Anda di halaman 1dari 18

A STUDY TO ASSESS THE FACTORS INFLUENCING SUICIDAL

BEHAVIOR AMONG THE COLLEGE STUDENTS AT BANGALORE, WITH


A VIEW TO DEVELOP AN INFORMATIONAL BOOKLET
M.Sc Nursing Dissertation Protocol submitted to

Rajiv Gandhi University of Health Science,Karnataka, Bangalore


By
Mr.JENEESH JABAR
M.Sc NURSING I YEAR
2011-2012
Under the guidance of
HOD, Department of Psychiatric Nursing
Nightingale college of Nursing
Guruvanna Devara Mutt
Near Binnysten Garden
Magadi Road
Bangalore-23

Rajiv Gandhi University of Health Science,Karnataka, Bangalore


Curriculum Development Cell
CONFIRMATION FOR REGISTRATION OF SUBJECTS FOR DESERTATION
Registration No.

Name of the candidate

: Mr. Jeneesh Jabar

Address

: Nightingale College Of Nursing


Guruvanna Devara Muttu,Near Binniysten Garden
Magadi Road Bangalore-23

Name of the institution

: Nightingale College Of Nursing


Guruvanna Devara Muttu,Near Binniysten Garden
Magadi Road Bangalore-23

Course of study and subject

: M.Sc Nursing in Psychiatry

Date of Admission to the course

Title of the topic

: A study to assess the factors influencing suicidal behavior


among the college students at bangalore, with a view to
develop an informational booklet

Brief resume of the intended work

: Attached

Signature of the student

Guide Name

: Mrs.Manjula Devi

Remarks of the Guide

Co- Guide Name

: Mr.Mohan Krishna

HOD Name

: Mrs.Manjula Devi

Principal Name

: Mrs. Jaya Kadambari

Principal Mobile No.

: 09886367287

Principal E-Mail ID

: nightingale_principal@rediffmail.com

Remarks Of the Principal

Principal signature

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE,KARNATAKA,


BANGALORE
ANNEXURE-II
PERORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Mr. JENEESH JABAR


MR. JENEESH JABAR
I YEAR M.Sc NURSING
1.

NIGHTINGALE COLLEGE OF NURSING

NAME OF THE CANDIDATE AND ADDRESS

GURUVANNA

DEVARA

MUTTU,NEAR

BINNIYSTEN GARDEN
MAGADI ROAD BANGALORE-23
NIGHTINGALE COLLEGE OF NURSING
2.

GURUVANNA

NAME OF THE INSTITUTE

3.

COURSE OF STUDY AND SUBJECT

4.

DATE OF ADMISSION

DEVARA

MUTTU,NEAR

BINNIYSTEN GARDEN
MAGADI ROAD BANGALORE-23
M.Sc NURSING IN
PSYCHIATRIC NURSING
13-5-2011
A STUDY TO ASSESS THE FACTORS
INFLUENCING SUICIDAL BEHAVIOR AMONG

5.

THE COLLEGE STUDENTS AT BANGALORE,

TITLE OF THE TOPIC

WITH

VIEW

TO

INFORMATIONAL BOOKLET.

DEVELOP

AN

6.

BRIEF RESUME OF INTENDED WORK


INTRODUCTION
Today India has a population of adolescents that is among the largest in the world.
This is the generation, which will shape India's future. One of the most important
commitments a country can make for its future economic, social, and political progress and
stability is to address the health- and development-related needs of its adolescents. 16
The word suicide has its origin in Latin; sui, of one self and caedere, to kill:
the act of intentionally destroying ones life. The phenomenon of suicide has at all times
attracted the attention of moralists, social investigators, philosophers and scientists. The
modern era of the study in suicide began around the turn of the 20 th century, with two main
threads of investigation, the sociological and the psychological, associated with the names
of Emile Durkheim (1858-1917) and Sigmund Freud (1856-1939), respectively. Suicidal
behavior represents a spectrum, ranging from suicidal ideation to suicidal plan to suicidal
attempts to completed suicide. 4
Worldwide, suicide is among the top five causes of mortality in the 15 to 19 year
age group. In many countries it ranks first or second as a cause of death among both boys
and girls in this age group. Suicide prevention among children and adolescents is therefore
a high priority. Given the fact that in many countries and regions most people in this age
group attend school, this appears to be an excellent place to develop appropriate preventive
action. 5
In India ,

