Indian contribution to suicide research during 2005–2014: A scientometric assessment using publications and citation data

Address for the Correspondence: Dr. B.M. Gupta, National Institute of Science Technology and Development Studies, New Delhi ‐ 110 012, India. E‐mail: bmgupta1@gmail.com This paper analyzes 1078 India’s publications on suicide research during 10 years, i.e., 2005–2014, as indexed in Scopus International Multidisciplinary Database. The study focuses on the various aspects of performance of India’s suicide research, such as the publication growth, citation impact, international collaboration, subject-wise distribution of publications, contribution and citation impact of Indian organizations and authors, medium of communication, and characteristics of its high-cited papers. This study reveals that India’s research output on suicides research witnessed an annual average growth rate of 10.49%, registered an average citation impact per paper of 9.75, and a share of 16.23% of international collaborative publications. India’s global publication and share to world suicide research was 2.47% during 1999–2014. Medicine contributed the largest publication share of 84.32%, followed by pharmacology, toxicology, and pharmaceutics and social sciences (19.94%), environment science (9.37%), biochemistry, genetics and molecular biology (8.35% share), psychology (7.05% share), neuroscience (4.36% share), economics, econometrics, and finance (2.23% share), and immunology and microbiology (1.95% share) during 2005–2014. About 294 organizations and 356 authors participated in 1078 Indian papers in suicide research, of which the top 15 most productive Indian organizations and authors together contributed 36.18% and 17.44% publications share and 49.58% and 56.06% citation share to the India’s publications and citation output on suicide research during 2005–2014. This study also suggests the need for taking up of measures at population, sub-population, and individual levels to prevent suicide and suicide attempts. Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society.


INTRODUCTION
Suicide is defined as the deliberate termination of life.The essential ingredients of a suicide are: (i) It should be an un-natural death, (ii) the desire to die should originate within him/her; and (iii) there should be some reason for ending life. [1]Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based, and often low-cost interventions.In high-income countries, the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established, however many suicides happen impulsively in the moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up,

Indian contribution to suicide research during 2005-2014: A scientometric assessment using publications and citation data
Gupta, et al.: India's contribution to suicide research or chronic pain and illness.Stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and are therefore not getting the help they need.In addition, other significant reasons such as experiencing conflict, disaster, violence, abuse, or loss, and a sense of isolation are strongly associated with suicidal behavior.Ingestion of pesticide, hanging, and firearms are among the most common methods of suicide globally.Around 30% of global suicides are estimated due to pesticide self-poisoning, most of which occur in rural agricultural areas in low-and middle-income countries.Other common methods of suicide are hanging and firearms.Suicide rates are also high among vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, intersex persons, and prisoners.By far, the strongest risk factor for suicide is a previous suicide attempt. [2,3]icide is a global phenomenon and occurs all over the world in all regions, including high-, middle-, and low-income countries, but 75% of global suicides occurred in low-and middle-income countries in 2012.More than 800,000 people die due to suicide every year around one person every 40 s, and for every suicide, there are many more people who attempt suicide every year.Suicides can take place at almost any age; however, suicide rates are highest in people aged 70 years and among 15-29 year-old globally.Suicides are the second leading cause of death in 15-29 year-old globally in 2012. [2,3]In high-income countries, three times as many men die by suicide than women; however, in low-and middle-income countries, young adults and elderly women have higher rates of suicide than their counterparts in high-income countries.
In the WHO South-East Asian region, the estimated suicide rate is the highest as compared to other WHO regions.Suicide rates show a peak among the young and among the elderly.Most suicides in the world occur in the South-East Asian region (39% of those in lowand middle-income countries in South-East Asia alone) with India accounting for the highest estimated number of suicides overall in 2012. [2,3]The number of suicide deaths reported in India has been constantly increasing over the years in India.The number of suicide deaths in India has increased from 38,829 in 1967 to 104,713 in 1998 and to 134799 in 2014.Among the geographical states, the maximum suicides were reported in Maharashtra (16,304), Tamil Nadu (16,122), and West Bengal (14,310), constituting 12.4%, 12.2%, and 10.9%, share respectively of the total suicides in India in 2014.Among 53 mega cities of India, Chennai (2214 cases), Bangalore (1906 cases), Delhi (1847 cases) together have reported almost 37% of the total suicides in India in 2014.The suicide death rates (number of suicides per lakh of population) in cities (12.2) were higher as compared to all-India suicide rate (10.6) in 2014.The overall male:female ratio of suicides victims for 2014 was 68:32.Hanging (41.8%), consuming poison (26.0%), self-immolation (6.9%), and drowning (5.6%) were the prominent means of committing suicides in 2014.Family problems (other than marriage-related problems) (21.7%) and illness (18.0%) have together reported around 37% of the total suicides in 2014.Other family problems (1586), failure in examinations (1284), and illness (1105) were the main causes of suicides among children's below 18 years of age.Bankruptcy and indebtedness happen to be the major causes of suicide by farmers in India. [1,4]

