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Morshidi MI, Chew PKH, Suárez L. Psychosocial risk factors of youth suicide in the Western Pacific: a scoping review. Soc Psychiatry Psychiatr Epidemiol 2024; 59:201-209. [PMID: 37414977 PMCID: PMC10838839 DOI: 10.1007/s00127-023-02529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION The Western Pacific region accounts for 25% of global suicide rates globally. In the last decade, however, there is a rising concern over the rate of youth suicides in the region. In line with the regional vision of reducing the rate of non-communicable diseases by 2025, the study contributes to the literature by utilizing a scoping review approach to identify psychosocial risk factors associated with youth suicide in the region. METHOD Publications on youth suicide in the Western Pacific region between 2010 and 2021 were reviewed. A total of 43 publications met the inclusion criteria and were read in full. RESULTS Psychosocial risk factors associated with suicide in each publication were identified and thematically classified into five themes: interpersonal factors, history of abuse, academic factors, work factors, and minority status. DISCUSSION Findings showed discrepancies in youth suicide research across member nations in the Western Pacific. Implications for regional policies on suicide prevention and future research were discussed.
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Affiliation(s)
| | | | - Lidia Suárez
- James Cook University Singapore, Singapore, Singapore
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2
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Cruzeiro Szortyka ALS, Faria NMX, Carvalho MP, Feijó FR, Meucci RD, Flesch BD, Fiori NS, Fassa AG. Suicidality among South Brazilian tobacco growers. Neurotoxicology 2021; 86:52-58. [PMID: 34214458 DOI: 10.1016/j.neuro.2021.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 05/04/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess prevalence of suicidal ideation and suicide attempt among South Brazilian tobacco growers and to analyze the associated factors related to the suicidal ideation. METHODS A cross-sectional study was conducted in 2011 with a random sample of 2469 tobacco growers in São Lourenço do Sul/RS. Suicidal ideation was characterized by the question "Has the thought of ending your life been on your mind?". Suicide attempt was assessed by the question "Have you ever tried to kill yourself?". Investigation of factors associated with suicidal ideation was done by means of Poisson regression. RESULTS Prevalence of suicidal ideation and suicide attempt was 2.5 % and 1.2 % respectively. In the adjusted analysis, suicidal ideation was associated with being female, older age, moderate participation in religious activities and difficulty in paying debts. Those who worked in activities that required inadequate postures (hunched over or other forced positions), as well as farmers who performed 6-9 pesticide-related tasks demonstrated greater risk of suicidal ideation. Regarding health conditions, medical diagnosis of asthma, chronic low back pain, number of lifetime green tobacco sickness episodes and lifetime pesticide poisoning were positively associated with suicidal ideation. CONCLUSION Suicidal thoughts and attempts are relevant mental health problems among tobacco growers. Reducing pesticide use, as well as exposure to nicotine and improving socio-economic conditions, can reduce suicidal ideation and improve the mental health of exposed workers.
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Affiliation(s)
- Ana Laura Sica Cruzeiro Szortyka
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil; Psychology Course, Federal University of Pelotas, Pelotas, Brazil.
| | - Neice Muller Xavier Faria
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Maitê Peres Carvalho
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando Ribas Feijó
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Health, Environment and Work, Federal University of Bahia, Brazil
| | - Rodrigo Dalke Meucci
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Public Health, Foundation Federal University of Rio Grande, Rio Grande, Brazil
| | - Betina Daniele Flesch
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Nadia Spada Fiori
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Anaclaudia Gastal Fassa
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
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Chen L, Ngoubene-Atioky AJ, Zanardelli G, Yuanping D, Yu L. Childhood Abuse and Suicidal Behaviors Among Chinese Migrant Workers: The Mediating Role of Alexithymia and Social Support. Arch Suicide Res 2020; 24:633-647. [PMID: 31502515 DOI: 10.1080/13811118.2019.1658142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aims to investigate the lifetime prevalence of suicidal behaviors in a sample of Chinese migrant workers. It also examined the mediating role of alexithymia and social support in the link between childhood abuse and suicidal behaviors. A total of 1,563 migrant workers were surveyed by using cluster sampling. Results showed that the estimated lifetime prevalence of suicide ideation, plan, and attempt among Chinese migrant workers was 12.8%, 8.1%, and 4.6%, respectively. Structural equation modeling analyses revealed a significant positive association between childhood abuse and suicidal behaviors; this association was partially mediated by social support. A significant path from childhood abuse through alexithymia and social support to suicidal behaviors was also established. Findings of this study emphasize the importance of social support and alexithymia in understanding the possible mechanisms underlying the relationship between childhood abuse and suicidal behaviors and suggest possible avenues for suicide interventions.
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Zhao J, Chi Y, Ju Y, Liu X, Wang J, Liu X, Lew B, Siau CS, Jia C. Shame and Suicidal Ideation among Undergraduates in China: The Mediating Effect of Thwarted Belongingness and Perceived Burdensomeness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072360. [PMID: 32244371 PMCID: PMC7178018 DOI: 10.3390/ijerph17072360] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 01/26/2023]
Abstract
Undergraduate students with shame are more likely to experience suicidal ideation, but there remains a lack of research investigating the factors underlying this relationship. The interpersonal theory of suicide posits that suicidal ideation is influenced by the simultaneous presence of thwarted belongingness and perceived burdensomeness. We examined the prevalence of suicidal ideation among undergraduate students in China and examined the association between shame and suicidal ideation mediated by perceived burdensomeness and thwarted belongingness. A survey was conducted in July 2018 involving 2320 undergraduate students, and the twelve-month prevalence of suicidal ideation was 8.95%. Shame played a crucial role in predicting suicidal ideation, and the mediating effects of perceived burdensomeness and thwarted belongingness between shame and suicidal ideation were significant. Suicidal ideation is common among undergraduate students in China and merits greater attention. Shame, perceived burdensomeness, and thwarted belongingness may be important factors to assess among undergraduate students in suicide risk assessment and psychological intervention.
