Suicide rates among young people in southern India are the highest in the world, researchers say.
Researchers focused on young men and women in Tamil Nadu
A study published in the British medical journal The Lancet says family conflicts, domestic violence and mental illness are the most common triggers.
The survey of 10- to 19-year-olds in the region around Vellore found that the average rate for women was 148 per 100,000, and 58 per 100,000 for men.
The average suicide rate worldwide is 14.5 per 100,000.
Globally, rates for men are three times higher than those for women.
'Major public health problem'
The report, due to be published on Friday, was written by researchers at the Christian Medical College and Hospital in Vellore, Tamil Nadu, in southern India.
They say the high rates emphasise the need to treat adolescent suicide as a major public health problem requiring urgent intervention.
They found that suicide accounts for half to three-quarters of all deaths in young women, and a quarter of deaths of young men in the region.
Hanging and poisoning with pesticides were the most common causes of death.
Despite the small sample of people studied, researcher Dr Anuradha Bose says the figures are representative of rates throughout India.
"Reported rates of suicide in other parts of India are low because identification of suicides is difficult, owing to inefficient civil registration systems, non-reporting deaths, variable standards in certifying deaths, and the legal and social consequences of suicide," he says.
"We do not believe that our findings are an aberration," he adds.
Experts believe suicide is under-reported throughout the developing world.
"There is a very major trend here " Dr Jose Bertolote of the World Health Organisation told the Associated Press.
In commentary on the research in the journal, Wun Jung Kim and Tanvir Singh of the Medical College of Ohio say higher suicide rates among girls have also been reported in China and Singapore.
Socio-cultural, economic and political upheaval could be a contributing factor, they suggest.
"One can surmise that intergenerational and gender conflicts are more intense in a traditional agricultural society transforming into an egalitarian industrial society than in stable developed countries."