suicide - a public health problem
history, global scenario, Indian scenario, etiology, risk factors. protective factors, suicide in adolescents, treatment, prevention, recommendations
special thanks and acknowledgement goes out to the contributors of the slide:
meroshana, haziman fauzi, griselda pearl, widad ulya, atiqah shakira, halim latiffi, farith che man and marwan omar.
Hopefully this is able to help medical students to understand about the psychiatry topic, suicide.
This is made by students so if there are any mistakes, please do correct us. We are open to constructive criticism. thank you :)
Suicide, risk factors, assessment and methodological problemsDr. Amit Chougule
Seminar on Suicide from a psychiatric point of view
definition, global and indian epidemiology of suicide, risk assessment of suicide and methodological issues associated with risk assessment and suicide research are covered.
special thanks and acknowledgement goes out to the contributors of the slide:
meroshana, haziman fauzi, griselda pearl, widad ulya, atiqah shakira, halim latiffi, farith che man and marwan omar.
Hopefully this is able to help medical students to understand about the psychiatry topic, suicide.
This is made by students so if there are any mistakes, please do correct us. We are open to constructive criticism. thank you :)
Suicide, risk factors, assessment and methodological problemsDr. Amit Chougule
Seminar on Suicide from a psychiatric point of view
definition, global and indian epidemiology of suicide, risk assessment of suicide and methodological issues associated with risk assessment and suicide research are covered.
Suicide, it’s importance, global burden, burden of suicide in India, theories of suicide, it’s prevention, psychiatric co-morbidities associated with suicide, its treatment
What is suicide? It is discuss in this presentation.
This slide covers theory and types of suicide, what are the reasons of suicide? What are the impacts of suicide?
Suicide prevention and role of media in preventing suicide also discuss in this presetnation.
Alcoholics Anonymous AA
Alcoholics Anonymous, often referred to simply as AA, is an international fellowship of people working together to overcome their addictions to alcohol.
This was a lecture in the course "Significant Medical Conditions in Seniors" presented at Peer Learning in Chapel Hill, NC, USA in 2016 by Michael C. Joseph, MD, MPH.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
Suicide, it’s importance, global burden, burden of suicide in India, theories of suicide, it’s prevention, psychiatric co-morbidities associated with suicide, its treatment
What is suicide? It is discuss in this presentation.
This slide covers theory and types of suicide, what are the reasons of suicide? What are the impacts of suicide?
Suicide prevention and role of media in preventing suicide also discuss in this presetnation.
Alcoholics Anonymous AA
Alcoholics Anonymous, often referred to simply as AA, is an international fellowship of people working together to overcome their addictions to alcohol.
This was a lecture in the course "Significant Medical Conditions in Seniors" presented at Peer Learning in Chapel Hill, NC, USA in 2016 by Michael C. Joseph, MD, MPH.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
read the full ultimate guide to suicidal thoughts and how to prevent and avoid this.
you can read the article on our website from here
https://www.websitesmarketo.media/2021/05/the-ultimate-guide-to-suicidal-thoughts.html
Psychiatric history
Basic structure
Standard history – presenting complaint, drug history, past medical history etc. – plus PSYCH extras:
Pre-morbid personality: "how would friends and family describe you before you were unwell?". Ask about previous hobbies and habits.
Substance use, including alcohol. Ask about frequency, volume, location and situation, and if relevant, administration route and needle sharing.
Youth: personal history.
Crime: forensic history.
Harm risk i.e. risk assessment. SO CRAP: Risk to Self, Risk to Others, Chronic physical health problems, Relapse risk, Medication Adherence, Protective factors.
Standard history components
Presenting complaint:
"What's been happening with you lately?". Put their own words in quotations as the presenting complaint.
If anxious, reassure: "we don't have to talk about anything you don't want to discuss".
Think about 4 key components of the episode, in a causal sequence: (1) triggers and life circumstances → (2) thoughts and emotions → (3) behavioural and physical symptoms, including functional impairments → (4) impacts on family, work, and physical health.