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Affiliation(s)
- Jingjing Zhao
- School of Marxism, Shandong University, Jinan 250012, China
| | - Yanna Chi
- School of Public Health, Shandong University, Jinan 250012, China
| | - Yanli Ju
- School of Public Health, Shandong University, Jinan 250012, China
| | - Xiyao Liu
- School of Public Health, Shandong University, Jinan 250012, China
| | - Jingjing Wang
- School of Public Health, Shandong University, Jinan 250012, China
| | - Xinglai Liu
- School of Public Health, Shandong University, Jinan 250012, China
| | - Bob Lew
- Department of Social Psychology, Putra University of Malaysia, Serdang 43400, Selangor Malaysia
| | - Ching Sin Siau
- Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur 56000, Malaysia
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan 250012, China
- Correspondence: ; Tel.: +86-0531-8838-2141-8803
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Lu L, Xu L, Luan X, Sun L, Li J, Qin W, Zhang J, Jing X, Wang Y, Xia Y, Li Y, Jiao A. Gender difference in suicidal ideation and related factors among rural elderly: a cross-sectional study in Shandong, China. Ann Gen Psychiatry 2020; 19:2. [PMID: 31956335 PMCID: PMC6958769 DOI: 10.1186/s12991-019-0256-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/31/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Suicide is a global public health problem which has significant negative influence on individuals, families and the society. The aim of this study is to investigate the prevalence of suicidal ideation and related factors among elderly people in rural China, and further examine the gender differences of suicidal ideation. METHODS Data were collected from the 2017 Survey of the Shandong Elderly Family Health Service, which was conducted by Shandong University. A total of 5514 elderly aged 60 and above from rural Shandong were included in this study. Binary logistic regression model was performed to examine the gender difference towards suicidal ideation, and to identify the influencing factors of suicidal ideation by gender among elderly. RESULTS 7.7% rural elderly reported suicidal ideation in the past 12 months in Shandong, China. The prevalence of suicidal ideation among females was significantly higher than that among males (P < 0.001). Education level, debts, stress of daily life, loneliness and psychological distress were significantly related to suicidal ideation in both males and females. Besides, negative life events and life satisfaction were found to be significantly associated with suicidal ideation in females but not in males. CONCLUSIONS There was a significant gender difference towards suicidal ideation among rural elderly in Shandong, China. So, gender difference should be considered when medical practitioners and public health workers seek to prevent and manage suicidal ideation among rural elderly, which will be important to develop strategies for coping with risk factors for suicidal ideation among males and females. In other words, more attention should be paid to females who had encountered negative life event or with lower life satisfaction.
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Affiliation(s)
- Lu Lu
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Lingzhong Xu
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Xiaorong Luan
- 4Department of Nursing Management of Qilu Hospital, Shandong University, Jinan, 250012 China
| | - Long Sun
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Jiajia Li
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Wenzhe Qin
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Jiao Zhang
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Xiang Jing
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Yali Wang
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Yu Xia
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Yaozu Li
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - An'an Jiao
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
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Zhong BL, Xie WX, Zhu JH, Lu J, Chen H. Prevalence and correlates of suicide attempt among Chinese individuals receiving methadone maintenance treatment for heroin dependence. Sci Rep 2019; 9:15859. [PMID: 31666637 PMCID: PMC6821703 DOI: 10.1038/s41598-019-52440-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/17/2019] [Indexed: 02/08/2023] Open
Abstract
To date, there have been very limited studies regarding the clinical epidemiology of attempted suicide in Chinese individuals with heroin-dependence. The objective of this study was to examine the prevalence and correlates of suicide attempt in Chinese individuals receiving methadone maintenance treatment for heroin dependence. Demographic, clinical, and psychosocial data of 603 methadone-maintained patients with heroin dependence were collected with a standardized self-administered questionnaire. The presence of suicide attempt and antisocial personality disorder was assessed by using a single question and the Mini-International Neuropsychiatric Interview 5.0. The one-month and lifetime prevalence rates of suicide attempt were 9.5% and 34.2%, respectively. In multivariable logistic regression, lifetime suicide attempt was significantly associated with female gender (OR = 2.81), being 20–39 years old (OR = 2.73), an education level of primary school or lower (OR = 2.07), poor economic status (OR = 3.06), injecting heroin before methadone maintenance treatment (OR = 2.92), depressive symptoms (OR = 3.46), anxiety symptoms (OR = 1.88), and antisocial personality disorder (OR = 2.85). Suicide attempt is very prevalent among Chinese individuals receiving methadone maintenance treatment for heroin dependence. Services for patients with heroin dependence in methadone maintenance treatment clinics in China should include psychosocial supports, periodic screening for suicide attempt and other suicidal behaviors and, when needed, psychiatric treatment and crisis intervention.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan Province, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Wu-Xiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Jun-Hong Zhu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Hongxian Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China. .,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan Province, China.
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Fang Y, Zeng B, Chen P, Mai Y, Teng S, Zhang M, Zhao J, Yang X, Zhao J. Mindfulness and Suicide Risk in Undergraduates: Exploring the Mediating Effect of Alexithymia. Front Psychol 2019; 10:2106. [PMID: 31572279 PMCID: PMC6753216 DOI: 10.3389/fpsyg.2019.02106] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022] Open
Abstract
The present study was designed to examine the relationship between dispositional mindfulness and suicide risk in undergraduates, and it further explored the potential mediating role of alexithymia in this relationship. A total of 2,633 undergraduates completed the Mindful Attention Awareness Scale (MAAS), the Suicidal Behaviors Questionnaire – Revised (SBQ-R), and the 20-item Toronto Alexithymia Scale (TAS-20). The results indicate that mindfulness and suicide risk were negatively correlated, and alexithymia partially mediated the relationship between mindfulness and suicide risk only in the female undergraduates. Moreover, only the difficulty in identifying feelings (DIF) factor of alexithymia mediated the relationship between mindfulness and suicide risk in the female undergraduates. These findings contribute to the potential mechanism that explains the relationship between mindfulness and suicide risk. Furthermore, it is possible to implement mindfulness in the suicide intervention of alexithymic individuals.
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Affiliation(s)
- Yuan Fang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Baoer Zeng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Peiyi Chen
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yiling Mai
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Shan Teng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Minting Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jingbo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiubo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Wang Z, Yu G, Tian X. Exploring Behavior of People with Suicidal Ideation in a Chinese Online Suicidal Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010054. [PMID: 30587805 PMCID: PMC6339245 DOI: 10.3390/ijerph16010054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/23/2018] [Accepted: 12/24/2018] [Indexed: 12/19/2022]
Abstract
People with suicidal ideation (PSI) are increasingly using social media to express suicidal feelings. Researchers have found that their internet-based communication may lead to the spread of suicidal ideation, which presents a set of challenges for suicide prevention. To develop effective prevention and intervention strategies that can be efficiently applied in online communities, we need to understand the behavior of PSI in internet-based communities. However, to date there have been no studies that specifically focus on the behavior of PSI in Chinese online communities. A total of 4489 postings in which users explicitly expressed their suicidal ideation were labeled from 560,000 postings in an internet-based suicidal community on Weibo (one of the biggest social media platforms in China) to explore their behavior. The results reveal that PSI are significantly more active than other users in the community. With the use of social network analysis, we also found that the more frequently users communicate with PSI, the more likely that users would become suicidal. In addition, Chinese women may be more likely to be at risk of suicide than men in the community. This study enriches our knowledge of PSI’s behavior in online communities, which may contribute to detecting and assisting PSI on social media.