rate of 11 per 100000 suicides per year, an increase from 6 per 100000

during the 1980s, India occupies the second highest rate of suicides in the Region. When
corrected for underreporting, these rates are likely to be much higher. While 89000 persons
committed suicide in 1995, the number increased to 96 000 in 1997 and to 104 000 in
1998, an increase of 25% compared to the previous year. During 1988-1998, suicides
increased by a staggering 33.7%. Major variations are noticed across the country, probably
related to reporting practices. Kerala (29 per 100 000), Karnataka (21 per 100 000) and
Tripura as well as West Bengal (19 per 100 000) had the highest rates of suicide. Among
the cities, Bangalore (17%), Mumbai (14%), Chennai (11%) and Delhi (7.5%) accounted
for nearly 50% of the total suicides in the country. 19
Suicidal behaviors are often associated with depression. However, depression by
itself is seldom sufficient. Other co-existing disorders, such as attention deficit
hyperactivity disorder, substance abuse or anxiety can increase the risk of suicide. Recent
4

stressful events can trigger suicidal behavior, particularly in an impulsive youth. Girls may
be more likely to make suicidal attempts, but boys are more likely to make a truly lethal
suicide attempt. 20
Adolescents often will try to support a suicidal friend by themselves. They may feel
bound to secrecy, or feel that adults are not to be trusted. This may delay needed treatment.
If the student does commit suicide, the friends will feel a tremendous burden of guilt and
failure. It is important to make students understand that one must report suicidal statements
to a responsible adult. Ideally, a teenage friend should listen to the suicidal youth in an
empathic way, but then insist on getting the youth immediate adult help.

20

6.1 NEED FOR THE STUDY


Beside physical change, the adolescent are on course for
adulthood. In other word this period is the foundation stone of their
lifestyle. Since 1950s, the incidence of suicide among adolescent and
young adults had nearly tripled. Suicide is now the second leading
cause of death among young people, aged 15-24 years, following the
motor vehicle crashes and homicide.

21

Suicidal behavior is the end result of a complex interaction of psychiatric, social


and familial factors. There are far more suicidal attempts and gestures than actual
completed suicides. One epidemiological study estimated that there were 23 suicidal
gestures and attempts for every completed suicide. However, it is important to pay close
attention to those who make attempts. 10% of those who attempted suicide went on to a
later completed suicide. A suicide has a powerful effect on the individuals family, school
and community. We must deal with it as a public health crisis in our schools, clinics and
doctors offices.20.
The college students whose childhood has been characterized by positive interaction
with a loving and supportive family and community and who has developed a strong sense
of self-worth and self esteem, experiences this period of transition and with some
confusion and self-doubt. Emotions go up and down like the proverbial roller coaster. New
challenges and problems are stressors that must be met with new coping and problem
solving skills. On the other hand, the adolescent whose childhood has been marred by
neglect; emotional, physical and/or sexual abuse or some other types of trauma faces even
greater confusion and self/doubt during this time of profound change. Scars from wounded
childhood can make the adolescent vulnerable to identity problems and suicidal ideation or
5

thoughts about killing one self. 01


Worldwide nearly a million people die by suicide annually. There are estimated 10
to 20 million attempted suicide every year as many as 60,000 people commit suicide in
Russia; approximately 30,000 people die by suicide each year in united states. Over 30,000
kill themselves in Japan and about 2,50,000 commit suicide in China. Teen suicide in the
United States is nearly five times as common among the boys as among girls; suicide is
also common in among young whites than black all ages. Suicide is third leading killer in
young people. The rate of suicide among the youth has tripled in past 30 years. 12
In India it is estimated that over one lakh people die by suicide every year. India
alone contributes more than 10% suicide in the world. In 1999 registering a 78% increase
over value of 1980. The number of Indians committing suicide rise from around 96,000 in
1997 to roughly 1.14 lakh in 2005.The suicide rate has been increasingly steadily and has
reached 11.2(per1, 00,000) till now. Majority of suicides occur among men and younger
group.
In the view of above and from the investigators experience as clinical instructor, he
came across various students who manifested suicidal behavior. Also nowadays suicidal
behavior becomes common in adolescents and number of suicidal cases and suicidal
attempts increasing gradually. Usually action is taken always after the incidents but there is
less attention given towards preventive measures and finding the exact cause to decrease
prevalence of suicidal behavior in adolescent. So investigator felt that study to assess the
factor influencing college students suicidal behavior will help for the prevention of
suicidal behavior among college students.
The current chapter deals with the existing problems, the background of the study
and need for the study.