Make sure to cover the onset, duration, and pattern of symptoms, and factors that perpetuate, exacerbate, or relieve them.
Get their ideas, concerns, and expectations: what do they think is going on?
Ask about specific psych symptoms – e.g. delusions – as part of the mental state exam.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. Suicide – defined as an act with a fatal outcome
that is deliberately initiated and performed by the
person in the knowledge or expectation of its fatal
outcome.
It’s a complex phenomenon
Insurmountable disparity between expectations and
outcomes, real or imagined – tremendous pressure on
mind, blinding its logic, forcing it a conclusion of escape
12/03/14 3
4. Derived from Latin word
sui = oneself , cidium = a killing
Primary emergency for mental health professional
Major public health problem
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5. The story of suicide is probably as old as that of man
himself
Suicide has variously been glorified, romanticized,
bemoaned, and even condemned
12/03/14 5
6. In ancient Athens, a person who committed suicide
without the approval of the state was denied the
honours of a normal burial
In ancient Greece & Rome suicide was deemed to be an
acceptable method to deal with military defeat
12/03/14 6
7. ISLAM: suicide is PROHIBITED
CHRISTIANITY: suicide is considered a sin
In 19th-century in Europe the act of suicide shifted
from being viewed as caused by sin to being caused
by insanity.
12/03/14 7
8. Hinduism:
When Lord Sri Ram died, there was an epidemic of
suicide in his kingdom, Ayodhya
The Bhagavad Gita - condemns suicide
Upanishads, the Holy Scriptures - condemn suicide
‘he who takes his own life will enter the sunless
areas covered by impenetrable darkness after
death’
12/03/14 8
9. Vedas - permit suicide for religious reasons
consider that the best sacrifice was that of one's own
life - ‘sallekhana’
Sati, where a woman immolated herself on the pyre of
her husband rather than live the life of a widow
12/03/14 9
10. More than 8,00,000 people die by suicide every year
Estimated annual mortality is 14·5 deaths per
1,00,000 people
Around one person every 40 seconds
75% of suicides occur in low- and middle-income
countries
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11. Suicide worldwide was estimated to represent 1.8% of
the total global burden of disease in 1998
By 2020 - projected to be 2.4%
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12. Tenth leading cause of death worldwide
It is the second leading cause of death in 15-29 year-olds
globally
12/03/14 12
14. Suicide belt – (25 per 100,000) Scandinavia,
Switzerland, Germany, Austria, eastern European
countries (Belarus, Estonia, Lithuania, and the
Russian Federation) and Japan
Prime suicide site of the world – Golden Gate Bridge in
San Francisco
Japan- reported to have highest number of cases
12/03/14 14
15. India ranks 43rd in descending order of rates of suicide
with a rate of 10.6/100,000 reported in 2009
About one-third of suicides over the world happen in
India
According to 2012 WHO data –
males -25.8/100,000population/year
females- 16.4/100,000
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16. According to NCRB : In 1989- 8.47/100,000
population/year
1999 – 11.21
2006 – 10.5
Under-reporting
• Pondicherry, Andaman & Nicobar Islands –
30/100,000
• Kerala, Sikkim, Tripura, Karnataka also have reported
high rates of suicide
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18. Egoistic - This type of suicide occurs when the degree of
social integration is low
Altruistic - degree of social integration too high
Anomic – Integration into society is disturbed
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19. Psychological Factors
Freud’s theory: “ Mourning and Melancholia”
Menninger’s theory: suicide as inverted homicide
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20. Biological Factors
Serotonergic system: low concentration of
5-HIAA (metabolite of serotonin)
Nonadrenergic system: stress-diathesis model
HPA axis: Dexamethasone suppression test- non-suppressors
( suicide is more common in groups with low cholesterol
levels) 12/03/14 20
22. Gender differences- Men 4 times > Women
Exceptions – India and China , ratio is 1.3:1
Age- Increase with age
men peak age- after 45 years
women – 55years
Race- Two out of every three suicides are White males
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23. Religion- degree of orthodoxy and integration
Marital status- lessens the risk
Occupation- higher social status greater the risk
unemployed > employed
Physician suicides - physicians particularly females are
at greater risk
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24. Climate – no significant variation
Physical health- loss of motility
disfigurement
chronic intractable pain
patients on hemodialysis
