Abstract

Background: Suicide and suicide attempts represent significant global public health concerns, particularly in developing countries like India. Stressful life events (SLEs) are recognized as critical risk factors for suicidal behavior (SB), yet limited research in India has directly compared the impact of SLEs between completed suicides and suicide attempts. Objectives: This study aimed to examine the role and comparative impact of SLEs in individuals who died by suicide versus those who attempted suicide in Khammam, Telangana. Methods: A cross-sectional study was conducted at the Government General Hospital, Khammam, from 2024 to 2025. Out of 624 individuals with documented SB, 186 participants were randomly selected 154 with suicide attempts and 32 with completed suicides. Data on socio-demographics and SLEs were collected via hospital records, structured interviews, and a culturally adapted Life Events Questionnaire. Statistical analyses, including logistic regression, were conducted to identify predictors of suicide. Results: Completed suicides were predominantly male (71.9%) and in the 26–40-year age group, whereas suicide attempts were more common in younger individuals (10–25 years) and females. The mean SLE score was significantly higher in suicides (552 ± 23.75) than in attempts (447 ± 27.06; p=0.001). Financial problems (OR=11.9), early marriage (OR=4.97), and family conflicts (OR=2.53) were the strongest predictors of completed suicide. Higher income, self-employment, and exposure to new environments also independently increased suicide risk. Conclusion: SLEs are strongly associated with increased suicide risk, particularly financial distress, early marriage, and family conflicts. Targeted interventions addressing these stressors, alongside socio-cultural factors, are imperative for suicide prevention strategies in rural and semi-urban Indian settings.

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