6.2 REVIEW OF LITERATURE


The review of literature in a research report is a summary of current knowledge
about a particular practice problem and includes what is known and not known about the
problem. The literature is reviewed to summarize knowledge for use in practice or to
provide a basis for conducting a study. 04.
The review of literature is defined as a broad, comprehensive in depth, systematic
and critical review of scholarly publications, unpublished scholarly print materials and
personal communications. 05

The literature is reviewed under the following headings


1. Studies related to prevalence of suicidal behavior.
2. Studies related to factors of suicidal behavior.
3. Studies related to suicide prevention in college students.
4. Studies related to suicide

6.2.1. STUDIES RELATED TO PREVALENCE OF SUICIDAL


BEHAVIOR
A study conducted on prevalence and Correlates of Suicidal
Behavior Among Adolescents. Despite being recognized by the World
Health Organization as a significant social and health concern,
information on suicidal behaviors in adolescents is unknown. Aim of
the study is to establish the prevalence and associated psychosocial
correlates of suicidal ideation and attempts in Nigerian youth.
Stratified sampling was used to identify youth aged 10-17 years who
completed the Diagnostic Predictive Scale (DPS) for youths (suicidal
behavior questions) in a classroom setting. Results of study shows a
total of 1429 youth completed the instruments. Over 20% reported
suicidal ideation and approximately 12% reported that they had
attempted suicide in the last year. Adolescents living in urban areas,
from polygamous or disrupted families, had higher rates of suicidal
behavior. Multiple psychosocial factors such as sexual abuse,
physical attack and involvement in physical fights were significant
predictors of suicidal behavior. 07.
As per the censes of 2001, India has a population of 102.53 cores and Kerala
has a population of 3.18 Crores (i.e., 3.1 % of National Population) But 10.1 % of all the
suicides in India is reported from Kerala. During the period from 1991-2002 population
growth reported in Kerala is 2.2 % but the increase in suicide rate reported is 4.6%. As per
the available statistics of 2002 Kerala has the highest suicidal rate (30.8/Lakh.) among
other states. The National rate is only 11.2/Lakh and the Global rate is14.5/Lakh. The total
number of Suicides reported in Kerala during 2002 is 9810 i.e., 27/day or one suicide per
hour (1/hr). The corresponding ratio of suicide in India is 1/5mts and the Global rate is
1/40sec Kerala is first in the suicide rate for the 7the time. DSH is 8-20 times more than
completed suicide and approximately Nearly 14 persons attempt suicide per hour in our
7

state. Suicide rate in young people is also increasing in Kerala. Family Suicide is also
increasing in Kerala .This has increased from 38 families to 53 families during 1998 to
2000. 16
A cross-sectional study conducted on the prevalence of suicidal behavior and
its epidemiological correlates amongst adolescent students. Study conducted in three
schools and two colleges. A total of 550 adolescent students aged 14 to 19 years selected
by cluster sampling. Statistical Analysis done by Proportions, chi square test, bivariate
logistic regression. Results of study shows about 15.8% reported having thought of
attempting suicide, while 28 (5.1%) had actually attempted suicide, both being more in
females than in males. Statistically significant associations were observed with the age of
the student, living status of parents, working status of mother, and whether the student was
working part-time. The two variables found significant on multivariate analysis were
female gender and the number of role models the student had ever seen smoking or
drinking. The prevalence of suicide-risk behavior was found to be quite high and is a
matter that should evoke public health concern.