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Affiliation(s)
- Zheng Wang
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Guang Yu
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Xianyun Tian
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
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Huang Y, Li P, Guo L, Gao X, Xu Y, Huang G, Deng X, Lu C. Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study. BMJ Open 2018; 8:e020969. [PMID: 30093513 PMCID: PMC6089305 DOI: 10.1136/bmjopen-2017-020969] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Suicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents. DESIGN Cross-sectional survey. SETTING A total of 506 high schools in 7 provinces of China. PARTICIPANTS A total of 150 822 students in grades 7-12 who completed the questionnaires (response rate of 95.9%) were included. MAIN OUTCOME MEASURES Suicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status. RESULTS Of the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06). CONCLUSIONS Our study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.
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Affiliation(s)
- Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xue Gao
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Yan Xu
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Guoliang Huang
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
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Gender-specific factors related to suicidal ideation among community-dwelling stroke survivors: The 2013 Korean Community Health Survey. PLoS One 2018; 13:e0201717. [PMID: 30071085 PMCID: PMC6072110 DOI: 10.1371/journal.pone.0201717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/21/2018] [Indexed: 11/20/2022] Open
Abstract
We assessed gender-specific factors associated with suicidal ideation among community-dwelling stroke survivors. In total, 4,322 stroke survivors who participated in the 2013 Korean Community Health Survey were included in the final analysis. Sociodemographic information, socio-family relationships, health behaviors, health status, and suicidal ideation were assessed using a standardized questionnaire. On fully adjusted analysis, suicidal ideation among males was more common in those who were widowed, rather than married (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.03–2.47), those who rarely contacted neighbors (OR 1.50, 95% CI 1.10–2.06), current smokers (OR 1.54, 95% CI 1.03–2.29), and frequent drinkers (OR 1.54, 95% CI 1.05–2.24). Suicidal ideation among females was more common in older subjects, those with lower monthly household incomes, the unemployed (OR 1.75, 95% CI 1.21–2.53), and housewives/students (OR 1.46, 95% CI 1.06–2.03), those who rarely contacted friends (OR 1.43, 95% CI 1.12–1.82), and diabetics (OR 1.35, 95% CI 1.05–1.73). Perceived persistent high-level stress, depressive mood, poor self-rated health, and a diagnosis of depression were commonly associated with suicidal ideation in both genders. Gender differences should be considered by medical practitioners and community policymakers when seeking to prevent and manage suicidal ideation in stroke survivors.
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11
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de Vries E, Rincon CJ, Tamayo Martínez N, Rodriguez N, Tiemeier H, Mackenbach JP, Gómez-Restrepo C, Guarnizo-Herreño CC. Housing index, urbanisation level and lifetime prevalence of depressive and anxiety disorders: a cross-sectional analysis of the Colombian national mental health survey. BMJ Open 2018; 8:e019065. [PMID: 29880561 PMCID: PMC6009503 DOI: 10.1136/bmjopen-2017-019065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. METHODS Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. OUTCOMES The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RIIurban0.96 (95% CI 0.51 to 1.81); RIIrural0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII -0.12 (95% CI -0.18 to -0.06)). Interestingly, within rural areas, persons living in 'populated centres' (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). INTERPRETATION In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Carlos Javier Rincon
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nathalie Tamayo Martínez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nelcy Rodriguez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
- Department of Psychiatry and Mental Health, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Epidemiology and Public Health, University College London, London, UK
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12
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Luo M, Jiang X, Wang Y, Wang Z, Shen Q, Li R, Cai Y. Association between induced abortion and suicidal ideation among unmarried female migrant workers in three metropolitan cities in China: a cross-sectional study. BMC Public Health 2018; 18:625. [PMID: 29764402 PMCID: PMC5952593 DOI: 10.1186/s12889-018-5527-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/01/2018] [Indexed: 11/30/2022] Open
Abstract
Background Despite reports of mental health issues, suicidality has not been closely examined among the migrant population. The association between induced abortion and suicidal ideation is unknown among unmarried female migrant workers of reproductive age in China. This study aims to examine induced abortion and suicidality among the Chinese migrant population. Methods We recruited 5115 unmarried female migrant workers during 2015 to 2016 from Shanghai, Beijing and Guangzhou, and collected demographic, psychosocial, reproductive and mental health information using structured questionnaires. We used logistic regression models to examine the association between lifetime induced abortion and suicidal ideation during the past year among the subjects. Results Overall, 8.2% of the subjects had suicidal ideation during the past year, and 15.5% of the subjects experienced induced abortion. Induced abortion was associated with nearly twice the odds of having past-year suicidal ideation (Odds ratio, OR = 1.89; 95% confidence interval, CI: 1.46, 2.44) after adjusting for age, education, years in the working place, tobacco use, alcohol consumption, daily internet use, attitude towards premarital pregnancy, multiple induced abortion, self-esteem, loneliness, depression, and anxiety disorders. The association was stronger in those aged > 25 (OR = 3.37, 95% CI = 2.16, 5.28), with > 5 years of stay in the working place (OR = 2.98, 95% CI = 2.02, 4.39), the non-anxiety group (OR = 2.28, 95% CI = 1.74, 3.00), and the non-depression group (OR = 2.94, 95% CI = 2.08, 4.15). Conclusions Induced abortion was associated with increased odds for suicidal ideation among the unmarried female migrant workers in urban cities in China. More attention should be paid to the mental health of the population.
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Affiliation(s)
- Mengyun Luo
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Xueqin Jiang
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Ying Wang
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Zezhou Wang
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Qiuming Shen
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Rui Li
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
| | - Yong Cai
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China.
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13
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Sun L, Zhou C. Association between body mass index and suicidal ideation among seniors in Shandong, China. Compr Psychiatry 2018; 82:68-72. [PMID: 29407361 DOI: 10.1016/j.comppsych.2018.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/11/2018] [Accepted: 01/13/2018] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Long Sun
- School of Public Health, Shandong University, Jinan 250012, China; Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan 250012, China; Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China.
