Article

Specific characteristics of suicide in China

March 2001
Acta Psychiatrica Scandinavica 103(2):117-21

DOI:10.1034/j.1600-0447.2001.00008.x

Source
PubMed

Authors:

Ping Qin

University of Oslo

Per Brøbech

Rigshospitalet

The aims of this paper are (i) to describe the specific characteristics of suicide in China and compare it with that in a western country, Denmark: and (ii) to discuss the accuracy of suicide data and the possible explanations for suicide behaviour in China. Data for the study are obtained from the World Health Statistics Annual based on official records in China and the Danish Cause-of-Death Register, and standardized according to the age-specified population of China in 1990. The specific characteristics of suicide in China differed strikingly from the general pattern of suicide in other western countries as well as in Denmark: suicide rates in females were higher than in males; rural rates were more than three times higher than urban rates; suicide rates peaked for those aged 75 + years, but with a minor peak in females for those aged 15-24 years old. These specific characteristics of suicide in China may possibly be interpreted in terms of traditional culture, social forces, political environment and economic status.

Behavior Characteristics and Risk Factors for Suicide Among the Elderly in Rural China

Article

Aug 2017

We examine the characteristics of suicide behavior and associated risk factors in the elderly in rural China, compared with the nonelderly. Paired case-control design and psychological autopsy were used for subject recruitment and data collection. The included cases were 104 suicides of the elderly aged 60 years or older, 86 suicides of the nonelderly, and sex- and age-paired controls from the same villages. Although the characteristics of suicide behavior were similar between the two age groups of victims, the elderly who died by suicide had a greater tendency to experience negative life events and not live with a spouse. Suicide of the nonelderly was associated with family history of suicide, poor social support, and impulsivity. The influence of negative life events on the risk of suicide was greater in the elderly. Thus, efforts for suicide prevention must be tailored to the needs of specific age groups.

Relationship between suicide rate and economic growth and stock market in the People’s Republic of China: 2004–2013

Article

Full-text available

Dec 2016

Objectives The objective of this study was to estimate the features of suicide rate and its association with economic development and stock market during the past decade in the People’s Republic of China. Methods Official data were gathered and analyzed in the People’s Republic of China during the period 2004–2013. Nationwide suicide rate was stratified by four year age-groups, sex, urban/rural areas, and regions (East, Central, and West). Annual economic indexes including gross domestic product (GDP) per capita and rural and urban income per capita were all adjusted for inflation. Variation coefficient of market index (VCMI) was also included as an economic index to measure the fluctuation of the stock market. Negative binomial regression was performed to examine the time trend of region-level suicide rates and effects of sex, age, urban/rural area, region, and economic index on the suicide rates. Results Suicide rates of each age-group, sex, urban/rural area, and region were generally decreased from 2004 to 2013, while annual GDP per capita and rural and urban income per capita were generally increased by year. VCMI fluctuated largely, which peaked around 2009 and decreased after that time. Negative binomial regression showed that the decreased suicide rate in East and Central rural areas was the main cause of the decrease in suicide rate in the People’s Republic of China. Suicide rate in the People’s Republic of China for the study period increased with age and was higher in rural than in urban area, higher in males than in females, and the highest in the Central region. When GDP per capita increased by 2,787 RMB, the suicide rate decreased by 0.498 times. VCMI showed no significant relationship with suicide rate in the negative binomial regression. Conclusion Suicide rate decreased in 2004–2013; varied among different age-groups, sex, urban/rural areas, and regions; and was negatively associated with the economic growth in the People’s Republic of China. Stock market showed no relationship with suicide rate, but this finding needs to be verified in a future study.

Suicide in China: The Trends and Differentials From 2002 to 2021

Article

Full-text available

Sep 2024
CLIN PSYCHOL PSYCHOT

Objective The objective of this study was to provide an updated analysis of suicide characteristics in China from 2002 to 2021, with the aim of informing the development of evidence‐based suicide prevention strategies. Methods The Ministry of Health‐Vital Registration System (MOH‐VR) provided the data on suicide mortality, which enabled us to examine the average annual percentage change (AAPC) in suicide rates using a Poisson regression model. Results Notably, there has been a significant decline in suicide rates observed in both urban and rural areas. In the early years of the study period, higher suicide rates were observed among females compared to males; however, a shift occurred after 2005, with male suicide rates surpassing those of females. Except for 2005, rural areas consistently exhibited higher suicide rates than urban areas. Furthermore, suicide rates exhibited an increasing trend with age, irrespective of gender or region. Conclusion These findings highlight a decreasing trend in suicide rates in China over the past two decades, although gender and regional disparities persist. Going forward, sustained efforts in suicide prevention, with a specific focus on mental health, are warranted.

Meaning in life as a protective factor against suicidal tendencies in Chinese University students

Article

Full-text available

Feb 2020
BMC PSYCHIATRY

Background: A substantial increase in rates of suicide worldwide, especially among late adolescents and young adults, has been observed. It is important to identify specific risk and protective factors for suicide-related behaviors among late adolescents and young adults. Identifying specific factors across the masses, not only in the Western, but also in the Asian context, helps researchers develop empirically informed intervention methods for the management of protective and risk factors of suicide. Methods: In the current study, 2074 students (706 males), filled out the Meaning in Life Questionnaire, with subscales of Search for Meaning (MLQ-S) and Presence of Meaning (MLQ-P); the Future Disposition Inventory-24 (FDI-24), with subscales of Positive Focus (PF), Suicide Orientation (SO), and Negative Focus (NF); and the Beck Hopelessness Scale (BHS). These scales measure protective and risk factors that are linked to suicidal behaviors; while suicidal behaviors were measured by the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Mediation analyses were performed to test the models with both the MLQ-S and MLQ-P as the mediators between a) hopelessness, as measured by BHS and suicidal behaviors; and b) PF, SO, and NF, as measured by FDI-24, and suicidal behaviors. Results: We found that only MLQ-P mediated the relation between hopelessness and suicidal behaviors; while both MLQ-P and MLQ-S mediated PF, SO, and NF (as measured by FDI-24), and suicidal behaviors, respectively. Conclusion: Meaning in life, including both the presence of meaning in life and search for meaning, can be good protective factors against suicidal behaviors.

Association between body mass index and suicidal ideation among seniors in Shandong, China

Article

Feb 2018

Background: Recently, an emerging group of studies has reported the association between Body Mass Index (BMI) and suicidal ideation in the Western countries. However, this relationship is still unclear with controversial results, and we have little knowledge about this relationship in China which is one of few countries reported higher suicide rates. Methods: This study aims to analyze the association between BMI and suicidal ideation among seniors (≥60 years old) in Shandong, China. A total of 3313 seniors were included in the data analysis. Suicidal ideation, weight, height, socio-demographic and psychological variables were evaluated in this study. Logistic regression was conducted to explore the association between BMI and suicidal ideation among male and female seniors. Results: The results showed that 4.2% of the seniors reported suicidal ideation, and 3.4% for men, 4.9% for women. After controlling social-demographic variables, economic status, physical disease, social support and mental health, an inverse relationship between BMI and suicidal ideation was found for men, but not for women. Mental health was still an important factor associated with suicidal ideation. Conclusion: The results inform health care professors that underweight in male seniors can be associated with higher risk of suicidal ideation in China.

Exploring Speech Acts in Suicide Notes from the Forensic Linguistics Approach: A Comparative Study of Chinese and American Cases

Article

Oct 2024

Shuying Liu

Suicide notes are the information left by people who commit suicide. In these notes, people employ various speech strategies to express their emotion and will. The strategies and content in suicide note vary with culture. Using the Linguistic Inquiry and Word Count (LIWC) and Chinese LIWC (CLIWC) programs, this study looks at the speech actions in suicide notes as well as the linguistic and affective traits of suicide notes from Chinese and American individuals. The results show that while expressive acts and social words are more prevalent in American notes, suggesting stronger social connectivity, forceful acts predominate in all countries. Chinese suicide notes, on the other hand, show more directed actions and a greater frequency of both good and negative feelings in these actions. Despite the study’s limitations due to the small sample size, it provides valuable insights into the cultural differences in the language of suicide and suggests directions for future research, including larger-scale analyses and the development of AI-driven tools for suicide prevention.

CiteSpace-based Survey of International Advances in Chinese Traditional Culture Research in 1999-2019

Article

Full-text available

Oct 2024

With the globalization strategy and the initiative “One Belt and One Road” in China, Chinese traditional culture has a great impact on the world. This study, based on CiteSpace, explores the total numbers, hotspots, characteristics and tendency of international research on Chinese traditional culture, by retrieving 866 articles from SSCI and A&HCI in the Web of Science (Core Collection). The results of the study revealed that: there is a strong increases in total output from 1999 to 2019 and the research on the theme of Chinese traditional culture has become interdisciplinary; the most productive authors aren’t the ones in the most cited documents and the journals on which the most cited documents publish aren’t the prolific journals; most of the researchers are from Hong Kong, Taiwan, mainland of China, Canada and USA. In view of the results, it is obvious that it is a good way to spread Chinese traditional culture over the world. It is strongly recommended that we should do more analysis on the international literatures with different paradigms, methods and metrics in order to get a more comprehensive and correct domain visualization map of Chinese traditional culture research.