13

.
6.2.2. STUDIES

RELATED TO RISK FACTORS OF SUICIDAL

BEHAVIOR.
A study conducted on bullying and risk of suicidal behavior among adolescents.
Total 2341 adolescents aged 13-19 years who were enrolled in grades 9 through 12 in
suburban school was selected for study. Researchers used Beck Depression Inventory to
assess depression and suicide Ideation Questionnaire. Suicide attempt, history included
any attempt, regardless extend of injury. With regard bullying behavior, students were
asked how often they had been bullied or had bullied others in and out of school during the
past 4 weeks. Being bullied was defined as having the student say or do unpleasant thing
or being teased repeatedly in a way the person does not like. Result shows about 20%
student reported that they were victims of bullying in school and about 10% reported that
they were victims of bullying outside the school. With regard to bullying behavior, about
25% students reported that they bullied other students in school and 15% reported that they
were bullied others outside school .The risk of depression, suicidal ideation and suicidal
attempt was significantly higher for students who were considered either a victim or a
bully compared with students who were not. The more frequent the bullying behavior the
greater risk of depression, suicidal ideation or suicidal attempt.08.
A study conducted on rates and factors associated with suicide. The main
outcome measure was death by suicide diagnosed by detailed verbal autopsy and census
8

and birth and death data to identify population base. Result shows the average suicide rate
was 92.1 per 1,00.000. The ratio of male to female suicide was 1:0.66. The age specific
suicide rate for women showed two peaks: 15-24 year and over 65 years of age. Hanging
(49%) and poisoning with organo-phosphorus compound

(40.5%) were commonest

method of suicide. Acute or chronic stress was elicited for nearly all subjects. More men
suffered from chronic stress while more women had acute precipitating events (x2= 4.58;
p<0.04). People less than 44 age had more acute precipitating events before death while
older subjects reported more chronic stress (x2=17.38;p<0.001). Conclusion of study is
there is need for sentinel centers in India and in developing countries to monitor trends and
to develop innovative strategies to reduce death by suicide.09
A case control study conducted on risk factors for completed suicide. A study
conducted with families of 269 completed suicides and 269 living control within the
broader population of city, using psychological autopsy method. Result shows that several
factors in the areas of family, marriage, education, occupation, general health, mental
health and absence of protective factors contribute significantly for suicides. The
significance factor were presence of previous suicidal attempt in self (odds ratio OR =
42.62), interpersonal conflicts and marital disharmony with spouse (O =27.98), alcoholism
in self (OR=23.38), presence of mental illness (OR=11.07), sudden economic bankruptcy
(OR=7.1), domestic violence (OR=6.82) and unemployment (OR= 6.15). Individual
completing suicide did not have a positive outlook towards life, problem solving
approaches and coping scale.15

6.2.3

STUDIES RELATED TO SUICIDE PREVENTION IN

COLLEGE STUDENTS.
A study conducted on suicide prevention in adolescent; a controlled study of the
effectiveness of school based psycho-educational programme. Sample collected from 172
high school students in the 16-18 age group include 108 girls and 64 boys. Method used a
structured self-report questionnaire. The results show that the programme had no effect on
coping styles and level of hopelessness. However positive effect on knowledge could be
identified an interaction effect of the programme with gender on attitude was also found. A
negative impact of programme could not be found. Result indicated effect of gender and
pretest knowledge attitude and coping. Findings from study suggest that psychoeducational programs in schools may influence knowledge about suicide and attitudes
towards suicidal persons but may not affect the use of coping styles or levels of
hopelessness 13
9

A study conducted on the evaluation of the signs of suicide prevention program.


Data collected from 4133 students in 9 schools. Method used self administered
questionnaires completed by students in both groups approximately 3 month after the
program implementation. Result shows significantly lower rates of suicide attempts and
greater knowledge and more adaptive attitude about depression and suicide were observed
in intervention group.14
A case control study conducted on risk factors for completed suicide. A study
conducted with families of 269 completed suicides and 269 living control within the
broader population of city, using psychological autopsy method. Result shows that several
factors in the areas of family, marriage, education, occupation, general health, mental
health and absence of protective factors contribute significantly for suicides. The
significance factor were presence of previous suicidal attempt in self (odds ratio OR =
42.62), interpersonal conflicts and marital disharmony with spouse (O =27.98), alcoholism
in self (OR=23.38), presence of mental illness (OR=11.07), sudden economic bankruptcy
(OR=7.1), domestic violence (OR=6.82) and unemployment (OR= 6.15). Individual
completing suicide did not have a positive outlook towards life, problem solving
approaches and coping scale.15

