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Psychological autopsy study of suicide in three rural and semi-rural districts of Sri Lanka



Knowledge concerning the epidemiology of suicide in Sri Lanka is limited despite its suicide rates being amongst the highest in the world.


To examine the characteristics of a large sample of Sri Lankan suicides to inform approaches to prevention.


Psychological autopsy study of suicides occurring in three rural districts of Sri Lanka during August–October 1997.


Interviews were conducted with contacts of 372 (74%) of the 499 suicides that occurred over the study period. Males accounted for 79% of the deaths. Twenty-one percent of male and 57% of female suicides were aged <25 years of age. Pesticide self-poisoning accounted for 259 (70%) of the deaths. Almost two-thirds (62%) of the deaths occurred in hospital and 95 (26%) had made previous suicidal gestures. 138 (37%) were moderately or severely depressed and 144 (49%) of male suicides, but only 2 (2.5%) of the females, were alcohol dependent. Illegally brewed alcohol (kasippu) was the main product used by two thirds (62%) of problem drinkers. There was a family history of suicide in 20% of cases.


Pesticide self-poisoning accounts for over two thirds of suicides in rural Sri Lanka. Suicide prevention efforts in Sri Lanka should focus on restricting access to pesticides, improving the medical management of pesticide poisoning, reducing alcohol misuse—particularly targeting the supply of illegal alcohol—and improving the identification and aftercare of people who self-harm.

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The work was funded by a grant from the Presidential Secretariat, Sri Lanka. Dr. Tara de Mel, for supporting this work in many ways. The research team consisted of: S.P.M. Karunaratne, M.G. Hemakumara and Vijitha Bandranayake. Input from the following people was vital: Dr. Priyani Ratnayake; Ms. Indika Bulumulla; Mr. Shelton Gamini; Dr. Amila Hewaratne; Dr. Thushari Wanigaratne and Dr. Thusari Hapuarachchi. Dr Michael Eddleston provided helpful comments on a draft of this paper.

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Correspondence to Dr. Ranil Abeyasinghe.

Appendix A

Appendix A

Four categories of drinking

When interpreting alcohol data, alcohol use was considered under four categories.

  • Those who never used alcohol and those who have stopped drinking completely.

  • Those who drank less than three times a week and only at parties. Their drinking never caused problems. These were categorised as social drinkers.

  • Those who could be categorised as abusing alcohol, according to the DSM 4 criteria.

  • Those who were dependent on alcohol and fulfilled criteria for DSM 4 category of alcohol dependence.

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Abeyasinghe, R., Gunnell, D. Psychological autopsy study of suicide in three rural and semi-rural districts of Sri Lanka. Soc Psychiat Epidemiol 43, 280–285 (2008). https://doi.org/10.1007/s00127-008-0307-3

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Key words

  • suicide
  • Sri Lanka
  • epidemiology