Associations between meaning in life and suicidal ideation in young people: A systematic review and meta-analysis

Article

Jan 2024
CHILD YOUTH SERV REV

Suicidal ideation is a strong predictor of suicide among young people and is an outcome of interactions between protective and risk factors. Previous studies have focused primarily on risk factors while there is little evidence on important protective factors such as meaning in life. We conducted a systematic review and meta-analysis to examine the association between meaning in life and suicidal ideation among young people, and to explore potential moderating effects including demographics (gender and age) and social factors (economy and culture). We searched EBSCO, Embase, PsycINFO, PubMed, Scopus and Web of Science for relevant studies that reported correlations between meaning in life and suicidal ideation from their inception to October 2022. Studies were included in this review if they were empirical studies, written in English and sampled general young people aged 10-24. We employed a random-effects model meta-analysis to estimate the effect size. We identified 3168 references after removing duplicates and 11 studies (of 18 samples) were included in the review and meta-analysis. The meta-analysis revealed a moderate negative correlation between meaning in life and suicidal ideation (r = -0.51, 95％CI [-0.57, -0.45]) in young people. In addition, the correlation between meaning in life and suicidal ideation was stronger in high-income (r = -0.51, 95％CI [-0.54, -0.48]) and individualist countries (r = -0.51, 95％CI [-0.53, -0.48]) compared with upper-middle-income (r = -0.39, 95％CI [-0.41, -0.37]) and collectivist countries (r = -0.40, 95％CI [-0.41, -0.38]), respectively, but comparable across gender and age. We identified strong negative associations between meaning in life and suicide ideation in high-income and individualist countries. This highlights that approaches targeting enhancing meaning in life should be considered in suicide prevention and intervention, especially in high-income and individualist countries.

The Association Between Relative Deprivation, Depression, and Youth Suicide: Evidence From a Psychological Autopsy Study

Article

Full-text available

Jul 2023
OMEGA-J DEATH DYING

Objective: Suicide is a serious public health concern in China. In the present study, we investigated the specific mechanisms underlying relative deprivation and suicide in rural China. Methods: A large psychological autopsy study was conducted in rural China, in which 392 suicides and 416 community-living controls were consecutively recruited. Multiple logistic regression analysis was used to assess the relationship between relative deprivation and suicide, with depression as a potential mediator. Results: Young people who experienced relative deprivation were at a greater risk of suicide and depression. Depression plays a mediating role in the relationship between relative deprivation and suicide. Limitations: Due to the limitations of the data, we cannot know whether there is mutual causation between relative deprivation and depression. The self-reported relative deprivation may also produce some influence on the results. Conclusions: The current findings demonstrate the importance of relative deprivation as one of the four sources of psychological strain to explain how relative status is associated with suicide. The findings also can be translated into the clinical and preventive practice for suicide.

The Execution of Psychological Autopsy to Manoeuvre Cryptic or Suicide Deaths Inquests; a Disquisition of Psychological Autopsy Praxis in Reference to the Indian Terrain

Article

Full-text available

Feb 2023

Purpose: One of the biggest issues with population health is suicide. It is an example of a self-catastrophe act brought on by a disaster that is frequently not adequately acknowledged by family, acquaintances, or the clinical community. Both sexes as well as all age groups are affected. The literature on Indian "psychological autopsy" (P.A) has not yet been the subject of any reviews. A PA procedure's core component, interview instructions, is similarly in short supply. So, the very purpose f this paper is to suggest or identify a psychological autopsy method that can fit into Indian terrain. Objective: The primary objective of this particular paper is to analyze various journal publications which deal with psychological autopsy and various novel findings from different suicide cases. Especially in India, the rate of psychological autopsy or equivocal death analysis is very low and society is not very clear about the basic use, concepts, and basic procedures of the psychological autopsy. So in this scenario, providing some basic understanding of psychological autopsy is one of the main objectives of this paper. Design/Methodology/Approach: From the beginning until June 2022, electronic searches of the pertinent topic were made using the database systems of PubMed, PsycINFO, Academia, Researchgate, and Google Scholar to find pertinent English or any other languages that had been translated into English language-reviewed articles from India as well as international writings that provided information on best practice elements in PA. Detailed checks were made to ensure that the provided summaries were legitimate. Following the retrieval of important data utilizing such a pre-configured prospectus, a semi-structured discussion outline was produced. The findings of investigations conducted both domestically and abroad on the subject matter have been carefully as well as scientifically compiled. Every scientific journal article finding received a rigorous, systematic, and scientific examination in order to increase the scientific soundness, reliability, as well as accuracy of this document. We gathered the opinions of several knowledgeable professionals in order to boost the originality and dependability of this article. Findings/Result: In order to describe the PA method, several genuine publications, including clinical studies, as well as several clinical reviews/expert comment writings were discovered in India. To evaluate threat elements related to suicidal behavior, the majority of research conducted in India focuses on suicide PA (SPA). The documented proportions of mental illness among suicide-direct descendants varied widely, and potentially distressing circumstances were the other important threat component for suicidal thoughts in the Indian context. The optimum time to tackle PA is presumably between five and a half years following the event when facts may be methodically gathered from selected respondents and certain other resources utilizing a narrative interviewing style, coupled with psychometric evaluations. Originality and Value: The components of physical autopsy analytical methods and psychological autopsy analytical methods were combined in a creative and comprehensive effort. It is hypothesized that a more accurate and scientific way of identifying a particular suicide case can be achieved by combining the two different clinical system dimensions. For reliable results, physicians should combine psychological autopsy data with information from physical autopsies and forensic chemical tests. Paper Type: Clinical analysis paper

Carbon Monoxide Poisoning was Associated With Lifetime Suicidal Ideation: Evidence From A Population-Based Cross-Sectional Study in Hebei Province, China

Article

Full-text available

Jun 2022
INT J PUBLIC HEALTH

Objectives: We want to test the association between carbon monoxide poisoning (CMP) experiencing and lifetime suicidal ideation/suicide plan among community residents. Methods: This is a population-based cross-sectional study conducted among community residents in Hebei province, China. We analyzed a total of 21,376 valid questionnaires. CMP experience and lifetime suicidal ideation/suicide plan were assessed in this study. Logistic regression and false discovery rate correction were conducted to analyze the associations and correct the p values. Results: We found that CMP (OR = 2.56, p < 0.001, corrected-p = 0.001) was associated with lifetime suicidal ideation, and the other risk factors were female ( OR = 0.53, p < 0.001, corrected-p = 0.001). The association between CMP and suicide plan was not supported after false discovery rate correction ( OR = 2.15, p = 0.035, corrected- p = 0.385). For the CMP patients, experiencing ≥2 times CMP ( OR = 2.76, p = 0.001, corrected-p = 0.011) was also in higher risk of lifetime suicidal ideation. The association between CMP times and lifetime suicidal plan was not supported after false discovery rate correction ( OR = 4.95, p = 0.021, corrected- p = 0.231). Conclusion: CMP patients are in higher risk of lifetime suicidal ideation. For CMP patients, some strategies are needed to control their suicidal ideation.

Risk Assessment on Suicide Death and Attempt among Chinese Rural Youths Aged 15–34 Years

Article

Full-text available

Dec 2021
Int J Environ Res Publ Health

Background: Although many suicide risk assessment tools are available in the world, their validity is not adequately assessed. In this study, we aimed to develop and evaluate a suicide risk assessment model among Chinese rural youths aged 15–34 years. Method: Subjects were 373 suicide deaths and 507 suicide attempters aged 15–34 years in three Chinese provinces (Shandong, Liaoning, and Hunan). Information about the community residents was also collected as the control groups. Social-demographic, social and psychological variables were examined for the suicides, suicide attempters, and community residents. Logistic regressions based on subjects from Shandong and Liaoning provinces were conducted to establish the suicide risk assessment models. Receiver operating characteristic (ROC) curves were drawn, and area under the ROC curves (AUC) were calculated to show how well the models separated the group being tested into those with and without suicide attempt or suicide. Results: The assessment model for suicide death included education years (OR = 0.773, p < 0.001), agricultural worker (OR = 2.091, p < 0.05), physical health (OR = 0.445, p < 0.05), family suicide history (OR = 6.858, p < 0.001), negative life events (OR = 1.340, p < 0.001), hopelessness (OR = 1.171, p < 0.001), impulsivity (OR = 1.151, p < 0.001), and mental disorder (OR = 8.384, p < 0.001). All these factors were also supported in the assessment model for suicide attempt, with an extension of very poor economic status (OR = 1.941, p < 0.01) and social interaction (OR = 0.855, p < 0.001). The AUC was 0.950 and 0.857 for the sample used to establish the assessment models of suicide death and attempt, respectively. The AUC was 0.967 and 0.942 for the sample used to verify the established assessment models of suicide death and attempt, respectively. Conclusions: Compared with some other assessment tools, the models for suicide death and attempt in the current study performed well among Chinese rural youths aged 15–34 years. A reliable suicide risk assessment approach, which includes multiple risk factors, should be evaluated in various cultures and populations.

Socio-economic determinants of suicide rates in transforming China: A spatial-temporal analysis from 1990 to 2015

Article

Full-text available

Feb 2022

Background China has experienced dramatic social changes in the last three decades. This study aimed to investigate socio-economic factors related to suicide rates in China from 1990 to 2015, and examine how the impacts of these factors on suicide rates changed over time. Methods Suicide rates in 31 provinces in mainland China between 1990 and 2015 were obtained from the Global Burden of Disease (GBD) Study 2019. Temporal-spatial modelling was applied to assess the effects of GDP per capita, urbanization, migration, employment, divorce, proportions of children and older adults on provincial overall, male and female suicide rates. Findings The overall suicide rate in China declined from 18·1 /100,000 in 1990 to 8·6 /100,000 in 2015, with considerable spatial variation in the magnitude of decline across provinces. The protective effects of increasing in GDP per capita, and urbanization, on provincial suicide rate were strong in 1990 (log GDP: -3·56 [95% CI: -6·15, -0·96], urbanisation: -0·07 [-0·14, -0·01]), however these effects were negligible by 2015. The association between employment and suicide rates has shifted from positive to negative over the study period, while migration remained a constant risk factor for high suicide rates (0·04 [0.00, 0·09]). Interpretation This study highlighted the dynamic effects of economic and social factors on suicide rates in the context of transforming China. To maintain further reductions in suicide rates cannot rely simply on improving people's materialistic and economic conditions. A more holistic approach to improve overall population well-being is needed. Funding Humanities and Social Sciences Prestigious Fellowship (37000320) and the General Research Fund (17611619) at the University of Hong Kong.