6.2.4. STUDIES RELATED TO SUICIDE


A comparative study conducted on attitude towards suicide among medical
students using the SUIATT questionnaire. Result show a very restrictive attitude in
Madras, rejecting the right to commit suicide, nearly always judging suicide as a cowardly
act, and rejecting idea of assisted suicide. On the other hand, in Vienna a more permissive
attitude was found. Possible relations to the risk of actual suicidal behavior are discussed
using respective answer concerning previous suicidal ideation and suicide attempt .The
answers concerning suicidal ideation seem to be strongly influenced by the different
attitude patterns: only 16.8% reported previous suicidal ideation in Madras, compared to
51.5% in Vienna, whereas the percentage of reported suicide attempts is equal in both
centers (5.9%: 4.9%). 01
A study conducted on suicidal tendencies and attitude towards freedom to
choose suicide among school children. The sample of school children, aged 11-15yr, wear
surveyed in 1994 (n=5428), 1998 (n=4513) and 2002 (n=5645). Result shows about
suicidal ideation plans or attempts to commit suicide. In the study period of 8 years, the
percentage of adolescent who reported sometime suicidal ideation decreased but the
percentage of adolescent who declared serious suicidal behavior remained on the same
10

high level (8.1%, 9.8% and 8.4% correspondingly in 1994, 1998 and 2002). Moreover, the
number of suicidal attempt changed from 1.0% in 1994 to 1.8% in the year 1998 and to
1.7% in the year 2002. The school childrens attitude towards suicide become more
agreeable: 36.6%, 41.9% and 62.5% of respondent correspondently in 1994, 1998 and
2002, answered that they agree with persons freedom to make a choice between life and
suicide. The study concluded, suicidal tendency are quite frequent among Lithuanian
adolescent.12.
A study conducted on the associations between peer and parental relationships
and suicidal behavior in early adolescents. Survey Method is used for data collection. This
cross sectional sample included 1049 girls and 1041 age 12 to 13 years. Answers obtained
through self- report questionnaires that included measures of peer relationships, parental
nurturance, and parental rejection, suicidal ideation and attempts. Result shows that among
early adolescent boys and girls, depression, poor peer relationships, decrease parental
nurturance and increase parental rejection wear all significantly associated with suicidal
ideation and attempt.02

6.3 STATEMENT OF PROBLEM : A STUDY TO ASSESS THE FACTORS INFLUENCING SUICIDAL BEHAVIOR
AMONG THE COLLEGE STUDENTS AT BANGALORE, WITH A VIEW TO DEVELOP
AN INFORMATIONAL BOOKLET.

6.4 OBJECTIVES OF THE STUDY


1. To assess the factors influencing suicidal behavior among college students.
2. To find the association between factors influencing suicidal behavior with selected
demographic variables.

3. To prepare an informational booklet on preventive measures regarding suicidal


behavior among college students.

6.5 HYPOTHESIS
H1.

There is a significant association of the suicidal behavior with their demographic

variables.

6.6

OPERATIONAL DEFINITION :-

FACTORS
11

Refers to any factors, which cause an adolescents to be vulnerable to suicidal


behavior such as physical abuse, feeling neglected, economic, emotional, family,
academic and social problems.

SUICIDE
Suicide is a type of deliberate self-harm and is defined as a human act of self-intentioned
and self-inflicted cessation. It ends with fatal outcome. Attempted suicide is an
unsuccessful suicidal act with non-fatal outcome

SUICIDAL BEHAVIOR
Refers to any observable, recordable and measurable act, movement or response
in terms of suicide ideation, threat and attempt in adolescents.

COLLEGE STUDENTS
Refers to boys and girls studying in colleges in the age group 18-22 years

INFORMATIONAL BOOKLET
Refers to booklet giving information on meaning, myths, risk factors,
management, and Preventive measures of college students suicidal behavior.

