate Computation
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Figure 2: Year-Wise Incremental Percentage over Suicide Rate with Different Exclusion Age Groups-6, 7, 8 and 9 Yrs
REFERENCES
1. Silverman, M M. The language of Suicidology. Suicide and Life-
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2. Singh, A., Singh, D. Nizamie, S.H. 2003; Accessed from http://
www.psyplexus.com/excl/cdmi.html
3. www.census.gov DataInternational Data BaseInternational
programstotal mid-year population of the world.
4. Accidental Deaths Suicides in India. National Crime Records
Bureau, Ministry of Home Affairs, Govt. of India website.
5. Gopala Sarma Poduri. Effective Suicide Rate. IJPP. 2014; 8: 33-5
6. Mishara, B. L. Conceptions of Death and Suicide in Children Ages
6-12 and Their Implications for Suicide Prevention. Suicide and
Life-Threat Behavi. 1999; 29: 105-18. doi: 10.1111/j.1943-278X.1999.
tb01049.x
7. Price A, McCormack R, Wiseman T, Hotopf M. Concepts of mental
capacity for patients requesting assisted suicide: a qualitative
analysis of expert evidence presented to the Commission on
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6939-15-32.
8. India Penal Code and Child related offenses - ChildLine India.
Accessed from http://www.childlineindia.org.in/india-penal-code-and-
child-related-offenses.htm.
9. Bennett ATandCollins KA. Suicide: a ten-year retrospective study.
J Forensic Sci. 2000; 45: 1256-8.
immaturity, deficient abstract thinking of that segment
of the population. In India, there are states where female
children are not favoured and family planning is not
practiced by some on religious and various other grounds.
In the light of above, inclusion of whole population can
lead to interpretational errors. In most of the Indian states
there exists a skewed sex ratio in favour of males. If the
above method of exclusion is followed, then the rate for
male will substantially go –up. Till such time of clarity
of capacity of the child, it may be meaningful to exclude
children from suicide rate computation. This will help
comparison across states, countries, communities, years,
ranking. This will give a truer picture for comparison
purposes as the dilution factor of non-vulnerable are
excluded.5 The concept of cognitive capacity being central
to the article can have far reaching effect on suicide
analysis.
CONCLUSION
Extensive probing on child’s age of awareness of death in
different cultures and arriving at that age in the population
for a realistic arrival of suicide rate for a meaningful
comparison and understanding of suicide is in order.
This is needed in the context of knowledge explosion and
easy and universal decimation in general and children in
particular.
How to cite this article: Poduri GS. Suicide Rate Computation-
Methodological Inexactitude. Acta Medica International. 2014;
1(2):82-84.
Source of Support: Nil, Conflict of Interest: None declared.
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