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Liu Q, Teng CC, Sun I, Muñoz RF, Garza M, Liu NH, Barakat S, Leykin Y. Suicide attempts in the absence of depression: Differences between broad cultural groups. J Affect Disord 2024; 356:722-727. [PMID: 38657769 DOI: 10.1016/j.jad.2024.04.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Suicide is one of the leading causes of death worldwide (WHO, 2021). Depression is a common precursor to suicide and suicidality; however, individuals' experience of depression and the meaning of suicide differs depending on one's cultural background (Colucci, 2013; Goodmann et al., 2021; Kleinman, 2004). The current study explores the relationship between suicide and depression among six broad cultural groups in a large sample (N = 17,015) of adults representing six broad cultural groups (Latin America, South Asia, former Soviet Bloc, Western English-speakers, Chinese, and Arab World). Participants were recruited to a multilingual depression and suicide screening study via Google Ads (Leykin et al., 2012; Gross et al., 2014). As expected, the presence of depression was associated with suicide attempts. However, cultural group moderated this association, with Chinese participants being most likely to report suicide attempts while screening negative for depression. Although depression remains an important predictor of suicidality, it appears that certain cultural groups may be at higher risk even when depression is not present. Clinicians should consider using culturally adapted assessments for depression and suicidality.
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Affiliation(s)
| | | | | | - Ricardo F Muñoz
- Palo Alto University; University of California, San Francisco, United States of America; Institute for International Internet Interventions for Health, United States of America
| | - Monica Garza
- Legacy Community Health, United States of America
| | - Nancy H Liu
- University of California, Berkeley, United States of America
| | - Suzanne Barakat
- University of California, San Francisco, United States of America
| | - Yan Leykin
- Palo Alto University; University of California, San Francisco, United States of America; Institute for International Internet Interventions for Health, United States of America.
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Wu Y, Su B, Zhong P, Wang Y, Huang Y, Zheng X. The long-term changing patterns of suicide mortality in China from 1987 to 2020: continuing urban-rural disparity. BMC Public Health 2024; 24:1269. [PMID: 38725017 PMCID: PMC11083847 DOI: 10.1186/s12889-024-18743-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Over the past three decades, China has experienced significant changes in urban-rural, gender, and age-specific suicide mortality patterns. This study aimed to investigate the long-term trends in suicide mortality in China from 1987 to 2020. METHODS Suicide mortality data were obtained from China's National Health Commission. Joinpoint regression analysis was used to examine changes in trends and age-period-cohort modeling to estimate age, period, and cohort effects on suicide mortality from 1987 to 2020. Net drift, local drift, longitudinal age curves, and period relative risks were also calculated. RESULTS Crude and age-standardized suicide mortality in China showed continuing downward trends from 1987 to 2020, with a more pronounced decrease in rural areas (net drift = -7.07%, p<0.01) compared to urban areas (net drift = -3.41%, p<0.01). The decline curve of urban areas could be divided into three substages. Period and cohort effects were more prominent in rural areas. Suicide risk was highest among individuals aged 20-24 and gradually increased after age 60. Females, particularly those of childbearing age, had higher suicide risk than males, with a reversal observed after age 50. This gender reversal showed distinct patterns in urban and rural areas, with a widening gap in urban areas and a relatively stable gap in rural areas. CONCLUSIONS Suicide mortality in China has consistently declined over the past three decades. However, disparities in age, gender, and urban-rural settings persist, with new patterns emerging. Targeted suicide prevention programs are urgently needed for high-risk groups, including females of childbearing age and the elderly, and to address the slower decrease and reversing urban-rural gender trends.
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Affiliation(s)
- Yu Wu
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing, 100730, China
| | - Binbin Su
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing, 100730, China
| | - Panliang Zhong
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing, 100730, China
| | - Yiran Wang
- APEC Health Science Academy (HeSAY), Peking University, Beijing, China
| | - Yueqin Huang
- NHC Key Laboratory of Mental Health (Peking University), Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Xiaoying Zheng
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing, 100730, China.
- APEC Health Science Academy (HeSAY), Peking University, Beijing, China.