6.7 ASSUMPTIONS
It is assumed that:
1. College students are more prone for suicidal behavior.
2. Demographic as well as personal, social, emotional factors are responsible
for suicidal behavior.
3. There may be relationship between demographic variable and risk factor
contributing to suicidal behavior in adolescent.

6.8 DELIMITATIONS
1. The study is delimited to students who are attending selected college only.
2. Studies are limited to only for 4 weeks
12

6.9 PROJECTED OUTCOME


This helps to assess the factors influencing suicidal behavior among the college
students
Does the study require any investigation to be conducted on patient or other
human or animal:NO

Has the clearance being obtained from institution :-- YES

MATERIALS AND METHODS


7.I. SOURCE OF DATA
College students belonging to the age group 18 22 years from selected colleges in
Bangalore.

7.1.1 RESEARCH DESIGN


Research design is an investigators overall plan for obtaining answers to the research
questions.
For the present study, a descriptive survey design was adopted which was best
suited to assess the factors influencing suicidal behavior among the adolescents with a
view to develop an informational booklet.

7.1.2 SETTING
Selected colleges in banglore

7.1.3 POPULATION
100 college students belonging to the age group 18-22 years from selected colleges
in Bangalore.

7.2 .METHODOLOGY
7.2.1. SAMPLING TECHNIQUE
Purpose random sampling technique
7.2.2 SAMPLE SIZE
100 samples
13

7.2.3 SAMPLING CRITERIA


Sampling criteria is that which specifies the characteristics that the sample in the
population must possess. The following criterion is used in the present study to select
samples.

Inclusion criteria
1. Students belonging to the age group between 18-22 years.
2. Students who are willing to participate in the study.
3. Students who can read write and understand English.

Exclusion criteria
1. Students not willing to participate in the study.
2. Students absent during the study.
3. Student who are not sensitized with similar intervention previously.
7.2.4 TOOLS FOR DATA COLLECTION
a) Socio demographic variables such as Age, gender, religion,occupation of father
and mother ,type of family, history of mental illness etc.
b) Self administered questionnaire.

7.2.5 METHOD OF DATA COLLECTION


The researcher will use appropriate statistical technique for data analysis and present in
the form of table, graphs and diagrams.

PILOT STUDY
10 samples will be selected and study will be conducted to find the feasibility.
Sample will be excluded from main study.

7.2.6 DATA ANALYSIS


The plan for data analysis was as follows;

The data obtained will be analyzed in view of the objectives of the study
using Information booklet

The plan for data analysis was as follows

Frequencies and percentage of distribution will be used to analysis the demographic


14

data

Mean, median, mode standard deviation is used to analyze demographic data

Scores

7.3 HAS THE ETHICALCLEARANE BEEN OBTAINED FROM YOUR


INSTITUTION?
All the subjects will be explained about the purpose ,the objectives & the
procedure of the study.

15

REFERENCES
1. Noreen CF, Lawrence EF. Psychiatric mental health nursing. 1 st ed. United state of
America: Delmar publishers; 1998. p.500.
2. Basavanthappa BT. Nursing research. 2nd edition. New Delhi: Jaypee brothers
3.

medical publishers: 2006.p.148-178


Nancy Burns. Understanding nursing research; second edition, Philadelphia;

samsuders publications; 2002. p. 103-104


4. Brent DA, Perper JA. Prevalence of specific suicidal behavior. American Journal of
Psychiatry 2004;149: 159-165.
5. Joffe RT, Offord DR. Suicidal behavior in youth. American journal of psychiatry
2005; 145:1420-1428.
6. Bhugra Dinesh, Desai Manisha. Attempted suicide in South Asian women. British
Journal of Psychiatry Advances in Psychiatric Treatment.2002;8: 418-423.
7. Dogra Nisha, Olayinka Omigbodun, Oluyomi Esan, Babatunde Adedokun.
Prevalence and Correlates of Suicidal Behavior Among Adolescents in Southwest
Nigeria. International Journal of Social Psychiatry. 2008;54(1): p. 34-46
8.

