Psychopathology of suicide in Bali

Although suicide is one of the major causes of death worldwide, research regarding suicide in developing countries is still lacking. In this chapter, we discuss the psychopathology of suicide in Bali, Indonesia. In the first section, we present research investigating the suicide rate in Bali. An examination of case records from police stations and interviews with police, community leaders, doctors, and victims' families was conducted. This investigation revealed that the annual suicide rate in Bali was 4.6 per 100,000 population in 2006. In the second section, we describe a psychological autopsy study comparing 60 suicide cases and 120 living controls matched for age, sex, and area of residence. This study identified the following risk factors for suicide: at least one diagnosis of an Axis-I mental disorder, low level of religious involvement, and severe interpersonal problems. Overall, 80.0% of the suicide cases were diagnosed with mental disorders; however, only 16.7% had visited a primary care health professional and none had received psychiatric treatment during the 1 month prior to death. These results highlight the importance of early recognition and treatment of mental disorders, religious activities, and interpersonal problem-solving strategies for suicide prevention in Bali.