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Lyu J, Zhang J, Wang L. Declining suicide rates in China (1990-2017): Gender and age specific analyses. J Affect Disord 2024; 352:19-25. [PMID: 38336166 DOI: 10.1016/j.jad.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND In China suicide rates have been declining for about three decades. Patterns of suicide for women and men across the lifespan over time however have not been systematically documented. METHODS Official suicide mortality data (from 1990 to 2017) available via China CDC were used to examine suicide patterns by gender and age in each of the 33 provincial-level regions. Suicide data were aggregated by five years, except for the year of 2017. The bar graphs were used to descriptive the change tread of the suicide rate. RESULTS In the past three decades, the decline in female suicide rates was greater than that in the male rates, with the overall male to female (M/F) ratio changing from 0.88 in 1996 to 1.56 in 2017. The overall suicide rate of male was 8.82 and female was 5.65 per 100,000 persons in 2017. However the decline of suicide rates for people aged 70 and older was the greatest declination (33.73/per 100,000 persons) among all the age groups in China. CONCLUSION Overall suicide rates have declined over the three decades in China, particularly among females and individuals age 70+ years. Suicide rates continue to be higher among individuals aged 50 and older (particularly among men), and this population should continue to the focus for prevention.
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Affiliation(s)
- Juncheng Lyu
- Shandong Second Medical University, Shandong, China
| | - Jie Zhang
- Central University of Finance and Economics Department of Sociology, Beijing, China; State University of New York Buffalo State University Department of Sociology, New York, USA.
| | - Lijun Wang
- China Centers for Disease Control and Prevention (CDC), Beijing, China
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Najafi S, Razmjouie F, Shiraly R, Afzali Harsini P, Khani Jeihooni A. Evaluation of an Educational Intervention Based on Theory of Planned Behavior to Reduce Suicidal Ideation and Attempts in Drug Addicts Receiving Methadone: A Quasi-Experimental Study. Subst Use Misuse 2024; 59:858-866. [PMID: 38254342 DOI: 10.1080/10826084.2024.2305799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Drug addiction can lead to suicidal ideation or suicide attempt so that half of those who attempt suicide have a history of substance abuse. The purpose of this study was to investigate the effect of educational intervention based on Theory of Planned Behavior (TPB) on reducing suicidal ideation and suicide attempt of addicts. METHODS A longitudinal quasi-experimental educational intervention was conducted on 200 methadone-treated addicts with suicidal ideation under the auspices of government addiction centers of Shiraz city from 2021 to 2022. Baseline data on demographic characteristics, suicidal ideation, and TPB questionnaire were collected from two groups at the beginning of the study and then three months after the intervention. The experiment group received educational intervention including sessions of individual and group counseling, training and organizational supports. The questionnaire was completed by both the experimental and control groups before the educational intervention and three months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, Chi-square and paired t-test (p = 0.05). RESULTS The mean age of addicts in the experimental and control groups was 38.80 ± 11.64 and 39.41 ± 11.18 years, respectively (p = 0.206). 22% of the experimental group and 18% of the control group had a history of suicide. According to the results, there was no significant difference between the experimental and control groups in terms of knowledge, attitude, subjective norms and perceived behavioral control before the educational intervention, however, the mentioned variables increased significantly in the experimental group three months after the educational intervention. There was no significant difference in suicide attempt and suicidal ideation between the experimental and control groups before the educational intervention, however, there was a significant change in the experimental group after the educational intervention. CONCLUSION The results of the present study showed the effect of educational intervention on the knowledge, attitude, subjective norms, perceived behavioral control, suicidal ideation and suicidal attempt of addicts, thus confirming the effectiveness of the TPB-based intervention on reducing suicide of addicts.
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Affiliation(s)
- Siamak Najafi
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Fatemeh Razmjouie
- Department of Health Promotion and Aging, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Shiraly
- Department of Community Medicine , School of Medicine, Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Khani Jeihooni
- Department of Public Health, Nutrition Research Center, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Xuan L, Hua S, Lin L, Jianli Y. Gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students. J Affect Disord 2023; 327:1-6. [PMID: 36736787 DOI: 10.1016/j.jad.2023.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Depression and aggression are related to the risk of suicide. Previous studies have associated different characteristics with depression and aggression in separate gender groups. The main aim of this study was to investigate the gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students. METHODS A total of 2004 first-year undergraduates (80.5 % female, mean age = 19.4 ± 0.8 years) were surveyed by a battery of questionnaires that contained the Chinese version of the Beck scale for Suicide Ideation, the Chinese version of the 12-item Aggression Questionnaire, and the Center for Epidemiologic Studies Depression scale. RESULTS (1) Depression severity was significantly associated with the suicidality risk (r = 0.090, p < 0.01). (2) Suicide risk correlated positively with physical aggression, verbal aggression, anger, and hostility in the aggression questionnaire (r = 0.308, 0.227, 0.284, 0.277, p < 0.01). (3) A possible gender difference was noted for suicide risk in that depression degree was a significant risk factor for females but not males (R2 = 0.095, F = 41.554, p < 0.01), whereas anger was a significant predictor of suicide risk for males but not for females (R2 = 0.21, F = 25.75, p < 0.01). CONCLUSIONS Gender differences exist in the predictive effect of depression and aggression on suicide risk among first-year college students.