alcohol related illnesses
Drugs : Reserpine, corticosteroids, anti-cancer agents
12/03/14 24
26. Depression
Schizophrenia
Addiction disorder
Family history
& past history of
suicidality
Dysregulated
serotonergic system
Early parental
loss
Isolation
Unemployment
Acute life
events
Older age
Male sex
Vulnerable
periods
12/03/14 26
27. Strong connections to family and community support
Skills in problem solving, conflict resolution, and non-violent
handling of disputes
Personal, social, cultural and religious beliefs that
discourage suicide and support self-preservation
Restricted access to means of suicide
Seeking help and easy access to quality care for
mental and physical illnesses
12/03/14 27
31. STAGES OF SUICIDE
Ideation
Threatening
Attempting
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Intervention
32. Parasuicide : injures themselves by self
mutilation but do not wish to die
Cyber-suicide : suicide pact made between
individuals who meet on the internet
Copycat suicide : a suicide within a peer
group/publicized suicide can serve as a model for
next suicide in absence of sufficient protective
factors (Werther syndrome)
Anniversary suicide: persons take their lives on
the day a member of their family did
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33. IPC S. 309 Attempt to Commit Suicide
S.306 Abetment of Suicide
• S.305 Abetment in Special Cases
12/03/14 33
34. Suicide in adolescents:
Highly vulnerable group
Living in violent & abusive environment
Lack of support network
They are usually successive in their attempt to suicide
Male : female ratio almost equal
12/03/14 34
35. Causes- mental illness
school difficulties
broken romance
separation
rejection
physical/ sexual abuse
Children –bullying /being bullied
(NOTE: Direct questioning about suicidal thoughts is
necessary)
12/03/14 35
36. Trouble coping with recent losses, death, divorce,
moving, break-ups, etc.
Feelings of hopelessness and despair
Making final arrangements: writing a will or
eulogy, or taking care of details (i.e. closing a bank
account).
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37. Gathering of lethal weapons
Giving away prized possessions
Preoccupation with death, such as death and/or
'dark' themes in writing, art, music lyrics, etc.
Sudden changes in personality or attitude,
appearance, chemical use, or school behavior.
12/03/14 37
38. “I can't go on anymore"
"I wish I was never born"
"I wish I were dead"
"I won't need this anymore"
12/03/14 38
39. "My parents won't have to worry about me anymore"
“Everyone would be better off if I was dead”
“Nobody cares if I live or die”
12/03/14 39
40. Treatment of suicide attempters
For every completed case of suicide there are about 20
non fatal attempts
Repetition – 15-25% within a year
Poor problem solving skills
12/03/14 40
43. 1) Assessment- ( SAD PERSON’S scale – high specificity
but low sensitivity so not used anymore)
2) Treatment:
a)Psychiatric disorders to be treated
b)Community therapy- problem solving and outreach
c) Adolescents – family therapy, group therapy
12/03/14 43
46. Population strategies
Intervention at community level:
1. Increasing public awareness
2. Campaign to reduce stigma
3. Guidelines for the mass media
4. Regulating formulations, packaging and sale of
pesticides
5. Regulation of over-the-counter medication
6. Gender-related legislation and action
7. Introducing alcohol policies
12/03/14 46
47. Interventions at institutional and organizational
levels:
1. Establishing sentinel centres and developing an
information system
2. Training of personnel working in high risk settings
3. Establishing crisis intervention and counselling centres
and telephone hotlines
4. Increase in specific clinical training programmes for lay
counsellors
5. Redesigning the curriculum for medical and nursing
personnel
6. Intervention programmes for high schools
12/03/14 47
48. High-risk strategies
1. Patients with psychiatric disorder
a) Risk identification
b) Preventive strategies- active treatment of individuals
and psychological therapy
2. Elderly people- care and support
12/03/14 48
49. 3. Suicide attempters
4. High-risk occupational groups- all these groups have
easy access to methods of suicide – removing the
access
5. Prisoners- young males held at remand
Ensuring that prison cells are safe in terms of absence of
structures favorable for suicide
12/03/14 49
51. Key Gatekeepers
o Primary health care providers
o Mental health care providers
o Emergency health care providers
o Teachers and other school staff
o Community leaders
o Police officers and other first responders
o Military officers
o Social welfare workers
o Spiritual and religious leaders
o Traditional healers
12/03/14 51
54. In the WHO Mental Health Action Plan 2013-2020 - the
global target of reducing the suicide rate in countries
by 10% by 2020.