Assessing Suicide Reporting in Top Newspaper Social Media Accounts in China: Content Analysis Study

Article

Full-text available

May 2021

Background Previous studies have shown that suicide reporting in mainstream media has a significant impact on suicidal behaviors (eg, irresponsible suicide reporting can trigger imitative suicide). Traditional mainstream media are increasingly using social media platforms to disseminate information on public-related topics, including health. However, there is little empirical research on how mainstream media portrays suicide on social media platforms and the quality of their coverage. Objective This study aims to explore the characteristics and quality of suicide reporting by mainstream publishers via social media in China. Methods Via the application programming interface of the social media accounts of the top 10 Chinese mainstream publishers (eg, People’s Daily and Beijing News), we obtained 2366 social media posts reporting suicide. This study conducted content analysis to demonstrate the characteristics and quality of the suicide reporting. According to the World Health Organization (WHO) guidelines, we assessed the quality of suicide reporting by indicators of harmful information and helpful information. Results Chinese mainstream publishers most frequently reported on suicides stated to be associated with conflict on their social media (eg, 24.47% [446/1823] of family conflicts and 16.18% [295/1823] of emotional frustration). Compared with the suicides of youth (730/1446, 50.48%) and urban populations (1454/1588, 91.56%), social media underreported suicides in older adults (118/1446, 8.16%) and rural residents (134/1588, 8.44%). Harmful reporting practices were common (eg, 54.61% [1292/2366] of the reports contained suicide-related words in the headline and 49.54% [1172/2366] disclosed images of people who died by suicide). Helpful reporting practices were very limited (eg, 0.08% [2/2366] of reports provided direct information about support programs). Conclusions The suicide reporting of mainstream publishers on social media in China broadly had low adherence to the WHO guidelines. Considering the tremendous information dissemination power of social media platforms, we suggest developing national suicide reporting guidelines that apply to social media. By effectively playing their separate roles, we believe that social media practitioners, health institutions, social organizations, and the general public can endeavor to promote responsible suicide reporting in the Chinese social media environment.

A comparison between American and Chinese college students on suicide-related behavior parameters

Article

Full-text available

May 2020
INT J CLIN HLTH PSYC

Background/Objective The United States (US) and China are the two largest economies, but recent and directly comparable studies on suicide-related behaviors in the two countries are lacking. By using the Suicidal Behaviors Questionnaire-Revised (SBQ-R), item-level comparison was performed in assessing self-reported suicide-related behaviors between the US and Chinese undergraduates. Method This study involved a total of 3,185 college students aged between 18 to 24 years (1,185 US college students, and 2,000 Chinese students who were randomly selected from a large sample of 11,806 Chinese college students). Participants filled out the 4-item SBQ-R. Results Participants’ responses were compared by country and sex. There was a higher overall risk of suicide-related behaviors among US students (24.3%) compared to Chinese students (17.0%). US students also reported higher lifetime attempt, past-year ideation, and lifetime threat. US female college students reported the highest suicide-related behaviors compared to other sub-groups. Conclusions There is a need to tailor specific interventions to alleviate college students’ suicide-related behaviors in the US and China, with a particular focus on US females.

Association between interpersonal trust and suicidal ideation in older adults: A cross-sectional analysis of 7070 subjects in Shandong, China

Article

Full-text available

Jul 2019
BMC PSYCHIATRY

Backgrounds: Suicidal ideation is an important public health issue due to devastating mortality. In the meantime, interpersonal trust was found to be negatively associated with mental disorder and physical health. Although there is increasing evidence that interpersonal trust is a significant predictor of suicidal ideation, evidence of this association is still lacking in the developing world. The aim of this study was to test the association between interpersonal trust and suicidal ideation among older adults in China. Methods: Using a multi-stage stratified sampling strategy, 7070 older adults aged 60 and above from Shandong Province, China were recruited in this study. Socio-demographic characteristics, health status, family relationship, psychological distress, interpersonal trust and suicidal ideation in the last 12 months were obtained through face to face interviews. The association between interpersonal trust and suicidal ideation was assessed using multiple logistic regression models adjusting for socio-demographic characteristics, health status, family relationship and psychological distress. Results: 7.1% of participants reported suicidal ideation in the past 12 months, which was related to gender, resident area, marital status, educational level, self-rated economic, chronic disease, self-rated health status and family relationship within 1 month, psychological distress and interpersonal trust. After adjusting for sociodemographic factors, health status, family relationship and psychological distress, interpersonal mistrust was associated with two times odds of suicidal ideation when compared to interpersonal trust CONCLUSIONS: The interpersonal trust was associated with suicidal ideation among elderly in Shandong, China. Intervention approaches regarding inducing and promoting interpersonal trust should be developed to prevent suicide.

Factors associated with Help-seeking Behavior among Medically Serious Attempters Aged 15-54 Years in Rural China

Article

Feb 2019
PSYCHIAT RES

Increasing help-seeking behavior was one of the effective methods for suicide prevention. However, help-seeking behavior was less explored in rural China. In this study, we aimed to analyze the factors which were associated with help-seeking behavior among medically serious suicide attempters in rural China. Subjects were 791 medically serious suicide attempters aged 15–54 years in rural China. A face-to-face interview was conducted to evaluate the age, gender, education years, marital status, occupation, religious belief, living alone, physical disease, pesticide at home, family suicide history, negative life events, social support, impulsivity, mental disorder, prior suicide act, suicide intent and suicide method for the attempters. The results supported that there were 29.2% of attempters seek help before suicide behavior, and factors that male (OR = 1.45), experiencing negative life events (OR = 1.12), impulsivity (OR = 1.05), suicide intent (OR = 0.92) and suicide by pesticide (OR = 0.68) were associated with increased help-seeking behavior. It is helpful for us to understanding the features of suicide attempters who do not seek help before suicide behavior, and we also should pay more attention on people with these factors in Chinese suicide prevention.

Features for medically serious suicide attempters who do not have a strong intent to die: a cross-sectional study in rural China

Article

Full-text available

Sep 2018

Objective Previous studies have implied that there were many Chinese suicide attempters who did not want to die by suicide. In the current study, we explored the factors which were associated with low levels of suicide intent. We also examined features for medically serious suicide attempters who do not have a strong intent to die in rural china. Design Cross-sectional study. Setting The interviews occurred between May 2012 and July 2013 in 13 rural counties in Shandong and Hunan provinces, China. Participants Subjects were 791 medically serious suicide attempters whose injury and wounds were so serious they required hospitalisation or immediate medical care. Results The results supported that less years of education (β=−0.11, p=0.037), religious beliefs (β=1.20, p=0.005), living alone (β=1.92, p=0.017), negative life events (β=0.29, p=0.003), low levels of impulsivity (β=−0.10, p=0.013) and mental disorders (β=2.82, p<0.001) were associated with higher levels of suicide intent. Conclusion Results imply that there are some medically serious suicide attempters with a higher education and/or exhibit impulsivity who do not want to die by suicide. These findings can inform practice to prevent suicide in rural China.

Changing of suicide rates in China, 2002-2015

Article

Nov 2018
J AFFECT DISORDERS

Background: The overall suicide rate in China has dropped substantially since the 1990s, with patterns changing significantly. This study aims to further explore the latest changes in suicide rates in China. Methods: Data on gender-age-specific suicide rates for rural and urban residents aged 15 years and above were retrieved from official records. Joinpoint regression analyses were applied to analyze time trends of suicide rates. Results: Overall, suicide rates in China dropped significantly from 2002 to 2015. However, the national suicide rates have decreased at a slower pace since 2006. Joinpoints on time trends of suicide rates were also observed among rural males, rural females and urban males in 2005, 2006 and 2008, respectively. Declines in suicide rates of a majority of groups aged 25-54 slowed around 2007, and even reversed among males aged 25-34 in both areas and rural males aged 45-54. Male suicide rates were increasingly higher than females' after 2006. Rural suicide rates were about twice those of urban groups in recent years. Limitations: Data on suicide is based on a large-sampled surveillance system, which may suffer from some quality flaws. Improvements in the quality of suicide rate data may lead to bias. Information on other potential differences in suicide rates over time is not available. Conclusions: Although the suicide rate in China dropped significantly from 2002-2015, a slowdown in the decrease and even a reversing trend was observed in some certain groups, which highlights the urgent need for targeted suicide prevention programs.

Impulsivity Kills Some Who Did Not Plan to Die by Suicide: Evidence From Chinese Rural Youths

Article

Jul 2018

This study aimed to compare the mental disorders, psychological factors, and suicidal intent between high- and low-impulsivity Chinese rural young suicides. Rural young women and men aged 15 to 34 years who died by suicide and various risk factors were examined. The data were obtained using psychological autopsy method with instruments as Dysfunctional Impulsivity Scale, the Structured Clinical Interview for DSM-III-R, Beck Hopeless Scale, Social Support Index, Coping Response Inventory, Hamilton Depression Rating Scale, and Beck Suicide Intent Scale. Compared with low-impulsivity suicides, the high-impulsivity suicides were younger, had less mental disorders, owned less social support, scored lower on approach coping and higher on avoidance coping, and scored a lower score on the Suicide Intent Scale. Characteristics of high-impulsivity suicides differed significantly from low-impulsivity suicides in rural China. It was important to develop different prevention and intervention strategies to reduce the suicide rate in China.