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Affiliation(s)
- Li Xuan
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shao Hua
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lin Lin
- Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Yang Jianli
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China.
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Azizi H, Esmaeili ED, Khodamoradi F, Sarbazi E. Effective suicide prevention strategies in primary healthcare settings: a systematic review. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
There is a fundamental need for health systems, health managers, and policymakers to identify effective components of suicide prevention strategies (SPS) and programs in primary healthcare (PHC) settings. Accordingly, this systematic review aimed to identify and summarize effective and significant evidence on suicide prevention in PHC setting. We systematically searched the published literature in English from PubMed, Web of Science, Scopus, CINAHL, PsychoINFO, and Embase up to 31 July 2022. The study searched all records reporting effective and significant strategies and programs on suicide prevention in PHC settings. A content analysis approach was carried out to extract major components of suicide prevention strategies in PHC settings.
Results
A total of 10 records (8 original articles and 2 reports) with 1,199,986 samples were included. In all the included articles, SPS decreased suicide rates. The majority of studies were conducted among the general population. The content analysis approach emerged five major components to SPS in PHC setting: (1) training and educating healthcare providers, (2) screening and suicide risk assessment, (3) managing depression symptoms and mental disorders, (4) managing suicide attempters and at-risk cases, and (5) prevention strategies at the general population.
Conclusions
This review provided reliable evidence for health systems to develop SPS in PHC and practitioners who are eager to provide brief and effective contact interventions for suicide risk to well-serve their patients.
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Brailovskaia J, Teismann T, Lewitzka U, Gao Z, Zhang XC, Margraf J. Suicidal ideation, suicide attempts and positive mental health in Chinese medical students. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Qiao J, Xia T, Fang B, Cai R, Chen L, Qian N, Yu H, Jin S, Wang C, Fu C. The reversing trend in suicide rates in Shanghai, China, from 2002 to 2020. J Affect Disord 2022; 308:147-154. [PMID: 35429532 DOI: 10.1016/j.jad.2022.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/08/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND To explore changing patterns in suicides and provide suggestions for suicide prevention by reviewing all suicide deaths from 2002 to 2020 in Shanghai, China. METHODS Suicide-death data were obtained from the Shanghai Death Surveillance System and analyzed in terms of year, sex, age group, area, suicide method, and depression diagnosis. Joinpoint regression analyses were conducted to examine time trends in suicide rates. RESULTS The age-adjusted suicide rate was 6.15/100,000 in 2002 and 5.10/100,000 in 2020. The change in this rate was U-shaped, with a downward trend before 2009 followed by an upward trend. The rate initially decreased by 6.33% annually (95% confidence interval [95%CI]: 4.25-8.37%) but, after 2009, increased by 2.60% annually (95%CI: 1.49-3.71%). Similar trends were found for men and women, the 0-29y and 30-49y age groups, and residents of central and suburban areas, respectively. In 2020, jumping from a high place was the leading suicide method (39.54%), and 22.54% of suicide victims had a diagnosis of depression. LIMITATIONS Suicides may be misclassified in coding (however, provided misclassification rates remain stable, this should not influence overall trends). Suicides among temporary residents were not included because of inadequate stratified population data. The finding of a higher prevalence of depression may have been impacted by a higher detection rate. CONCLUSIONS The post-2002 decline in Shanghai suicide rates reversed in 2009, and the suicide pattern changed greatly from 2002 to 2020. With the current increasing trend in suicide rates, targeted suicide-prevention strategies featuring multi-departmental cooperation are necessary.
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Affiliation(s)
- Jiaying Qiao
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Tian Xia
- Institute of Health Information, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Bo Fang
- Department of Vital Statistics, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Renzhi Cai
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Lei Chen
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Naisi Qian
- Department of Vital Statistics, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Huiting Yu
- Department of Vital Statistics, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Shan Jin
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Chunfang Wang
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Chen Fu
- Shanghai Municipal Center for Disease Control and Prevention, China.