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14
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Malalagama AS, Tennakoon S, Abeyasinghe DRR. Validation of Adolescent Suicide Assessment Protocol-20 (ASAP-20) to Sri Lankan adolescents. Asian J Psychiatr 2018; 33:11-17. [PMID: 29505971 DOI: 10.1016/j.ajp.2018.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/02/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Youth suicide rates are rising worldwide, including Sri Lanka, where 46.5/100,000 among 15-19yrs was reported in 1986. Identifying high risk adolescents is vital. Dearth of trained professionals, demands an instrument utilizable by non-psychiatrists. Such was not available in Sinhalese. Adolescent Suicide Assessment Protocol (ASAP-20) and its' manual was translated and validated to Sri Lankan adolescents. METHOD A validation study. Forward/back translations followed by cultural adaptation. Face validity, operational equivalence were assessed. Panel of Psychiatrists assessed semantics, conceptual, content/construct validity using external criticism. Final Sinhalese version was applied to 100 Sinhalese speaking 10-19yr olds referred to Psychiatry units of two Teaching Hospitals following a suicide attempt or with suicidal ideation (cases) excluding psychotic disorder, acute emergencies or special needs and compared with same aged adolescents on treatment for respiratory problems as controls. Discriminant ability was calculated using area under the Receiver Operating Curve (AUC). Reliability was calculated using Cronbach's alpha. RESULTS Sinhalese version showed satisfactory face/contents/construct validity and operational equivalence. Median suicide risk score was 18 and mean 17.99 (SD = 7.56) for cases, median = 4 and mean = 4.86 (SD = 2.41) for controls. AUC was 0.969 (SE = 0.11), indicating a high ability to discriminate moderate/high from low suicidal risk. Cut off value, 8.5 was lower than original tool at a sensitivity of 91% and a specificity of 91%. Cronbach's alpha was 0.811 indicating high reliability and consistency. CONCLUSION Sinhalese version of ASAP-20 is a successful screening instrument to detect high suicide risk among adolescents in clinical and non clinical settings.
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Affiliation(s)
- A S Malalagama
- Psychiatry Unit, Teaching Hospital Kandy, William Gopallawa Mawatha, Kandy, Sri Lanka.
| | - S Tennakoon
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka.
| | - D R R Abeyasinghe
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Sri Lanka.
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15
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Suicidal Ideation and Psychological Strain Among Patients Diagnosed With Stomach Cancer: The Mediation of Psychopathological Factors. J Nerv Ment Dis 2017; 205:550-557. [PMID: 28323661 DOI: 10.1097/nmd.0000000000000679] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with stomach cancer are at high risk to experience suicidal ideation. Strain theory of suicide assumes that suicide is preceded by psychological strain. Despite wide international acceptance of the theory, its use with a sample of patients with stomach cancer has not previously been reported. The aims were to examine the relationship between psychological strain and suicidal ideation among patients with stomach cancer and to determine whether psychopathological factors act as mediators. A cross-sectional study was undertaken involving subjects with no history of mental disorder, and questionnaires were administered by face-to-face interview. Patients who experienced more psychological strain, especially coping strain, are more likely to experience suicidal ideation. The mediation effects of hopelessness and psychological distress are significant. Psychological strain, hopelessness, and psychological distress may be the vital factors among patients with stomach cancer in the suicide-risk assessment interview and for care planning and psychological intervention.
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16
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Knipe DW, Gunnell D, Pieris R, Priyadarshana C, Weerasinghe M, Pearson M, Jayamanne S, Dawson AH, Mohamed F, Gawarammana I, Hawton K, Konradsen F, Eddleston M, Metcalfe C. Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross-sectional study of 165 000 individuals. BMJ Open 2017; 7:e014006. [PMID: 28336743 PMCID: PMC5372106 DOI: 10.1136/bmjopen-2016-014006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Lower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high-income countries, but this association is unclear in low-income and middle-income countries. METHODS We investigated the association of SEP with attempted suicide in a cross-sectional survey of 165 233 Sri Lankans. SEP data were collected at the household (assets, social standing (highest occupation of a household member), foreign employment and young (≤40 years) female-headed households) and individual level (education and occupation). Respondent-reported data on suicide attempts in the past year were recorded. Random-effects logistic regression models, accounting for clustering, were used to investigate the association of SEP with attempted suicide. RESULTS Households reported 398 attempted suicides in the preceding year (239 per 100 000). Fewer assets (OR 3.2, 95% CI 2.4 to 4.4) and having a daily wage labourer (ie, insecure/low-income job; OR 2.3, 95% CI 1.6 to 3.2) as the highest occupation increased the risk of an attempted suicide within households. At an individual level, daily wage labourers were at an increased risk of attempted suicide compared with farmers. The strongest associations were with low levels of education (OR 4.6, 95% CI 2.5 to 8.4), with a stronger association in men than women. CONCLUSIONS We found that indicators of lower SEP are associated with increased risk of attempted suicide in rural Sri Lanka. Longitudinal studies with objective measures of suicide attempts are needed to confirm this association. TRIAL REGISTRATION NUMBER NCT01146496; Pre-results.
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Affiliation(s)
- D W Knipe
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
| | - D Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
| | - R Pieris
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
| | - C Priyadarshana
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
| | - M Weerasinghe
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Faculty of Medicine & Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - M Pearson
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology Unit, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
| | - S Jayamanne
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Faculty of Medicine, University of Kelanyia, Kelanyia, Sri Lanka
| | - A H Dawson
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Central Clinical School, University of Sydney, Sydney, Australia
| | - F Mohamed
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Translational Australian Clinical Toxicology (TACT) Group, School of Medical Science, University of Sydney, Sydney, Australia
| | - I Gawarammana
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Faculty of Medicine, Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - K Hawton
- Department of Psychiatry, Centre for Suicide Research, University of Oxford, Oxford, UK
| | - F Konradsen
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Faculty of Health and Medical Sciences, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - M Eddleston
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology Unit, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
| | - C Metcalfe
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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17
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Kim M, Oh GJ, Lee YH. Gender-Specific Factors Associated with Suicide Attempts among the Community-Dwelling General Population with Suicidal Ideation: the 2013 Korean Community Health Survey. J Korean Med Sci 2016; 31:2010-2019. [PMID: 27822943 PMCID: PMC5102868 DOI: 10.3346/jkms.2016.31.12.2010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/23/2016] [Indexed: 11/21/2022] Open
Abstract
We identified traditional risk factors and investigated poorly understood risk factors for suicide attempts according to gender in a large Korean population. We analyzed the data from 6,768 males and 12,475 females with suicidal ideation obtained from the nationwide 2013 Korean Community Health Survey. The dependent variable was suicide attempts within the past year. There was a significant trend towards an increase in suicide attempts with decreasing age in both genders. Compared with those who were married, suicide attempts were significantly higher among those who were widowed, divorced, or separated for males (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.34-3.20), but lower for females (OR, 0.66; 95% CI, 0.45-0.98). Current smoking and depression were significant risk factor for suicide attempts in males and females. However, monthly household income, myocardial infarction, and osteoporosis were significantly associated with suicide attempts only in males, whereas education level, recipient of National Basic Livelihood Security, family contact, leisure activity, and drinking frequency were significantly associated only in females. These findings indicate that gender difference should be considered in the assessment, prevention, and management of future suicide attempts by community policy-makers and clinicians.