Suicidal behaviours in men: determinants and prevention

Technical Report

Jan 2011

Suicide rates in China, 2004-2014: Comparing data from two sample-based mortality surveillance systems

Article

Full-text available

Feb 2018
BMC PUBLIC HEALTH

Background: The decreasing suicide rate in China has been regarded as a major contributor to the decline of global suicide rate in the past decade. However, previous estimations on China ’ s suicide rates might not be accurate, since often they were based on the data from the Ministry of Health ’ s Vital Registration ( “ MOH-VR ” ) System, which is biased towards the better-off population. This study aims to compare suicide data extracted from the MOH-VR System with a more representative mortality surveillance system, namely the Center for Disease Control and Prevention ’ s Disease Surveillance Points ( “ CDC-DSP ” ) System, and update China ’ s national and subnational suicide rates in the period of 2004 – 2014. Methods: The CDC-DSP data are obtained from the National Cause-of-Death Surveillance Dataset (2004 – 2014) and the MOH-VR data are from the Chinese Health Statistics Yearbooks (2005 – 2012) and the China Health and Family Planning Statistics Yearbooks (2013 – 2015). First, a negative binomial regression model was used to test the associations between the source of data (CDC-DSP/MOH-VR) and suicide rates in 2004 – 2014. Joinpoint regression analyses and Kitagawa ’ s decomposition method are then applied to analyze the trends of the crude suicide rates. Results: Both systems indicated China ’ s suicide rates decreased over the study period. However, before the two systems merged in 2013, the CDC-DSP System reported significantly higher national suicide rates (IRR = 1.18, 95% Confidence Interval [CI]: 1.13 – 1.24) and rural suicide rates (IRR = 1.29, 95% CI: 1.21 – 1.38) than the MOH-VR System. The CDC-DSP System also showed significant reversing points in 2011 (95% CI: 2006 – 2012) and 2006 (95% CI: 2006 – 2008) on the rural and urban suicide trends. Moreover, the suicide rates in the east and central urban regions were reversed in 2011 and 2008. Conclusions: The biased MOH-VR System underestimated China ’ s national and rural suicide rates. Although not widely appreciated in the field of suicide research, the CDC-DSP System provides more accurate estimations on China ’ s suicide rates and is recommended for future studies to monitor the reversing trends of suicide rates in China ’ s more developed areas.

A reversed gender pattern? A meta-analysis of gender differences in the prevalence of non-suicidal self-injurious behaviour among Chinese adolescents

Article

Full-text available

Jul 2017
BMC PUBLIC HEALTH

Background A reversed gender pattern has been observed in the suicide rate in China compared to elsewhere. Like suicidal behaviour, non-suicidal self-injurious (NSSI) behaviour is a health-risk behaviour. We examined whether a reversed gender pattern existed in the prevalence of NSSI. Methods Online literature databases were searched for English and Chinese articles on NSSI behaviours among the Chinese. A meta-analysis with a random-effects model and a subgroup analysis were used to estimate the odds ratios of gender differences in NSSI prevalence among Chinese adolescents including college students, middle school students, and clinical samples, as well as rural, urban, and Hong Kong middle school students. Results There was a male bias in NSSI prevalence among college students (OR = 1.56, 95% CI = [1.30, 1.87], p < 0.001), and a female bias among middle school students (OR = 0.83, 95% CI = [0.73, 0.94], p < 0.01), but there was no gender difference among clinical samples (OR = 0.88, 95% CI = [0.41, 1.89], p > 0.1). The NSSI prevalence among middle school students had a female bias in the rural (OR = 0.58, 95% CI = [0.47, 0.72], p < 0.001) and Hong Kong areas (OR = 0.91, 95% CI = [0.86, 0.96], p < 0.001), with the gender difference in NSSI prevalence in the Hong Kong areas being greater than in rural areas. No gender difference in NSSI prevalence was found in urban areas (OR = 1.01, 95% CI = [0.84, 1.22], p > 0.1) among middle school students. Conclusions Our analysis indicated the existence of specific gender and age patterns in NSSI prevalence among Chinese adolescents. The sample type, age, and the areas that have different gender norms and culture could partly explain this pattern. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4614-z) contains supplementary material, which is available to authorized users.

Male suicides in different settings

Chapter

Jan 2013

Male suicide risk groups

Chapter

Jan 2013

Determinants of suicidal behaviours in men

Chapter

Jan 2013

Comparative analysis of death by suicide in Brazil and in the United States: Descriptive, cross-sectional time series study

Article

Full-text available

Apr 2017
SAO PAULO MED J

Context and objective:: The World Health Organization recognizes suicide as a public health priority. Increased knowledge of suicide risk factors is needed in order to be able to adopt effective prevention strategies. The aim of this study was to analyze and compare the association between the Gini coefficient (which is used to measure inequality) and suicide death rates over a 14-year period (2000-2013) in Brazil and in the United States (US). The hypothesis put forward was that reduction of income inequality is accompanied by reduction of suicide rates. Design and setting:: Descriptive cross-sectional time-series study in Brazil and in the US. Methods:: Population, death and suicide death data were extracted from the DATASUS database in Brazil and from the National Center for Health Statistics in the US. Gini coefficient data were obtained from the World Development Indicators. Time series analysis was performed on Brazilian and American official data regarding the number of deaths caused by suicide between 2000 and 2013 and the Gini coefficients of the two countries. The suicide trends were examined and compared. Results:: Brazil and the US present converging Gini coefficients, mainly due to reduction of inequality in Brazil over the last decade. However, suicide rates are not converging as hypothesized, but are in fact rising in both countries. Conclusion:: The hypothesis that reduction of income inequality is accompanied by reduction of suicide rates was not verified.

Suicide rates in China

Article

Jan 2002

Michael Robert Phillips

Suicide attempters with high and low suicide intent: Different populations in rural China

Article

May 2017
PSYCHIAT RES

This paired case-control study aimed to compare characteristics between suicide attempters with high and low suicide intent in rural China. We evaluated 409 suicide attempters and their paired controls who were matched with the same gender, age (a difference of no more than 3 years), and similar residence. Compared to paired control, suicide attempt with high and low suicide intent shared the 3 common risk factors of negative life event, high depression score, and low social support score. In addition, mental disorder was an independent risk factor of suicide attempt with high intent. Having a low education level and occupation as a farmer were risk factors of suicide attempt with low intent. Mental disorder and depression were associated with a significantly increased risk of suicide attempt with high intent compared to low intent. Depression was found to be related to suicide attempt with high intent compared to low intent in the subgroups of male or female aged 35 to 54 or 55 to 70 years. Distinct characteristics were found in the suicide attempters with different intent. These findings are important and the aim is to transform them into concrete ideas for the prevention of suicide attempt in rural China.

Suicidal Ideation, Plans and Attempts among Medical College Students in China: The Effect of Their Parental Characteristics

Article

Nov 2016

Medical college students are a high-risk population of suicidal ideation, plan and attempt. However, few studies discuss the effect of parental characteristics on suicidal ideation, plans and attempts among medical college students in China. A total of 2,198 respondents answered the questionnaires referring social-demographic characteristics, psychological conditions, parental characteristics, suicidal ideation, plan and attempt. The prevalence of suicidal ideation, plan and attempt among the subjects were 17.9%, 5.2% and 4.3%, respectively. The results of multiple logistic regression showed that male, mother's education level, mother's parenting style, relationship in parents and psychological condition were associated with lifetime suicidal ideation. Male, mother's vocation, mother's parenting style, relationship in parents and psychological conditions were associated with suicide plan. Male, relationship in parents and psychological condition were associated with suicide attempt. Those imply that mother may play more roles on suicidal ideation and plan than father among medical college students in China. Psychological condition has a very strong association with suicidal ideation, plan and attempt.

Suicide Deaths in China: An Analysis of Forensic Cases

Article

Full-text available

Jan 2016

Suicide cases are often encountered during death investigations in forensic medicine. In this study, through a comparative analysis of our own data of 98 suicide cases and previous reports from various forensic institutions in China, we analyzed the risk factors of Chinese suicides and explored the implications thereof from a forensic point of view. Moreover, the age and sex differences, means, causes, and other concerns regarding suicide are discussed along with a review of the literature.

Temporal Trends of Suicide Mortality in Mainland China: Results from the Age-Period-Cohort Framework

Article

Full-text available

Aug 2016
Int J Environ Res Publ Health

The aim of this study is to explore the long-term trends of suicide mortality in China. We implemented the age-period-cohort (APC) framework, using data from the Global Burden of Disease Study 2013. Our results showed that the net drift of suicide mortality was´4was´4.727% (95% CI: ´4.821% tó4.634%) per year for men and´6and´6.633% (95% CI: ´6.751% tó6.515%) per year for women, and the local drift values were below 0 in all age groups (p < 0.01 for all) for both sexes during the period of 1994–2013. Longitudinal age curves indicated that, in the same birth cohort, suicide death risk increased rapidly to peak at the life stage of 20–24 years old and 15–24 years old for men and women, respectively, and then showed a decelerated decline, followed by a rise thereafter after 54 years old for men and a slight one after 69 years old for women. The estimated period and cohort RRs were found to show similar monotonic downward patterns (significantly with p < 0.01 for all) for both sexes, with more quickly decreasing for women than for men during the whole period. The decreasing trend of suicide was likely to be related to the economic rapid growth, improvements in health care, enhancement on the level of education, and increasing awareness of suicide among the public in China. In addition, fast urbanization and the effective control of pesticides and rodenticides might be the special reasons behind these trends we observed in this study.