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Gianvecchio VAP, Jorge MHPDM. [Suicide in the state of São Paulo, Brazil: comparing Public Safety and Health data]. CIENCIA & SAUDE COLETIVA 2022; 27:2427-2436. [PMID: 35649029 DOI: 10.1590/1413-81232022276.16112021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 09/24/2021] [Indexed: 11/22/2022] Open
Abstract
Suicide is prevalent among people of almost all ages and has a high social and economic cost. It is widely known, however, that its true prevalence is underestimated. This article aims to study suicide in São Paulo based on Public Safety data, compared with mortality information system data (SIM/MS), in order to assess possible information gains. A database (Banco SSP) was assembled from spreadsheets for police reports, complemented with existing Forensic Medicine Institute information, which was compared with the SIM/MS data. The Banco SSP database (2,469) was 7.5% higher than SIM/MS (2,297), with results reflected in the sex and age of the victims, showing the highest rates among elderly men (rate of 12.8 per 100,000 inhabitants). In relation to the method of suicide, there was a predominance of hanging (60.2%); 92.5% of unspecified cases were clarified, with an increase in deaths from exogenous poisoning (55.7%). The police reports revealed variables considered as possible risk factors for suicide, such as the mention of mental disorders (39.4%), other pathologies (5.0%), other problems (23.2%) and earlier attempted suicides (10.0%). The source studied enabled obtaining quantitative and qualitatively enhanced data compared to the SIM/MS data.
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Alrasheed FK, Alowairdhi YA, Alkharashi YM, Alomar AO, Alqirnas MQ, Alhussaini NA, Albassam A, Almosa AS, Alkhars AZ, Alhelail M. Suicide Attempts by Poisoning: An Experience From a High-Volume Emergency Department. Cureus 2022; 14:e23330. [PMID: 35464598 PMCID: PMC9015061 DOI: 10.7759/cureus.23330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/05/2022] Open
Abstract
Background There has been a tremendous increase in self-poisoning behavior worldwide, with different trends depending on cultural and geographic aspects. Objectives Our study aims to assess the trends, outcomes, and predictors in patients of suicide attempts by poisoning at King Abdulaziz Medical City (KAMC) ED. Materials and methods A retrospective cohort study took place at KAMC. Frequencies and percentages were used to display categorical variables. Minimum, maximum, mean, and SD were used to display continuous variables. Chi-squared test and independent t-test were utilized to test for factors associated with suicidal intention. Results A total of 130 cases were identified. The participants were mostly females (73.8%, n = 96). Most of the participants were pediatric patients (57.7%, n = 75). The most consumed agents were acetaminophen in 59 (45.83%) and non-steroidal anti-inflammatory drugs (NSAIDs) in 22 (16.92%). The ICU admission rate was 8.5% (n = 11). The management for both populations was unspecific, involving observation, supportive measures, and symptomatic treatment. BMI (p < 0.001), gender (p < 0.001), age (p = 0.012), and a history of neuropsychiatric disorders (p < 0.001) were associated factors. Conclusion It is crucial that the trends and risk factors of self-poisoning suicide attempts are identified to provide support to those in need. Several variables of interest were noted since the two most observed agents share several key features, such as accessibility and availability. However, contradicting literature reports warrant further investigation to confirm or negate the evidence.
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Matsubayashi T, Ueda M. Is suicide underreported? Evidence from Japan. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1571-1578. [PMID: 34767033 PMCID: PMC9288949 DOI: 10.1007/s00127-021-02188-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 10/31/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE The underreporting of suicides has been a serious global concern among scholars and policymakers. Several studies have sought to detect the prevalence of underreporting by examining whether suicide mortality rates are negatively correlated with those due to unknown intent or causes. This study adds to the literature by examining the potential underreporting of suicides in Japan, where suicide rates have greatly declined in the recent years. METHODS We compiled subnational data from 47 prefectures between 1995 and 2016, obtained from Vital Statistics of Japan. We examined whether (1) mortality rates due to unknown intent or causes increased as suicide rates decreased; and (2) major socioeconomic causes of suicide (unemployment and divorce rates) had any relationship with the deaths due to unknown intent or causes. RESULTS Our analysis indicates that mortality rates due to unknown intent or causes were uncorrelated with suicide rates and the above socioeconomic indicators. CONCLUSIONS In Japan, the frequency of suicides has no systematic relationship with deaths due to unknown intent or causes, suggesting the accuracy of suicide statistics.