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Affiliation(s)
- Mina Kim
- Department of Nursing, Graduate School, Chonnam National University, Gwangju, Korea
- Department of Counseling Psychology, Graduate School of Dongshin University, Naju, Korea
| | - Gyung Jae Oh
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Young Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.
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18
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Zhong BL, Chiu HFK, Conwell Y. Elderly suicide trends in the context of transforming China, 1987-2014. Sci Rep 2016; 6:37724. [PMID: 27886219 PMCID: PMC5123573 DOI: 10.1038/srep37724] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/31/2016] [Indexed: 11/09/2022] Open
Abstract
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.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.,Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
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19
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Iemmi V, Bantjes J, Coast E, Channer K, Leone T, McDaid D, Palfreyman A, Stephens B, Lund C. Suicide and poverty in low-income and middle-income countries: a systematic review. Lancet Psychiatry 2016; 3:774-783. [PMID: 27475770 DOI: 10.1016/s2215-0366(16)30066-9] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 12/12/2022]
Abstract
Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events.
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Affiliation(s)
- Valentina Iemmi
- London School of Economics and Political Science, London, UK.
| | | | - Ernestina Coast
- London School of Economics and Political Science, London, UK
| | | | - Tiziana Leone
- London School of Economics and Political Science, London, UK
| | - David McDaid
- London School of Economics and Political Science, London, UK
| | | | | | - Crick Lund
- University of Cape Town, Cape Town, South Africa
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20
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Wong TS, Xiang YT, Tsoh J, Ungvari GS, Ko FWS, Hui DSC, Chiu HFK. Suicidal ideation in Chinese patients with chronic obstructive pulmonary disease: a controlled study. Psychogeriatrics 2016; 16:172-6. [PMID: 26115202 DOI: 10.1111/psyg.12135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/29/2013] [Accepted: 04/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND No study has been published on the prevalence of suicidal behaviour in older Chinese patients with chronic obstructive pulmonary disease (COPD). This study examined the 1-year prevalence of suicidal ideation in older Chinese COPD patients and explored its demographic and clinical correlates. METHODS A consecutive sample of 143 COPD patients and 211 matched control subjects were recruited and interviewed using structured, standardized instruments. RESULTS The 1-year prevalence of suicidal ideation in COPD patients and controls were 15.4% and 10.9%, respectively. In multivariate analyses, suicidal ideation was significantly associated with the severity of depressive symptoms in COPD patients. CONCLUSION Suicidal ideation was not higher in COPD patients than in controls.
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Affiliation(s)
- Tak-Shun Wong
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Yu-Tao Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Joshua Tsoh
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia.,The University of Notre Dame Australia/Marian Centre, Perth, Western Australia, Australia
| | - Fanny W S Ko
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - David S C Hui
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
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21
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Poverty and suicide research in low- and middle-income countries: systematic mapping of literature published in English and a proposed research agenda. Glob Ment Health (Camb) 2016; 3:e32. [PMID: 28596900 PMCID: PMC5454768 DOI: 10.1017/gmh.2016.27] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/03/2016] [Accepted: 10/14/2016] [Indexed: 11/06/2022] Open
Abstract
Approximately 75% of suicides occur in low- and middle-income countries (LMICs) where rates of poverty are high. Evidence suggests a relationship between economic variables and suicidal behaviour. To plan effective suicide prevention interventions in LMICs we need to understand the relationship between poverty and suicidal behaviour and how contextual factors may mediate this relationship. We conducted a systematic mapping of the English literature on poverty and suicidal behaviour in LMICs, to provide an overview of what is known about this topic, highlight gaps in literature, and consider the implications of current knowledge for research and policy. Eleven databases were searched using a combination of key words for suicidal ideation and behaviours, poverty and LMICs to identify articles published in English between January 2004 and April 2014. Narrative analysis was performed for the 84 studies meeting inclusion criteria. Most English studies in this area come from South Asia and Middle, East and North Africa, with a relative dearth of studies from countries in Sub-Saharan Africa. Most of the available evidence comes from upper middle-income countries; only 6% of studies come from low-income countries. Most studies focused on poverty measures such as unemployment and economic status, while neglecting dimensions such as debt, relative and absolute poverty, and support from welfare systems. Most studies are conducted within a risk-factor paradigm and employ descriptive statistics thus providing little insight into the nature of the relationship. More robust evidence is needed in this area, with theory-driven studies focussing on a wider range of poverty dimensions, and employing more sophisticated statistical methods.
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22
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Qin Q, Jin Y, Zhan S, Yu X, Huang F. Suicidal ideation among rural immigrant daughters-in-law with multi-roles as females, farmers and immigrants in China. PSYCHOL HEALTH MED 2015; 21:608-17. [PMID: 26565419 DOI: 10.1080/13548506.2015.1112414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Suicide is a major public health issue in China, and suicidal ideation is an important step in the suicidal process. The purpose of this study was to understand the prevalence and correlates of suicidal ideation among rural immigrant daughters-in-law with multi-role of female, farmer and immigrant in China. A total of 939 participants including 474 local daughters-in-law and 465 immigrant daughters-in-law were surveyed using the self-rating questionnaire. Demographic characteristics, depression, anxiety, impulsivity and suicidal ideation were assessed. Results indicated that the lifetime prevalence of suicidal ideation among rural immigrant daughters-in-law was 9.68%. Physical disability, domestic violence and negative events demonstrated statistical significance by suicidal ideation (p < .05), and participants with suicidal ideation had higher scores of depression, anxiety and impulsiveness in the univariate analysis. Multivariate logistic regression showed that physical disability (OR = 7.43, 95%CI: 2.84-19.46), domestic violence (OR = 2.65, 95%CI: 1.02-6.88), depression (OR = 1.07, 95%CI: 1.01-1.12), impulsiveness (OR = 1.04, 95%CI: 1.01-1.08) and motor impulsiveness (OR = 1.07, 95%CI: 1.01-1.14) were significantly associated with suicidal ideation. Suicidal ideation is an issue that can't be ignored among rural immigrant daughters-in-law. And the findings should be considered for the intervention of the suicide among the rural immigrant daughters-in-law.