Wagnar KD. Bullying and risk of suicidal behavior in adolescents. Psychiatric


times. 2007 Jan 01; 24(6): p. 442-46

9. Prasad J, Abraham VJ, Minz S, Joseph A, George K, Jacob KS et al. Rates and
factors associated with suicide in Kaniyambadi block, Tamil Nadu, South India.
International journal of social psychiatry 2006;52(1): p.65-71.
10. Fergusson DM, Horwood LJ, Ridder EM, Beautrias AL. Suicidal behavior in
adolescent and subsequent mental health outcomes in young adulthood. Journal of
Adolescent Health. 2005 Jul; 35(7):983-93
11. L.Vijaykumar E. Etersdorfer, Schony w. Sonneck G. Comparative study on attitude
towards suicide among medical students of Madras (India) and Vienna (Austria).
Social Psychiatry and Psychiatric Epidemiology. 2004 Feb; 33(3).
12. Zemaitiene N, Zaborskis A. Suicidal tendencies and attitude towards freedom to
choose suicide among Lithuanian school children. BMC public health.2005;
(5):83:425-28
13. Gwendolyn P and Kees VH. Suicide prevention in adolescent: a controlled study of
the effectiveness of a school based psycho-educational program in Belgium. Journal
of Child Psychology and Psychiatry 2006 ;( 9): 910-18.
16

14. Robert H, Asetine J, Amy J, Elizabeth A, Jaime J. Evaluating the sign of suicide
prevention program. BMC public health 2007;(7): 161
15. Naik A.S. Pattnaik K. The prevalence of suicidal behavior and its epidemiological
correlates amongst adolescent students in south Delhi. Indian journal of psychiatry
2005; 26 (1): p. 34-38
16. Sarah AF, Laurence YK, Brian JC. The associations between peer and parental
relationships and suicidal behavior in early adolescents. Canadian journal of
psychiatry 2006 Oct; 51(11): 698-703.
17. http://www.indian express.com/2007/8/11/stories/. :Kadam DB, Pandit RD, Bhatt
Ambrish. Suicide in Adolescents and youth. Indian Express Newspapers 2007 Aug
11; [cited on 2007 Nov 04]
18. http://www.pubmed.com. :World health organization. Mental Health and Substance
Abuse, Facts and Figures, Suicide Prevention: Emerging from Darkness. [Online].
1997 [cited 2007 Oct10]
19. http://www.google.com :Kuckian Uday, Iype George. National Crime Records
Bureau. [Online]. 2004 April 15 [cited 2007 Oct10].
20. http://www.pubmed.com :Watkins Carol. Suicide and the School: Recognition and
intervention for suicidal students in the school setting. [Online]. 2003 [cited 2007
Oct10]; Available from: URL:.
21. http://www.ejop.org/archives/2007/08/suicide_ideatio.html :Upadhayay BK. Suicide
ideation and psychopathology among adolescents. Europe journal of psychology.
[serial online] 2006 Aug 13. [cited 2007 Oct10].
22. http://www.afsp.org. :Watkins Carol. Suicide in youth. [serial online] 2005 Apr 12
[cited 2007 Oct 09];
23. http://en.wikipedia.org/wiki/suicide :12OConnor R, Sheeehy NP. Suicide. [Serial
online] [cited 2007 Nov 05]
24. http://www.google.com :National Crime Record Bureau (NCRB) and State Crime
Record Bureau (SCRB). High rate of suicide in Kerala. [Serial online] 2007 [cited
2007 Oct 12] Gururaj
25. http://www.ncbi.nlm.nih.gov/sites/entrez.: G, Isaac MK, Subbakrishna DK, Ranjani
R. Risk factors for completed suicides: a case control study from Bangalore, India.
[Serial online] 2004 Sep [cited on 2007 Sept 9];11(3):183-91.

17

9.

SIGNATURE OF THE CANDIDATE

10

NAME AND DESIGNATION OF

10.1 GUIDE

10.2 SIGNATURE

10.3 CO-GUIDE

10.4 SIGNATURE

10.5 HEAD OF DEPARTMENT

10.6 SIGNATURE
11

11.1 REMARKS OF PRINCIPAL

11.2 SIGNATURE

18