Characteristics of suicide completers and attempters in rural Chinese population

Article

Oct 2016
COMPR PSYCHIAT

Objective: This study aimed to compare the similarities and differences between suicide completers and attempters in rural China.Methods: Two paired case–control studies of completed suicide and suicide attempts were conducted in rural Shandong, China. This analysis included 409 suicide attempters (SA) with a mean age of 43.90 (SD = 13.31), 117 suicide completers (SC) with a mean age of 50.38 (SD = 13.02) and their controls matched by gender, age (within 3 years), and residence. Logistic regression models were used to examine risk factors of suicide attempts and completed suicide and the differences between SA and SC. Results: Compared to their matched controls, suicide attempters and completers shared the following common risk factors: low levels of education (middle school or under) (OR, 95% CI: 2.79, 1.40–5.55 for SA and 16.98, 1.59–181.60 for SC), negative life events (OR, 95% CI:7.37, 4.73–11.50 for SA and 21.08, 4.74–93.71 for SC), and mental disorders (OR, 95% CI: 7.52, 3.85–14.69 for SA and 22.39, 2.65–189.60 for SC). Compared to suicide attempts, completed suicide was associated with the following risk factors: male gender (OR, 95%CI: 1.75, 1.06–2.90), advancing age (OR, 95% CI: 1.02, 1.00–1.04), poor family economic status (OR, 95% CI: 6.74, 3.22–14.13), prior suicide attempts (OR, 95% CI: 2.43, 1.18–4.97), family suicide history (OR, 95% CI: 2.59, 1.33–5.06), high suicide intent (OR, 95% CI: 1.15, 1.05–1.27), and highly lethal methods (OR, 95% CI: 13.65, 6.51–28.59).Conclusions: Although suicide completers and attempters share some common risk factors, suicide completers are more likely to have prior suicide attempts, family suicide history, and higher suicidal intent, and to use highly lethal methods in rural Chinese.

Analysis of Internet Suicide Pacts Reported by the Media in Mainland China

Article

Full-text available

Jun 2016
CRISIS

Background: In mainland China, frequent Internet suicide pacts in recent years have raised strong concerns from several social sectors and the influence of social networks on suicide is constantly growing. Aims: To identify the epidemiological characteristics of media-reported Internet suicide pacts in mainland China. Method: Our study comprised 62 Internet suicide pacts involving 159 victims in mainland China before June 1, 2015. Kendall's randomness test, a trend test, and a circular distribution test were applied to identify the rising or concentrated trends in the time of occurrence of Internet suicide pacts. Results: The overall male-to-female ratio was 2.3:1. Suicide victims were mainly people in their 20s to 30s (84.1%). In all, 87.1% suicide victims completed suicide in sealed hotels or rental housing, and charcoal-burning suicide accounted for 80.6% of cases. Conclusion: People who complete suicide as part of an Internet suicide pact are more likely to be males, aged 20–30 years. Charcoal-burning suicide in sealed hotels or rental housing was the commonest way of dying.

Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder

Article

Feb 2024
J PSYCHIATR RES

Socio-Economic Determinants of Suicide Rates in Transforming China: A Spatial-Temporal Analysis from 1990 to 2015

Article

Jan 2021

Parents parenting styles differences were associated with lifetime suicidal ideation: Evidences from the Chinese medical college students

Article

Sep 2021
J HEALTH PSYCHOL

This study aims to explore the association between parents parenting styles differences and lifetime suicidal ideation (LSI). The sample included 2598 Chinese medical students. Results showed that 10.5% of students reported LSI. Moreover, total differences in parenting styles (OR = 1.04, 95% CI = 1.02, 1.06), parental nurture rejects differences (OR = 1.11, 95% CI = 1.04, 1.18), parental emotional warmth differences (OR = 1.08, 95% CI = 1.03, 1.14), and parental overprotective differences (OR = 1.11, 95% CI = 1.06, 1.16), obtain a scholarship, physical disease and mental health were associated with LSI. The major finding reminds us of the importance of consistent parenting style for suicide prevention.

Quantitative risk assessment of suicide by self-poisoning among women in Morocco

Article

Apr 2021

Suicide by self-poisoning is a major public health problem worldwide both in terms of morbidity and mortality. This study aims to discuss its epidemiological features and to identify the potential factors of clinical outcome among women in Morocco. A retrospective study spanning 34 years examined a number of characteristics of suicide cases among women by poisoning in Morocco based on the database of health monitoring system of Moroccan Poison Control Center (MPCC). A total of 17,012 women have experienced at least one suicidal poisoning, with 346 confirmed deaths (3.1% if we consider the known clinical outcome). The annual number of registered cases increased year by year [min = 4 cases; max = 1166 cases]. The average age was 23.4 years old. The home was the main place for the suicide of Moroccan women. The most common method of suicide was drug overdose (54.8%) especially in women under 65. More than half of the victims had developed gastro-intestinal disorders (54.1%) associated or not with other disorders. Most of the poisonings needed only gastrointestinal decontamination (77.6%). According to the results of the multiple regression analysis, age (ORa = 1.017; 95%IC [1.003–1.031]; p < 0.05), incriminated product represented by drugs (ORa = 0.218; 95%IC [0.105–0.454]; p < 0.001), pesticides (ORa = 4.821; 95%IC [2.719–8.547]; p < 0.001), mineral products (ORa = 18.242; 95%IC [9.169–36.293]; p < 0.001) and plants (ORa = 3.748; 95%IC [1.483–9.470]; p < 0.01), as well as origin of the suicide victims (ORa = 1.505; 95%IC [1.082–2.095]; p < 0.05) explain the observed variability of the evolution of clinical outcome. In reality, the number of women who have committed or attempted to suicide by deliberate ingestion of toxic products must be much higher. High variability of suicide rates exists across different epidemiologic characteristics. This study may lead to better treatment of patients and also help to collect better data about the problem.

Perinatal Mental Health Among Young Women in Urban China

Book

Oct 2019

Simone Schwank

In order to reach the WHO’s Sustainable Development Goals relating to maternal and infant health, maternal mental health preconditional needs to be addressed. The purpose of the thesis project was to explore how Shanghai women and health care providers perceive mental health problems during the perinatal period in urban China, in the light of the two-child policy. Method: Data collections were conducted in Shanghai, urban China. In Study I, thirty-seven women were interviewed regarding their judgement and decision-making whether to have a second child after the introduction of the two-child policy. Qualitative systematic text condensation analysis was used to describe their decision-making factors. Study II involved 15 interviews with key health care informants and their perceptions of the current situation of perinatal mental health care in urban China. Qualitative content analysis was used to describe their responses. In Study III, sixteen women were interviewed about their insights on perinatal mental health problems. Thematic analysis of the semi-structured interviews was conducted. Study IV was a web survey study of 487 women. The topics discussed related to women’s perinatal and current mental health status, help-seeking behavior for mental health care, disclosure opportunities and preferences, and the kind of help they would expect and request. Descriptive and comparative statistics were performed. Results: Urban Chinese women’s decision-making regarding having a second child in reference to the two-child policy include women’s status, career, challenges of two children, one-child generation, restriction of reproductive freedom, and the expectation of governmental support. The outcomes highlight the impact of the child policy societal, economic, and on perinatal health changes (I). Key health care informants described how mental health was influenced by tradition affecting the perception of mental health in both society and the individual. The health care experts, policy makers, and public health professionals stressed the required resources and reflected in the lack of professional training, limited staff, and resources available to provide adequate care for patients with mental health problems (II). Intergenerational transition, maternal mental health, and transition into motherhood capture the Shanghai women’s position of being in between the traditional and modern Chinese role of motherhood. The urban Chinese woman in a modern society with a professional life expects to have access to high-tech medicine and all aspects of a cosmopolitan lifestyle (III). A total of 487 women confirmed the results in a survey and emphasized the trust in friends, husband, and community health care centers, but all of these were overshadowed by online resources. Women from the one-child generation reported less mental well-being compared to the older generation. The vast majority of the participating women (82.2%) would seek help from online resources and over 70% of the participants would seek help primarily at community health centers. The majority of the women trusted their friends and husband as their first contact to share their mental health problems with. The mother-in-law was the person the women trusted least. Conclusion: The findings provide an enhanced understanding of mental health problems in the perinatal period on local level, and provide suggestions for improved perinatal mental health care for urban Chinese women. The public health concern and cause for action to reach out to the young mothers of the one-child generation are evident. Hesitation to seek care due to lack of knowledge or lack of trust in the health care system are identified as obstacles for young women to seek care. These results are relevant in the current discourse surrounding the reduction of the fertility rate in China, despite the introduction of the two-child policy. This thesis illustrates the need to continue understanding perinatal mental health and the contribution of the new child policy on a societal and family level.

Gender Characteristics in Methods of Chinese Rural Young Suicides

Article

Full-text available

Apr 2021
Int J Ment Health Addiction

Suicidal men and women tend to use different means for suicide, but there has been a lack of studies on how Chinese male and female suicides are distributed on the various lethal methods. We studied 392 suicides (214 males and 178 females) consecutively sampled from selected rural areas of China, with the psychological autopsy (PA) design. It was found that majority of the Chinese rural young suicides died of swallowing pesticides or other farming chemicals (73.5%), and there was not much difference between men and women in all the suicide means as expected. Contrary to the findings in the USA, firearm was not available to Chinese civilians and was not the number one suicide means for the Chinese male suicides. In rural China, suicides with less violent methods outweighed those with violent methods in numbers, with more females that chose less violent suicide methods than males. However, results of logistic regression showed that there was no significant association between gender and suicide methods in rural China. Mental disorders and impulsivity were also not associated with violent or less violent suicide methods. Our findings indicated that access to suicide means might be most important explanation of suicide methods. These findings may have certain implications on suicide prevention, and researchers and policy makers should take into consideration the contexts of the people at risks of suicide.