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Affiliation(s)
- Qirong Qin
- a Ma'anshan Center for Disease Control and Prevention , Ma'anshan , China
| | - Yu Jin
- b Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , China
| | - Shengwei Zhan
- a Ma'anshan Center for Disease Control and Prevention , Ma'anshan , China
| | - Xiaodong Yu
- c Bowang Center for Disease Control and Prevention , Ma'anshan , China
| | - Fen Huang
- b Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , China
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Knipe DW, Carroll R, Thomas KH, Pease A, Gunnell D, Metcalfe C. Association of socio-economic position and suicide/attempted suicide in low and middle income countries in South and South-East Asia - a systematic review. BMC Public Health 2015; 15:1055. [PMID: 26472204 PMCID: PMC4608117 DOI: 10.1186/s12889-015-2301-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Forty percent of the world's suicide deaths occur in low and middle income countries (LAMIC) in Asia. There is a recognition that social factors, such as socioeconomic position (SEP), play an important role in determining suicidal risk in high income countries, but less is known about the association in LAMIC. METHODS The objective of this systematic review was to synthesise existing evidence of the association between SEP and attempted suicide/suicide risk in LAMIC countries in South and South East Asia. Web of Science, MEDLINE, MEDLINE in Process, EMBASE, PsycINFO, and article reference lists/forward citations were searched for eligible studies. Epidemiological studies reporting on the association of individual SEP with suicide and attempted suicide were included. Study quality was assessed using an adapted rating tool and a narrative synthesis was conducted. RESULTS Thirty-one studies from nine countries were identified; 31 different measures of SEP were reported, with education being the most frequently recorded. Most studies suggest that lower levels of SEP are associated with an increased risk of suicide/attempted suicide, though findings are not always consistent between and within countries. Over half of the studies included in this review were of moderate/low quality. The SEP risk factors with the most consistent association across studies were asset based measures (e.g. composite measures); education; measures of financial difficulty and subjective measures of financial circumstance. Several studies show a greater than threefold increased risk in lower SEP groups with the largest and most consistent association with subjective measures of financial circumstance. CONCLUSION The current evidence suggests that lower SEP increases the likelihood of suicide/attempted suicide in LAMIC in South and South East Asia. However, the findings are severely limited by study quality; larger better quality studies are therefore needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2014: CRD42014006521.
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Affiliation(s)
- Duleeka W Knipe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
| | - Robert Carroll
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Kyla H Thomas
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Anna Pease
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
| | - Chris Metcalfe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
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Xu H, Zhang W, Wang X, Yuan J, Tang X, Yin Y, Zhang S, Zhou H, Qu Z, Tian D. Prevalence and influence factors of suicidal ideation among females and males in Northwestern urban China: a population-based epidemiological study. BMC Public Health 2015; 15:961. [PMID: 26404535 PMCID: PMC4582628 DOI: 10.1186/s12889-015-2257-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 09/11/2015] [Indexed: 11/25/2022] Open
Abstract
Background Suicide is an urgent public health challenge for China. This study aims to examine the prevalence, influence factors, and gender differences of suicidal ideation among general population in Northwestern Urban China. Methods Data used in this study were derived from the third wave of a cohort study of a randomized community sample with 4291 participants (≥20 years) in 2008 in Lanzhou City and Baiyin City, Gansu Province. Data were collected via face-to-face interview by the trained interviewers. Descriptive analyses, chi-square tests and multivariate logistic regressions were performed by using Stata 12.0, as needed. Results The prevalence of 12-month suicidal ideation was 4.29 %, there was no significant difference between males and females [5.04 % vs 3.62 %, Adjusted Odds Ratio (AOR) = 0.83, p = 0.351]. Several risk factors for suicidal ideation were confirmed, including being unmarried (AOR = 1.55, p = 0.030), having depression symptoms (AOR = 2.33, p < 0.001), having other insurance (AOR = 1.83, p = 0.01) or no insurance (AOR = 1.73, p = 0.024). In addition, several influence factors were significantly different in males and females, such as being currently married (unmarried vs married, AOR = 1.84, p = 0.027, for females; no difference for males), feeling hopeless (hopless vs hopeful, AOR = 1.92, p = 0.06, for females; no difference for males), having other insurances (having other insurances vs having basic employee medical insurance, AOR = 1.92, p = 0.044, for males; no difference for females), having debts (having debts vs no debts, AOR = 2.69, p = 0.001, for males; no difference for females), currently smoking (smoking vs nonsmoking, AOR = 3.01, p = 0.019 for females, no difference for males), and currently drinking (drinking vs nondrinking, AOR = 2.01, p = 0.022, for males; no difference for females). Discussion and conclusion These findings suggested that comprehensive suicide prevention strategies should be developed or strengthened in order to prevent suicide ideation in China, and the gender-specific differences need to be explored through further researches.
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Affiliation(s)
- Huiwen Xu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China. .,Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
| | - Weijun Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Xiaohua Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Jiaqi Yuan
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Xinfeng Tang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Yi Yin
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Shengfa Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Huixuan Zhou
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Zhiyong Qu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
| | - Donghua Tian
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
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Dai J, Zhong BL, Xiang YT, Chiu HFK, Chan SSM, Yu X, Caine ED. Internal migration, mental health, and suicidal behaviors in young rural Chinese. Soc Psychiatry Psychiatr Epidemiol 2015; 50:621-31. [PMID: 25403568 PMCID: PMC4536925 DOI: 10.1007/s00127-014-0985-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE There is a dearth of data on the association of internal migration with mental health in young rural Chinese. This study aims to explore the associations between migrant status, mental health, and suicidal behaviors in young rural Chinese. METHODS We recruited 1,646 rural subjects aged 16-34 years, of whom 756 were migrant workers and 890 non-migrants, from ten representative villages in rural Sichuan Province, the southwestern part of China. To assess subject's depressive symptoms and general psychological quality of life (psycho-QOL), the study protocol included the Centre for Epidemiological Studies Depression Scale, and psycho-QOL subscale of the World Health Organization's QOL Questionnaire-Brief Version, in addition to structured questions regarding one-year suicidal thoughts and behaviors (serious ideation, plan, and attempt), socio-demographic, social support, and physical health information. RESULTS After adjustment for confounders, migrant workers had relative to non-migrant rural residents a decreased risk for depression (OR = 0.69, P = 0.026), but comparable risk for poor psycho-QOL (OR = 0.91, P = 0.557) and one-year suicidal behaviors (OR = 0.59-1.10, P = 0.19-0.90). Migrant status only accounted for 0.5, 2.8, 4.7, 9.8, and 12.6% of the total explainable variance for suicide attempt, poor psycho-QOL, suicide plan, depression and serious suicide ideation, respectively. CONCLUSION Our findings suggested that among young rural Chinese there were no significant associations involving migrant status and poor psycho-QOL or one-year suicidal behaviors, while migrant status significantly correlated with a decreased risk of depression. The unique contribution of migrant status to mental health among young rural Chinese participants in this study was very small.