Literature review
Vogelzang et al. [5] analyzed the publications trends in depression and suicide during 1900-2007, using scientometric methods and density-equalizing techniques.The study focused on different aspects such as growth of publications, distribution of publications by countries, authors, and journals.The published papers were also correlated with gross domestic product and purchasing power parity.Cardinal [6] quantified certain characteristics of publications covered in a serial "Suicide and Life-Threatening Behavior" during 1971-1975, 1984-1988, and 1997-2001.The characteristics studied include geographic origin of articles, number of authors per article, number of references listed per article, and number of times an article is cited in the literature.Changes across the three periods in terms of distribution of subjects/participants by age group and gender are also examined.Goldblatt et al. [7] examined all publications covered in three suicide-related journals, namely Crisis: The Journal of Crisis Intervention and Suicide Prevention, Archives of Suicide Research, and Suicide and Life-Threatening Behavior during 2006-2010, and categorized each paper by subject.They found that the journals were similar with respect to subject allocation.Most papers dealt with epidemiological issues (32.7-40.1%);prevention (5.8-15.3%)and research (8.3-10.6%)were the next best represented subjects.Clinical papers comprised from 2.8% to 8.2% of the studies published.English-language suicide journals publish a preponderance of epidemiological studies.Clinical studies are relatively underrepresented.

OBJECTIVES
This study makes a quantitative assessment of India's publications on suicides, as indexed in Scopus international database during 2005-2014.In particular, the study focuses on the following objectives:

METHODOLOGY
The publications of top 10 most productive countries on suicides were sourced using a set of significant keywords from Scopus International Bibliographical Database (http://www.scopus.com) covering 10 years period from 2005 to 2014.The significant keyword "suicide" were used in "Title, Abstract, and Keyword" tag and restricting the hits to the period 2005-2014 in "date range tag" for searching and retrieving global publications on suicides.This statement became our main search string.The main search string was further restricted to individual 10 countries in "country tag" for obtaining publications data of these countries (as shown below).On further restricting the India's search string to "subject area tag," "country tag," "source title tag," "journal title name" and "affiliation tag," statistics on distribution of publications by subject, collaborating countries, organization, and author-wise and journal-wise, etc., were obtained.Citation data were obtained from the date of publications till October 2015.

Global publication output and share of top 10 most productive countries
The

Significant keywords
About 40 significant keywords have been identified in the Indian suicide research output, which throw light on the nature of research as the causes and factors leading to suicides in India.The largest number of papers (631) was found on keyword suicide, followed by intoxication (209), psychosis autopsy (183), depression anxiety (159), poisoning (136), hanging (110), etc., [Table 6].

Contribution and citation impact of top 15 most productive organizations
In

Contribution and citation impact of top 15 most productive authors
In    The prevention of suicide has not been adequately addressed in India due to a lack of awareness of suicide as a major public health problem and the taboo of societies to openly discuss it.To date, only a few countries have included suicide prevention among their health priorities and only 28 countries report having national suicide prevention strategy.Raising community awareness and breaking down the taboo is important for countries to make progress in preventing suicide.Knowledge of the most commonly used suicide methods is important to devise prevention strategies in India which have shown to be effective, such as restriction of access to means of suicide.Suicides are preventable.There are a number of measures that can be taken at population, sub-population, and individual levels to prevent suicide and suicide attempts.These includes educating access to the means of suicide (e.g., pesticides, firearms, and certain medications), reporting by media in a responsible way, introducing alcohol policies to reduce the harmful use of alcohol,    training of nonspecialized health workers in the assessment and management of suicidal behavior, and follow-up care for people who attempted suicide and provision of community support.Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labor, agriculture, business, justice, law, defense, politics, and the media.These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide.

Financial support and sponsorship
Nil.

TP=
Total publications, TC = Total citations, ACPP = Average citation per paper, ICP = International collaborative publications, HI = H-index Gupta, et al.: India's contribution to suicide research early identification, treatment, and care of people with mental and substance use disorders, chronic pain and acute emotional distress,

Table 7 : Scientometric profile of top 15 most productive organizations in suicide research in India during 2005-2014
TP = Total publications, TC = Total citations, ACPP = Average citation per paper, ICP = International collaborative publications, HI = H-index