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Affiliation(s)
| | - Michiko Ueda
- grid.5290.e0000 0004 1936 9975Waseda University, Tokyo, Japan
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12
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Outcomes of community-based suicide prevention program in primary health care of Iran. Int J Ment Health Syst 2021; 15:67. [PMID: 34348779 PMCID: PMC8336287 DOI: 10.1186/s13033-021-00492-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/27/2021] [Indexed: 01/20/2023] Open
Abstract
Background Suicidal management and prevention in communities, especially in its first stages, is an effective intervention for the health systems. However, in numerous societies most cases go undetected. Primary Health Care (PHC) is an effective place for the management of Suicide Prevention Programs (SPP). In Malekan County, a health community assessment found suicide as the most important health problem. A regional SPP was performed for suicide prevention during 2014–2017. Methods This study was carried out in six steps: (1) Establishing a research team, (2) Improving a registry for suicidal behaviors (SBs), (3) Identifying local determinants of SBs, (4) Training healthcare providers, (5) Follow-up and monitoring of SBs, and (6) Public awareness campaigns. Our ultimate goal was to lower the rates of suicide, and suicide attempt (SA) by 15 and 20 %, respectively. Multiple logistic regression was used to estimate the adjusted odds ratios and the 95% confidence intervals. Results A total of 821 SAs and 32 suicides were identified. The gender distribution for suicides was 70% males whereas SAs were 64% among females. The majority of suicides occurred in spring 18 (56.25%) while summer was the most common season among SAs 288 (35.8%). Almost 62 and 75% of suicides and SAs have used hanging and poisoning methods, respectively. Hanging increased suicide risk significantly (OR: 8.5, 95% CI 2.9–76.99). During the study, 93 life-skill and parenting education sessions were held. The incidence rates of suicide and SA decreased from 11.22, and 203 per 100,000 in 2013 to 2.63, and 157 in 2017, respectively. Similarly, the re-attempt to SAs ratio decreased from 12% to 2013 to 6.7% in 2017. Moreover, more than 8% of SBs were collected from adjacent Counties. Conclusions At the study end, suicide, SA, and re-attempt were lowered by 75%, 22%, and 42%, respectively. The practical framework that achieved in this study could be used as a basis for developing future SPPs and suicide researches in the Iranian context. Furthermore, the various socio-economic and socio-cultural challenges highlight the need to consider a wide range of contextual factors when developing an SPP.
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Zou W, Tang L, Bie B. The stigmatization of suicide: A study of stories told by college students in China. DEATH STUDIES 2021; 46:2035-2045. [PMID: 34323165 DOI: 10.1080/07481187.2021.1958396] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study unpacks the dimensions of suicide stigma through an analysis of the stories told by college students in China. The phronetic iterative approach was used to analyze the interview data of 30 college students. Findings showed that college students use the strategy of othering in creating a distinction between us and them. Those who attempt or die by suicide are labeled as irresponsible, fragile, impulsive, and attention-seeking. Suicides of ingroup members are usually described as controllable, while the suicides of outgroup members are often deemed uncontrollable. Finally, suicides lead to a status loss for individuals and their social groups.
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Affiliation(s)
- Wenxue Zou
- Department of Communication, Texas A&M University, College Station, TX, USA
| | - Lu Tang
- Department of Communication, Texas A&M University, College Station, TX, USA
| | - Bijie Bie
- Independent Scholar, San Jose, CA, USA
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Wild P, Bovio N, Guseva Canu I. Part-time work and other occupational risk factors for suicide among working women in the Swiss National Cohort. Int Arch Occup Environ Health 2021; 94:981-990. [PMID: 33523245 PMCID: PMC8238695 DOI: 10.1007/s00420-020-01629-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/06/2020] [Indexed: 12/13/2022]
Abstract
Objective The aim of this study was to describe the factors associated with mortality by suicide among working women focusing on work-related factors. Methods The study population consisted in all Swiss residents recorded in the 1990 and/or the 2000 compulsory national censuses and were linked to emigration and mortality registers. We selected all women aged 18–65 and at work at the official census dates. Following work-related variables were available: socio-economic status, weekly hours of work, the sector of activity and the job title coded according to the International Standard Classification of Occupations (ISCO). The risk of suicide was modelled using negative binomial regression. Results The cohort comprised 1,771,940 women and 2526 deaths by suicide corresponding to 24.9 million person-years. The most significant non-occupational predictors of suicide were age, period, civil status, religion, nationality and geographical regions. Adjusted on these factors, part-time work was associated with increased suicide rates. According to job codes, health and social activities, in particular care-worker had the highest suicide risks. Conclusion Suicide among working women depended on work-related factors even taking into account other socio-demographic factors.
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Affiliation(s)
- Pascal Wild
- Institut National de Recherche et Sécurité (INRS), Vandoeuvre lès Nancy, France.
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
| | - Nicolas Bovio
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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