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Affiliation(s)
- Jing Dai
- Department of Psychiatry, The Chinese University of Hong Kong, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, N.T., Hong Kong SAR, People's Republic of China
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Tang F, Qin P. Influence of personal social network and coping skills on risk for suicidal ideation in Chinese university students. PLoS One 2015; 10:e0121023. [PMID: 25803665 PMCID: PMC4372485 DOI: 10.1371/journal.pone.0121023] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 02/09/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Personal social network and coping skills have important influences on suicidality of young people and such influences must be understood in the context of other factors. This study aims to assess the influences of social contacts and coping skills on risk for suicidal ideation and to disentangle their possible pathways using a large sample of university students from China. METHODS 5972 students, randomly selected from 6 universities in China, completed the questionnaire survey for the study. Logistic regression was performed to estimate individual effect of social contacts and coping skills on risk for suicidal ideation. A partial least squares path model (PLSPM) was used to probe possible paths of their effects in the context of psychopathology. RESULTS Of the 5972 students, 16.39% reported the presence of suicidal ideation. Poor social contacts were significantly associated with an increased risk for suicidal ideation. The influence of coping skills varied by coping styles adapted toward problems. A high score of skills on seeking guidance and support, problem solving as well as seeking alternative rewards was associated with a reduced risk of suicidal ideation; whereas a high score of acceptance or resignation, emotional discharge as well as logical analysis was associated with a significantly increased risk. Modeling the data with PLSPM indicated that the avoidance coping skills conferred the most important dimensional variable in suicidal ideation prediction, followed by the approach coping skills and social network. CONCLUSIONS Poor social contacts and deficient coping skills are strong risk factors for suicidal ideation in young students. Prevention program focusing on these problems may have an enduring effect on reducing suicidal behavior in this population.
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Affiliation(s)
- Fang Tang
- Department of Epidemiology and Biostatistics and Centre for Suicide Prevention and Research, School of Public Health, Shandong University, Jinan, China
- Health Management Centre, Qianfoshan Hospital Affiliated to Shandong University, Jinan, China
| | - Ping Qin
- Department of Epidemiology and Biostatistics and Centre for Suicide Prevention and Research, School of Public Health, Shandong University, Jinan, China
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Kang EH, Hyun MK, Choi SM, Kim JM, Kim GM, Woo JM. Twelve-month prevalence and predictors of self-reported suicidal ideation and suicide attempt among Korean adolescents in a web-based nationwide survey. Aust N Z J Psychiatry 2015; 49:47-53. [PMID: 25122451 DOI: 10.1177/0004867414540752] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The suicide rate in South Korea was the highest among the Organisation for Economic Co-operation and Development (OECD) countries in 2011. Although the suicide rate in adolescents is lower than that of adults and is reported to be decreasing in young males in some countries, it has consistently increased in recent years in South Korea. We aimed to determine the prevalence, pattern, and predictors of suicidal ideation and attempt in the past 12 months. METHODS A total sample of 72,623 adolescents aged 12-18 years who responded to a web-based anonymous self-reported survey between September and October 2010 was used for the analysis. RESULTS The suicidal ideation and suicide attempt rates were 19.1% and 4.9%, respectively. Being female, having a poor perceived socioeconomic status and a poor perceived academic performance, subjective feelings of depression, cigarette smoking, alcohol use, perceived general medical health, and experiences of any involvement with sexual intercourse were the contributing factors that predicted elevated risks for suicidal ideation and suicide attempt. In contrast to previous reports in other countries, the suicide attempt rate in Korean female adolescents peaked at age 13 years, and there were no differences in suicidal ideation in females by age. There were no differences in both suicidal ideation and attempt rates in males by age. CONCLUSION A multidisciplinary approach that takes into consideration the characteristics of Korean adolescents with suicidal ideation or suicide attempt is warranted for developing prevention and treatment programs.
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Affiliation(s)
- Eun-Ho Kang
- Department of Psychiatry, Bugokoncheon Hospital, Kyungnam, Korea National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Min Kyung Hyun
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Korea
| | - Seong Mi Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Ji-Min Kim
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Gyung-Mee Kim
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea Department of Psychiatry, Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea Stress Research Institute, Inje University, Seoul, Korea
| | - Jong-Min Woo
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea Stress Research Institute, Inje University, Seoul, Korea
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Wang L, He CZ, Yu YM, Qiu XH, Yang XX, Qiao ZX, Sui H, Zhu XZ, Yang YJ. Associations between impulsivity, aggression, and suicide in Chinese college students. BMC Public Health 2014; 14:551. [PMID: 24894449 PMCID: PMC4082288 DOI: 10.1186/1471-2458-14-551] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 04/21/2014] [Indexed: 12/01/2022] Open
Abstract
Background Although there are accumulating data regarding the epidemiology of suicide in China, there are meager data on suicidal ideation and attempts among college students. Interestingly, elevated impulsivity is thought to facilitate the transition from suicidal thoughts to suicidal behavior. Therefore, the objective of this research was to identify the associations between suicide and the personality factors of impulsivity and aggression. Methods This study’s sampling method employed stratified random cluster sampling. A multi-stage stratified sampling procedure was used to select participants (n = 5,245). We conducted structured interviews regarding a range of socio-demographic characteristics and suicidal morbidity. The Patient Health Questionnaire depression module (PHQ-9) was used to acquire the information about thoughts of being better off dead or hurting themselves in some ways during the past two weeks. The impulsivity symptoms in this study were assessed with the BIS-11-CH (i.e., the Chinese version of the BIS-11), and the Aggressive symptoms were assessed with the BAQ. The statistical package for social science (SPSS) v.13.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Socio-demographic variables such as ethnic and gender were compared between groups, through the use of χ2 tests. The nonparametric test (k Independent Sample test, Kruskal-Wallis H) was performed to determine differences between the personality factors of impulsivity and aggression and suicide. Results In total, 9.1% (n = 479) of the 5,245 students reported they have ever thought about committing suicide; and 1% (n = 51) reported a history of attempted suicide (attempters). The analyses detected significant differences in scores on cognitive impulsivity (p < 0.01), when comparing individuals who only had suicidal ideation and individuals who had attempted suicide. Moreover, significant differences were found between ideators only and attempters on scores of self-oriented attack (p < .001). Conclusions Suicidal ideation is prevalent among Chinese university students. Students with high aggression scores were more susceptible to committing suicide. Scores on self-oriented attack and cognitive impulsivity may be important factors for differentially predicting suicide ideation and suicide attempts.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yan Jie Yang
- Psychology Department, Public Health Institute, Harbin Medical University, 157 Baojian Road, Nangang, Harbin 150081, China.