Section: Criminal and Cultural Behavior Bibliography

Research

Full-text available

Apr 2019

Michael Hochrein

This represents one of several sections of "A Bibliography Related to Crime Scene Interpretation with Emphases in Geotaphonomic and Forensic Archaeological Field Techniques, Nineteenth Edition" (The complete bibliography is also included at ResearchGate.net.). This is the most recent edition of a bibliography containing resources for multiple areas of crime scene, and particularly outdoor crime scene, investigations. It replaces the prior edition and contains approximately 10,000 additional citations. As an ongoing project, additional references, as encountered, will be added to future editions. The impact of one’s culture on daily activities is inescapable. That impact, whether conscious or not, must in some ways extend to the commission of crimes as well as victim reactions. The compiler witnessed this in the investigation of the abduction and murder of a young Bosnian girl who had resettled in the United States with more than 8,000 other refugees from the Balkan Wars of the early 1990s. The ease with which her neo-Nazi murderer was able to enter the homes of the Bosnian refugees, and ultimately kidnap this victim, was partly the result of the cultural experiences of the victimized families who feared law enforcement in their home country and so were reluctant to report the preadtor who introduced himself into their community as a health inspector. This category includes citations beyond those about death rituals and includes references about criminal psychology, cultural studies, and forensic psychiatry. A greater understanding of the psychological and cultural motivation subjects might have in committing crimes will impact approaches to searching for, and processing, evidence. One need not be a behavioral scientist or criminal profiler to realize that a subject diagnosed with paranoia might dispose of a victim in a manner different than a sociopath. An example of cultural influence in the selection of a victim’s disposal site is the case of Jeremiah James Bringsplenty. Accounts of this 1992 case included that of the abuse and murder of Jeremiah by family acquaintances who were babysitting the infant in his Clarksville, Tennessee home. Both the victim and the subjects were of Native American ancestry. The subjects left Tennessee for the Rosebud Reservation in South Dakota with plans to bury Jeremiah near relatives. Because of decomposition, however, they were forced to stop outside Lincoln, Nebraska to bury the remains. This section also contains references valuable for investigators interviewing subjects and witnesses. This category and “General and Cultural Anthropology of Death” overlap to some degree. The examples or accounts examined in the resources within this section involve a spectrum of physical traumas which might befall victims of homicide or suicide. For that reason, the reader/research should also look in Taphonomy-Trauma for related citations. (3305 citations)

Reviewer comments

Data

Full-text available

Sep 2018

Author's manuscript

Data

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Aug 2018

A systematic analysis of online broadcasts of suicidality in China

Article

Oct 2017

Introduction: This study attempts to analyze the epidemiological characteristics of online broadcasts of suicidality in China. Methods: A total of 193 incidents were identified by systematically searching for relevant news reports on the internet. A content analysis on these news reports was conducted to obtain information on the characteristics of each individual incident. Results: Of these incidents, the ratio of males to females was 1:1.7 (age: 24.6 ± 6.1 years old). Approximately 45.4% and 70.8% of incidents were located in the region of Eastern China and Southern China, respectively, and 15.7% of incidents were unemployed. The most common suicide method was wrist cutting (57.5%), and the most common suicide location was at home (35.2%). Instant messaging apps (52.8%) were most frequently used for broadcasting suicidal thoughts and actions. Relationship breakup (61.1%) was reported as the leading cause of suicide. Furthermore, of the 193 incidents, 19 indicated that they suffered from a mental disorder, and 12 revealed that they had a history of suicide attempts. There were significant gender, age, regional, and occupational differences across the categories. Discussion: This study indicates that in China, suicide prevention programmes need to target internet users.

Elderly suicide trends in the context of transforming China, 1987–2014

Article

Full-text available

Nov 2016

In the context of rapid ageing, understanding the time-trend of elderly suicide (ES) could inform China’s efforts on suicide prevention. We examined time-trends in Chinese ES rates (ESRs) from 1987 to 2014, a period of profound social changes. Suicide rates by residence (rural/urban), gender, and 5-year age-group (65+) in 1987–2014 were provided by the Chinese Ministry of Health. Time-trends were analyzed with joinpoint analysis. The time-trend of national ESRs was downward (average annual percent change [AAPC] = −3.7, P < 0.001): 76.6/100000 in 1987 and 30.2/100000 in 2014. However, the time-trend of corresponding percentages of ESs among the total suicides was monotonically increasing (AAPC = 3.4, P < 0.001): 16.9% in 1987 to 41.2% in 2014. The time-trends in ESRs of both rural and urban men and women were decreasing, but only the rural trends were significant (P < 0.001). Rural-urban and male-female differences in ESRs were decreasing over time (slope = −4.2 and −3.0, P ≤ 0.006), but the rural-urban and male-female ESR differences in 2014 remained large (16.3/100000 and 9.8/100000, P < 0.001). While national ESRs decreased significantly during the past three decades, the current ESR remains high in China. Further, the age-pattern of Chinese suicide is transitioning to elderly predominance. ES, particularly rural ES, should be a public health priority in China.

Suicide by pesticide poisoning remains a priority for suicide prevention in China: Analysis of national mortality trends 2006-2013

Article

Nov 2016

Background: Despite recent declines, suicide remains a priority for China. Ease of availability of high-lethality suicide methods, such as pesticides and firearms, contributes to the overall incidence and is an important target for suicide prevention. This study investigates whether changes in the distribution of methods of suicide have contributed to the recent reduction in suicide in China. Method: Suicide rates (2006-2013) were calculated using the Chinese Disease Surveillance Points system, stratified by gender, age group, and urban-rural residence, to investigate trends in suicide over the study period. Multilevel negative binomial regression models were used to investigate associations between socio-demographic factors and method-specific suicide. Results: The most common method of suicide in China for both males and females was pesticide poisoning, followed by hanging. All methods declined over the study period, with the exception of suicide by jumping in males. Suicide rates for pesticide poisoning and for hanging increased exponentially with age in those aged over ≥45 years in both sexes. Pesticide poisoning declined from 55% to 49% of all suicides, while hanging increased from 27% to 31%. Limitations: This was an ecological study of a time series of suicide rates, with risk factor adjustment being limited to population-level point estimates derived from a single census. Conclusions: Suicide by pesticide poisoning and hanging remain the leading methods of suicide in China. Changes to the safe use of pesticides and targeted prevention initiatives to restrict access, along with socio-economic development and urbanisation, are likely contributors to declines in suicide by pesticide poisoning.

Rates and characteristics of elderly suicide in China, 2013-14

Article

Sep 2016

Background: The number of older adults (OAs) is growing rapidly and the elderly suicide rate (ESR) is highest among all age-groups in China. Examining the epidemiology of elderly suicide (ES) may facilitate population-specific suicide prevention efforts, however, little is known about the patterns of ES in China. Objective: To describe the rates and characteristics of ES in China during 2013-14. Methods: Suicide mortality data by gender, quinquennial age-group, residence (urban/rural) and geographic location (east/central/west) were obtained from China's Integrated National Mortality Surveillance System for 2013-14. Crude ESRs of OAs aged 65 years or above were standardized to the 2010 China's Census population and adjusted for under-reporting. Results: While OAs comprised 8.9% of the Chinese population, they represented 38.2% of suicide deaths. The average annual ESR in China was 34.5 per 100000 in 2013-14. ESRs varied widely across OA subgroups, with the highest rates in central rural men (67.1) and women (53.1), and the lowest rate in eastern urban women (13.6). Male gender (incident rate ratio [IRR]=1.47), every five-year increase in age (IRR=1.33), rural residence (IRR=1.83), and geographic location of central China (IRR=1.93) were significantly associated with increased number of ESs. Limitations: Information on means of ES are lacking in the data source. Conclusions: ESs disproportionately account for a large portion of China's current total suicides, and ESR, particularly in central rural OAs, is very high in China. Prevention of ES should be given priority as an important public health issue in China. Central rural OAs are key target population for current ES prevention.

Modernization and Women’s Fatalistic Suicide in Post-Mao Rural China: A Critique of Durkheim

Chapter

Jan 2012

Hyeon Jung Lee

Durkheim’s Suicide (1951 [1897]) has influenced social scientific perspectives on suicide for over a century. Based on his four-fold typology of suicide (egoistic, anomic, altruistic, and fatalistic), Durkheim argued that the process of modernization can engender an increase in egoistic and anomic types of suicide, which results from a lack of social integration and regulation. Comparatively, altruistic or fatalistic suicide, each of which is caused by excessive social integration or regulation, rarely occur in modern society and can be regarded as relics of a traditional, premodern world. Furthermore, Durkheim emphasized that in modern society suicide among urbanites and males is more frequent and scholarly significant because these populations are more exposed to the hazards of modernization. Rural residents and women are assumed to be protected from suicide due to their traditional roles and dispositions.

Decomposing change in China’s suicide rate, 1990–2010: Ageing and urbanisation

Article

Jun 2016

Objective The study empirically quantifies the contributions of age composition and urbanisation to changes in the suicide rate in China over the periods 1990–2000 and 2000–2010. Methods A decompositional method was used to quantify the absolute and relative contributions of the age structure; the age-specific proportion of the urban population and the suicide rate of each age-specific, gender-specific and urban/rural cohort to the overall suicide rates in the two 10-year intervals. Results In the period between 1990 and 2000, a significant decline in the suicide rate among younger age groups (especially young rural women) was identified as the main driving force of the downward trend in the overall suicide rate. In 2000–2010, the rate of decline in suicide was predominantly explained by the drop in the suicide rate among all age groups in rural areas, with the exception of those aged over 80. The positive impact of urbanisation on the decline of the suicide rate has gradually diminished relative to the earlier period. Conclusion As the positive impact of urbanisation on suicide rates is diminishing, further urbanisation and rapid change in society may induce stress and adjustment problems that are not conducive to the promotion of well-being. Furthermore, as China is facing the prospects of slower economic growth and a rapidly ageing population, suicides among older adults may also be elevated, particularly among those in rural areas with insufficient healthcare and social support. In order to maintain the decreasing trend of suicide in China, it is important for the Chinese government to pay more attention to the mental well-being of the population and to mitigate the stress of urban life and to provide timely support to older adults especially in rural areas.

Suicide study and suicide prevention in mainland China

Chapter

Mar 2009

Xiao Shuiyuan

The Oxford Texbook of Suicidology is the most comprehensive work on suicidology and suicide prevention that has ever been published.

