Patients with chronic ailments such as diabetes, or who have undergone major surgery recently, have a 40 per cent chance of dying by suicide as compared to people who are not ill.

These are the findings of various research papers.

The sudden death of patients suffering from chronic ailments or recuperating after major surgery, has a possible mental illness connection, and such patients give signals before they die, say experts.

"If you acknowledge the signals, deaths can be averted," said Dr Adarsh Tripathi, a senior faculty member at the Department of Psychiatry.

He said, "Such patients coming to our OPD are referred by their treating doctors and even brought by their family, in equal proportion, when they are able to sense a mental issue. These patients can be anywhere, around us and even in our houses."

Dr Devashish Shukla, medical superintendent, said, "A majority of those diagnosed with chronic ailments initially ask what the outcome of treatment will be and whether they will survive the treatment or not."

Dr Shukla, who is a qualified psychiatrist and had been a senior consultant at the psychiatry department said, "At least one or two such patients came to the hospital OPD in a week, and I can say that with early intervention, over 90 per cent respond well. Even patients ask about the outcome of the treatment. We identify the reason behind their fear and motivate them for treatment."

Chronic ailments make the person apprehensive about life and finances ahead. There are biological reasons for depression.

Medically, with high sugar, the body releases a cellular toxin that, in the long run, adversely affects the brain along with other vital organs. These toxins cause mental illness, said Dr Tripathi.

Mental disorders have mostly been associated with illnesses causing pain or illnesses that have reported high mortality, for example, cancer. People think now it is the end, despite advances in medical sciences.

Early detection and treatment increase survival rate but in many cases, the toxin used as medicine affects the cells. Patients might also suffer memory loss, he said.

"Among chronic ailments is arthritis. When a patient ignores the disease for long and they lose their ability to move even inside their room due to excessive pain, they often think negatively about life," said Dr Sandeep Kapoor, an eminent joint replacement surgeon.

The second category of reasons that cause mental illness is related to accidents, where the patient suffers a major injury, changing their lives. If they suffer from lower back pain or have to leave the routine they followed before the accident, it has a negative impact.

Dr Adarsh Tripathi said that the first signal a patient with depression gives is a change in behaviour, where they may withdraw from social life or start expressing things in a more emotional manner. They may reduce their involvement in daily life with family or may overreact to things.