WHO’s Mental Health Gap Action Programme,
launched in 2008, includes suicide prevention as a
priority and provides evidence-based technical
guidance to expand service provision in countries
12/03/14 54
56. Model for developing countries in public health
low IMR
MMR
High life expectancy
Marched forward in physical health, neglected mental
health
12/03/14 56
57. Evidenced by high suicide rates
32/100,000 population/ year
KRISIS (Kerala Integrated Scheme for Intervention in
Suicide)- launched in 2004
In 2008- 26/100,000 population/yr
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58. Public awareness
Integration of mental health and general health in
suicide prevention approaches
At MBBS level – making it a compulsory subject of
study and a examination paper
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59. Foundations providing services in prevention of suicide
Prerana group- Mumbai
Sneha NGO – Chennai based
Maithri -Ernakulam
12/03/14 59
60. When someone is suicidal , he or she will always
remain suicidal
Heightened suicide risk is often short-term and
situation-specific.
While suicidal thoughts may return, they are not
permanent and individual with previously suicidal
thoughts and attempts can go on to live a long life
12/03/14 60
61. Talking about suicide is a bad idea and can be
interpreted as encouragement
Given the widespread stigma around suicide, most
people who are contemplating suicide do not know
who to speak to.
Rather than encouraging suicidal behaviour, talking
openly can give an individual other options or the time
to rethink his/her decision, thereby preventing
suicide.
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62. Only people with mental disorders are suicidal
Suicidal behaviour indicates deep unhappiness but not
necessarily mental disorder.
12/03/14 62
63. Most suicides happen suddenly without warning
The majority of suicides have been preceded by
warning signs, whether verbal or behavioural.
Of course there are some suicides that occur without
warning
12/03/14 63
64. Someone who is suicidal is determined to die
On the contrary, suicidal people are often ambivalent
about living or dying
Someone may act impulsively by drinking pesticides,
and die a few days later, even though they would have
liked to live on
12/03/14 64
65. People who talks about suicide do not
mean to do it
People who talk about suicide may be reaching out for
help or support
12/03/14 65
68. Kaplan & Sadock’s Synopsis of Psychiatry (10th edi)
New Oxford Textbook of Psychiatry ; Michael Gelder, Nancy Andreasen
(2nd edition)
Community Mental Health in India; B. Chavan, Nithin Gupta
Essentials of Psychiatry; Jerald Kay, Allan Tasman
A hand book on Suicide Prevention Strategies, KRISIS
World Health Organization. World Health Report 2001. Mental health:
New understanding, new hope. Geneva
S.Manoranjitham;Towards a National Strategy to Reduce Suicide in
India; The National Medical Journal of India vol. 18, no. 3, 2005
Aaron R, Joseph A, Abraham S, Muliyil J, George K, Prasad ; Suicides in
young people in rural southern India Lancet; 2004;363:1117–18
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