The gender difference in Chinese suicide rates

Article

Full-text available

Apr 1997

Chinese women have a higher rate of suicide than Chinese men in the regions of mainland China currently reporting mortality data to the World Health Organization. This gender difference is documented. and possible reasons for the gender differences are explored using data from a survey of female suicides in Chuanzhou County in the Guangxi region of China. A definitive explanation for the gender difference must await detailed psychological autopsy studies.

Suicides in Beijing, China, 1992–1993

Article

Full-text available

Jun 1996
SUICIDE LIFE-THREAT

Jie Zhang

Analyzing the raw data of suicides reported to the Beijing Public Security Bureau in 1992 and 1993, this study reveals for the first time to the academic public in the West the rate, gender difference, the timing, causes, and means of Chinese suicides. In comparison with suicide patterns in Western societies, mainly reported by Durkheim (1897/1951), Diekstra (1990) and the National Center for Health Statistics (1991), the findings of this study suggest more differences than similarities. The comparatively low suicide rate (4.8 per 100,000 population), the reversed gender effect (55.4% of suicides are female and 44.6% male), alleged causes, and reported means of suicides in China are explained in terms of history, culture, and social forces. However, the direct relationship of warm seasons to Chinese suicide rates is consistent with what is known about Western societies.

Statistical Models in Epidemiology

Article

Full-text available

Jan 1995

Antony Selwyn St Leger

Suicide in the People's Republic of China categorized by age and gender: Evidence of the influence of culture on suicide

Article

Full-text available

Jun 1996

Colin Pritchard

Pritchard C. Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide. Acta Psychiatr Scand 1996: 93: 362–367. © Munksgaard 1996. Throughout the developed world suicide is predominantly associated with psychiatric disorders and substance misuse. The main social factors are age, as suicide increases with each decade, and gender, as suicide is more frequent among men than women, and proportionately more young men die than their female peers. An analysis of suicide in the People's Republic of China found that the profile was the opposite to that reported in the rest of the world, as more female subjects kill themselves than males, particularly younger women. Also, unlike the situation in other countries, suicide occurred more often in rural than in urban areas. It is argued that the Chinese data provide evidence of a greater cultural influence upon suicide rates than had previously been realized.

Risk factors for suicide in patients with schizophrenia: Nested case- control study

Article

Full-text available

Nov 1997

Of 9156 patients admitted to psychiatric hospitals in Denmark between 1970 and 1987 and diagnosed for the first time as having schizophrenia, 508 committed suicide. The purpose of the study was to identify risk factors for suicide among patients with schizophrenia, particularly factors relating to hospitalisation. From the cohort of all 9156 patients, the 508 who had committed suicide were individually matched to 10 controls from the same cohort, and data were analysed using conditional logistic regression. Suicide risk was particularly high during the first 5 days after discharge, and increased risk was also associated with multiple admissions during the previous year, previous suicide attempts, previous diagnosis of depression, male gender, and previous admissions to general hospitals for physical disorders. After adjusting for these factors, no effect was found for age. There was some evidence of an excess of suicides during temporary leave from the psychiatric department. The findings suggest that preventive measures could be focused on the first period after discharge, when closer monitoring and better social support may be needed. This may also apply to patients on temporary leave during a period of admission.

Why women are less likely to commit suicide

Article

Full-text available

Jul 1998
COMPR PSYCHIAT

George E. Murphy

Major depression forms the background of upwards of half of all suicides. Women are twice as likely as men to experience major depression, yet women are one fourth as likely as men to take their own lives. Current and past explanations of this paradox are built on androcentric assumptions that women are deficient in some way. The reverse may be true where suicide is concerned. Men value independence and decisiveness, and they regard acknowledging a need for help as weakness and avoid it. Women value interdependence, and they consult friends and readily accept help. Women consider decisions in a relationship context, taking many things into consideration, and they feel freer to change their minds. It is argued here that women derive strength and protection from suicide by virtue of specific differences from men. Factors that protect women from suicide are opposite to vulnerability factors in men.

Suicide, Deprivation, and Unemployment: Record Linkage Study

Article

Full-text available

Dec 1998

To investigate the association between suicide and socioeconomic status, unemployment, and chronic illness. Longitudinal study. England and Wales. Individuals from the Office for National Statistics longitudinal study for whom 1981 census data were available. The longitudinal study is a representative 1% sample of the population of England and Wales in which census variables are linked to mortality data. Suicide and undetermined deaths occurring between 1983 and 1992. Odds ratios estimated with logistic regression adjusted for attrition of cohort members. There was a strong independent association between suicide and individuals who were unemployed (odds ratio 2.6; 95% confidence interval 2.0 to 3.4) and permanently sick (2.5; 1.6 to 4.0). Those without access to a car had an increased risk (1.3; 1.0 to 1.5), but other measures of socioeconomic status were not associated with suicide. The association between suicide and unemployment is more important than the association with other socioeconomic measures. Although some potentially important confounders were not adjusted for, the findings support the idea that unemployment or lack of job security increases the risk of suicide and that social and economic policies that reduce unemployment will also reduce the rate of suicide.

Statistical Models in Epidemiology

Article

May 1995

Demographic Yearbook, 1957

Article

Oct 1958
Am Cathol Socio Rev

Clement S. Mihanovich

A Probe into the Mentality of Sixty-Five Rural Young Women Giving Birth to Baby Girls

Article

Apr 1988
CHINESE SOC ANTHROP

Zhou Juhua

Last year when I was at Qidong, I heard that a village woman left her newborn baby girl by the side of the public restroom. This year I personally saw in Qiyang a resident find a girl infant at his doorstep when he opened the door in the morning. Tied to the infant was a slip of red cloth on which was written the infant's birth date and a message begging other people to adopt the child, as the father would not accept the baby girl and the mother had no choice but to abandon her. This has aroused my indignation and provoked my thinking. I felt the necessity to visit the countryside to probe into rural women's mentality regarding the bearing of baby girls in an attempt to answer the following questions:

Statistical Models in Epidemiology

Article

Mar 1995

World Health Statistics Annual I

Book

Jan 1992

Changing Patterns in Methods of Suicide by Race and Sex

Article

Dec 1982
SUICIDE LIFE-THREAT

Suicide rates vary greatly by sex and race but the methods employed by these groups and changes in those methods have been studied neither closely nor systematically across time. In the present study annual official national statistics for specific methods of suicide by sex and racial group from 1923 to 1978 were examined. During this time period shifts were found among groups in the proportions of various suicide methods employed, most notably for women and Asian-Americans. Generally, firearm use increased among nearly all ethnic/racial-sex groups while the use of poisons declined. Although women continue to be more likely than men to kill themselves with solid and liquid poisons, in very recent years firearms have become a more common method. Among Japanese - and Chinese-Americans of both sexes the most frequently employed method has been hanging. Although this is still the case, the proportions have declined over time while the use of firearms has increased. Explanations are offered for the noted changes in method choice with particular attention being given to acculturation and changing societal roles.

The influence of ethnicity and social and demographic factors on Swedish suicide rates

Article

Apr 1997

The aim of this follow-up study, based on individual data, was to analyse the influence of ethnicity and other demographic and social factors on suicide rates between 1986 and 1989 for the Swedish population according to the 1985 census. The data were analysed by sex and age using a Poisson regression model. During the study period there were 8,310 cases of suicide and undetermined death. The main finding in this study was that ethnicity, defined as being foreign-born, was a significant risk factor for suicide in both sexes and in all age groups except for males aged 30 to 49 years. Not being married was a significant risk factor in all age groups for both males and females. Form of tenure, i.e. living in rented flats, was a significant risk factor for suicide in middle-aged males and females, while overcrowding was a risk factor for middle-aged males and for the over 50''s of both sexes. As ethnicity, defined as foreign-born, was an important variable related to suicide, the association between different ethnic groups and suicide will be evaluated in forthcoming studies.

Psychiatric illness and risk factors for suicide in Denmark (In Process Citation)

Article

Jan 2000

Several risk factors for suicide have been identified. We assessed the relative risks and population attributable risks of suicide associated with various socioeconomic factors and with previous mental illness that necessitated hospital admission. Our aim was to assist in the choice of potential strategies for preventing suicide in the general population. We did a population-based nested case-control study based on register data. Data were collected on a random 5% sample of the Danish population aged 16-78 years during a 15-year period (1980-94) and analysed with conditional logistic regression. 811 cases of suicide were found and 79871 controls were chosen in this population. Unemployment, low income, being single, and a history of mental illness necessitating hospital admission were associated with increased risk of suicide. However, in the multivariate analysis, the strongest risk factor was mental illness necessitating hospital admission; risk of suicide was especially high during admission (relative risk 62.6 [95% CI 41.1-95.4]) and during the year after discharge (6.51 [5.03-8.44]). The effect of socioeconomic variables decreased after adjustment for history of mental illness. The population attributable risk associated with mental illness necessitating admission to hospital was 44.6% (43.6-45.5); the attributable risks associated with the other factors were 3.0% (1.4-6.6) for unemployment and 10.3% (6.13-16.9) for being single. Suicide prevention aimed at patients who are admitted to hospital with mental disorders and improved detection and treatment of mental disorders in the general population may be the most efficient strategy to decrease risk of suicide. Reports of high relative risk and attributable risk associated with unemployment and other socioeconomic risk factors may be confounded and overestimated owing to the lack of adjustment for the association with mental disorders.

Routines and practices in the registration of suicide in Scandinavia

Article

Feb 1987
Acta Psychiatr Scand Suppl

Rolf Hessø

Procedures followed in reporting and registering death in each of the Scandinavian countries are scrutinized to find out whether the pronounced difference in the suicide rates between Norway and the other Scandinavian countries might be due to the under-reporting of suicide in Norway. A survey is also given of the practices followed when classifying and coding cause-of-death. The routine and practice followed when registering, classifying and coding varies considerably from country to country. However, none of the procedural differences could explain the low Norwegian rates and the Norwegian suicide statistics were found to be at least as accurate and reliable as those in Denmark, Finland or Sweden.

Guardianship Networks for Rural Psychiatric Patients: A Non-Professional Support System in Jinshan County, Shanghai

Article

Sep 1994
Br J Psychiatr Suppl

This paper describes the 'rural guardianship network' method of managing persons with severe mental illnesses and reports on a retrospective case-control study that compares the outcome of 561 schizophrenic patients from townships with guardianship networks to that of 103 schizophrenic patients from a township without guardianship networks. Each patient enrolled in a guardianship network is assigned a guardian--usually a family member--who ensures that the patient takes medication and gets medical follow-up, and reports any changes in the patient's condition to the village health worker or the township doctor who is responsible for psychiatric care. These guardians are supported and supervised by management groups at the village and township levels composed of government officials, medical administrators, physicians from township hospitals, and village health workers. Compared with patients who are not enrolled in guardianship networks, enrolled patients have significantly lower rates of hospital admission, lower rates of socially disruptive behaviour, and lower levels of psychopathological symptoms. The rural guardianship network is an effective and economical means of providing close supervision of mentally ill patients in their homes.

Recent life events, Social support and suicide

Article

Feb 1994
Acta Psychiatr Scand Suppl

The occurrence of recent life events during the last 3 months, and Social support received were studied in a nationwide suicide population (N = 1,067) in Finland. Recent life events were reported in 80 % of the suicides. Job problems (28 %), family discord (23 %), somatic illness (22 %), financial trouble (18 %), unemployment (16 %), separation (14 %), death (13 %) and illness in family (12 %) were the most common life events. Sex differences were found in recent life events: any life event, separation, financial trouble, job problems and unemployment were more common among males. The mean number of life events was also higher among males. Living alone was more common among female victims. Females had children more often than males. In terms of friendships, more females had a close friend, whereas more males had friends sharing common interests. Females had complained of loneliness more often than males. Those females who had lived alone had encountered a recent death more often than other females. The male victims who had lived alone had experienced separation, financial trouble and unemployment during the last 3 months more frequently than other males, suggesting a concurrent stressor effect of these recent life events with living alone in male suicides.

The sex ratio of suicide rates in China

Article

Feb 1994

Suicide is the leading cause of non-natural deaths in China. Female suicide rates are higher than male rates, and the rural suicide rate is 2.8 times higher than the urban rate. In 16,568 cases of suicide, the male to female ratios observed were 0.92 and 0.81 in urban and rural areas, respectively. The male to female ratio of the suicide rates in China is close to that of other Asian countries (1.2-1.5), but much lower than that in 26 European countries. In about two-thirds of all suicides, family disputes and love disappointments are the precipitants. The higher rate of suicide among women probably reflects the fact that Chinese women are of low social and economic position, and have few social resources to protect them, especially in remote areas.

Suicide after discharge from psychiatric inpatient car

Article

Aug 1993

People with a history of psychiatric disorder are at higher risk of suicide than people without such a history. The policy of reducing inpatient care in psychiatry has probably meant that some of the risk of suicide has shifted from the hospital to the community setting. We have quantified the risk of suicide within a year of psychiatric discharge in a population-based study in the Oxford health region, UK. We calculated suicide rates per 1000 person-years at risk (time from discharge to death, subsequent readmission, or the end of the study) and the standardised mortality ratio (SMR) for suicide, taking the value among the general population as 1. Among male patients the SMR for suicide (defined by coroner's verdict of suicide) in the first 28 days after discharge from inpatient care was 213 (95% CI 137-317); the equivalent SMR for female patients was 134 (67-240). The result was similar when we defined suicide more broadly as a suicide, open, or misadventure verdict. The suicide rate in the first 28 days after discharge was 7.1 (4.1-12) times higher for male patients and 3.0 (1.5-6.0) times higher for female patients than the rate during the remaining 48 weeks of the first year after discharge. Most of the patients studied (both those who committed suicide and those who did not) had been psychiatric inpatients for only a short time. The findings confirm that there is significant clustering of suicide soon after discharge from psychiatric care. Skilled support after discharge for high-risk patients in the community is essential. Audit of suicides that occur soon after discharge may help identify the patients at highest risk and thereby reduce the number of avoidable deaths.

Gender differences in completed and attempted suicide

Article

Apr 1994
ANN EPIDEMIOL

Eve K Moscicki

Attempted suicides occur primarily among women, while completed suicides occur primarily among men. Risk factors for both attempted and completed suicides include mental and addictive disorders, disrupted family environments, and precipitating events. This article presents an overview of findings on gender differences from epidemiologic studies of completed and attempted suicides, with a focus on suicide attempts among women, and discusses possible reasons for gender differences in suicidal behaviors.

Suicide in Hong Kong 1971–1990: age trend, sex ratio, and method of suicide

Article

Mar 1993

Kit-Tai Hau

This study gives an overview of the suicide rates in Hong Kong in the last 2 decades (1971-1990). It was found that the average suicide rate for the whole population was 11.3 per 100,000 population and it has been quite steady in recent years. The male and female adolescent (age-group 10-24 years) suicide rates were approximately the same, while the ratio of the overall male to female rate was 1.3:1. This indicated a relatively high female rate as compared with other countries. An examination of the suicide rates for various age-groups showed that the rate increased with age. The adolescent suicide rate was not particularly high (4.7 per 100,000 population for the age-group 10-24 years), but that for the elderly was 4-5 times the overall rate (49.5 per 100,000 population for those aged over 70 years). As regards the method of suicide, jumping from a height and hanging predominated in all age-groups. These methods were in great contrast to those used in other countries.

The role of sex and age in suicidal behavior

Article

Feb 1993
Acta Psychiatr Scand Suppl

U Bille-Brahe

Danish suicide rates for the last 65 years and data from 1976-1979 and 1989-1990, respectively, on attempted suicide in a representative Danish area show that marked changes have taken place in the distribution by sex and age of suicides and suicide attempters. Relatively more women are now taking their own life and, although suicidal risk still increases by age, the high-risk group also has come to include younger age groups. In contrast, relatively more men are attempting suicide, and the suicide attempters are getting older. Thus an equalization of the sexes has taken place, and the effect of age has become less pronounced. Both trends tally with the general trends in society.

Suicides in Beijing, China, 1992-1993

Article

Feb 1996

Jie Zhang

The influence of ethnicity and social and demographic factors on Swedish suicide rates. A four year follow-up study

Article

May 1997

The aim of this follow-up study, based on individual data, was to analyse the influence of ethnicity and other demographic and social factors on suicide rates between 1986 and 1989 for the Swedish population according to the 1985 census. The data were analysed by sex and age using a Poisson regression model. During the study period there were 8,310 cases of suicide and undetermined death. The main finding in this study was that ethnicity, defined as being foreign-born, was a significant risk factor for suicide in both sexes and in all age groups except for males aged 30 to 49 years. Not being married was a significant risk factor in all age groups for both males and females. Form of tenure, i.e. living in rented flats, was a significant risk factor for suicide in middle-aged males and females, while over-crowding was a risk factor for middle-aged males and for the over 50's of both sexes. As ethnicity, defined as foreign-born, was an important variable related to suicide, the association between different ethnic groups and suicide will be evaluated in forthcoming studies.

Introduction to the Transformation of Social Experience in Chinese Society: Anthropological, Psychiatric and Social Medicine Perspectives

Article

Apr 1999

Diagnosis Postponed: Shenjing Shuairuo and the Transformation of Psychiatry in Post-Mao China

Article

Oct 1999

Sing Lee

Building on Arthur Kleinman's seminal work in Hunan, this paper examines the social context in which shenjing shuairuo (neurasthenia), a ubiquitous psychiatric disease in China prior to 1980, is contested, marginalized, and reconstituted as the popular Western disease of depression among academic psychiatrists in urban China. It is argued that this dramatic change of diagnostic labelling is not only based on empirical evidence. Rather, it is also a product of interests and strategies that are themselves embedded in a confluence of historical, social, political, and economic forces. Specifically, China's open door policy, the hegemony of DSM discourse, the depoliticization of experience, and the transnational commercialization of suffering have all played a role in creating the new-found disease of depression. As a new social construct in China, depression may serve different social functions for different institutional groups, such as drug companies' marketing of new antidepressant therapy, and academic psychiatrists' effort to render the study of suicide more admissible to the state. Because of the government's budgetary limitations and drastic changes in health care financing, however, global diagnostic technology and markets for drugs merely reinforce people's markedly unequal access to health care, which is but one facet of the pervasive social inequity that is China nowadays.

China: long-term issues and options in the health transition. A World Bank country study

Jan 1992

Bumgarner Jr

BUMGARNER JR. China: long-term issues and options in the health transition. A World Bank country study. Washington, DC: The World Bank, 1992.

The Danish National Board]. Dùd-sa Êrsagerne 1991 [Cause of death in Denmark

Jan 1991

Sundhedsstyrelsen

Sundhedsstyrelsen [The Danish National Board]. Dùd-sa Êrsagerne 1991 [Cause of death in Denmark 1991].

Dùdsa Êrsagerne 1991 [Cause of death in Denmark 1991]. Copenhagen: The Danish National Board

Jan 1993

Sundhedsstyrelsen

Sundhedsstyrelsen [The Danish National Board]. Dùdsa Êrsagerne 1991 [Cause of death in Denmark 1991]. Copenhagen: The Danish National Board, 1993.

Suicide after discharge from psychiatric inpatient care (see comments)

Jan 1993
283

Goldacre

GOLDACRE M, SEAGROATT V, HAWTON K. Suicide after discharge from psychiatric inpatient care (see comments). Lancet 1993;342:283±286.

Specific characteristics of suicide in China

Abstract

No full-text available

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