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Dai J, Chiu HFK, Xiang YT, Chan SSM, Yu X, Hou ZJ, Ungvari GS, Caine ED. The prevalence of insomnia and its socio-demographic and clinical correlates in older adults in rural China: a pilot study. Aging Ment Health 2014; 17:761-5. [PMID: 23547946 DOI: 10.1080/13607863.2013.781117] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To investigate the prevalence of insomnia (DIS: difficulty initiating sleep; DMS: difficulty maintaining sleep; and EMA: early morning awakening), its socio-demographic and clinical correlates, and the treatment patterns in older adults in rural China. METHOD A sample of 263 subjects was recruited in Mianyang and interviewed using standardized instruments. Basic socio-demographic and clinical data were collected. RESULTS The expected mean total sleep time (TST) of the whole sample was 6.8 ± 2.2 hours, and the actual mean TST was 6.3 ± 2.1 hours. The 1-year prevalence of at least one type of insomnia was 7.6%; the rates of DIS, DMS, and EMA were 5.7%, 7.2%, and 6.8%, respectively. On multivariate analyses, female sex and psychiatric disorders were independently associated with more frequent insomnia. CONCLUSION Insomnia is not uncommon in older adults in rural China, and the low percentage of subjects treated suggests that improved access to treatment might be indicated.
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Affiliation(s)
- Jing Dai
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
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Wei HS, Chen JK. Filicide-suicide ideation among Taiwanese parents with school-aged children: prevalence and associated factors. CHILD ABUSE & NEGLECT 2014; 38:468-478. [PMID: 24439665 DOI: 10.1016/j.chiabu.2013.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 11/30/2013] [Accepted: 12/06/2013] [Indexed: 06/03/2023]
Abstract
This study explored the prevalence of filicide-suicide ideation among Taiwanese parents with school-aged children. Multiple risk factors associated with filicide-suicide ideation were assessed, and the potential effect of traditional family values was evaluated. A random sample of 1,564 parents was recruited from 21 elementary schools in a rural area of Taiwan. Potential risk factors, including demographics, family finance, psychological maladjustment, family interaction, and cultural beliefs, were further examined using a hierarchical logistic regression. Overall, 14.6% of the respondents reported having filicide-suicide ideation during the past year. The hierarchical logistic regression analysis showed that demographic factors including age, gender, and ethnicity had no significant effect. Family finances, depression, and conflict with the respondent's spouse were positively associated with filicide-suicide ideation. Finally, the parents' beliefs in traditional family values had a positive effect on filicide-suicide ideation. In other words, filicide-suicide thoughts were more common among those who upheld a strong parental responsibility for care giving and family solidarity. This study revealed a substantial prevalence of filicide-suicide ideation among local parents and identified a number of risk factors associated with those thoughts, namely family financial status, parental depression, and conflict with one's spouse. More importantly, the results highlighted the effect of traditional family values in the process. The potential intention of filicide-suicide as mercy killing and its cultural relevance were discussed.
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Affiliation(s)
- Hsi-Sheng Wei
- Department of Social Work, National Taipei University, Taiwan.
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
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Chiu HFK, Xiang YT, Dai J, Chan SSM, Yu X, Ungvari GS, Caine ED. Sleep duration and quality of life in young rural Chinese residents. Behav Sleep Med 2014; 11:360-8. [PMID: 23461412 DOI: 10.1080/15402002.2013.764524] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to determine the mean total sleep time (TST) and the relation between sleep duration (short sleep: < 7 hr per day; medium sleep: 7-8 hr per day; and long sleep: > 8 hr per day) and quality of life (QOL) in young Chinese rural residents. A sample of 1,632 participants was recruited in Mianyang, Sichuan province and interviewed. Expected and actual TSTs were asked using standardized questions. QOL was measured with the Chinese version of the World Health Organization Quality of Life Schedule-Brief. In the full sample, the mean expected TST was 8.8 ± 1.3 hr, and the mean actual TST was 8.3 ± 1.4 hr. Multivariate analyses revealed that compared to medium sleepers, short sleepers had lower QOL in the physical, psychological, and environmental domains, whereas long sleepers had higher QOL in the environmental domain. Being short or long sleepers was not associated with more major medical conditions. Given the significant associations between short sleep and poor QOL, more attention should be paid to young Chinese rural residents with short sleep.
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Affiliation(s)
- Helen F K Chiu
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR, China
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Abstract
The suicide rate of females is very close to that of males in China, in contrast to Western societies, in which the rates of male suicide outnumber those of females by three to four times. This study investigated the prevalence of suicidal ideation and prosuicide attitude (acceptability) among females of childbearing age. With the Chinese version of the Scale for Suicide Ideation and the General Social Survey questionnaire, we examined the demographic and psychological risk factors of suicide among Chinese rural young females aged 15 to 34 years. Logistic regression analysis was performed to explore the factors related to suicidal ideation and suicide acceptability. The prevalence rates of suicidal ideation and suicide acceptability among the sampled females are 22.5% and 3.8%, respectively. Education, depression, social support, hopelessness, and negative life events were significantly associated with suicidal ideation. Ethnicity, education, abortion, and depression were significantly associated with suicide acceptability. There is statistical difference between suicide ideation and acceptability. The results indicate that mental disorder remains a major risk factor of suicidal ideation. Sociodemographic and psychological characteristics are associated with suicide acceptability.
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Wen C, Wang WQ, Ding LJ, Feng L, Wong JCM, Kua EH. Suicidal and help-seeking behavior in Xiamen, south China. Asia Pac Psychiatry 2013; 5:168-74. [PMID: 23857953 DOI: 10.1111/appy.12017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 09/30/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study is to examine the association between suicidal behavior and mental health status of south Chinese people, and explore the mediating effect of help-seeking behaviors. METHODS The study participants were 10,757 persons aged 18 years and older from the mental health survey of Xiamen city. Data on suicidal behavior and help-seeking behavior were collected by trained psychiatric nurses through face-to-face interviews. Mental health status was assessed using the 12-item General Health Questionnaire (GHQ-12). Multiple logistic regression and general linear model were used in statistical analysis. RESULTS In the entire study sample, 236 study participants reported suicide ideation (2.19%, 95% CI: 1.92-2.47%), and 59 reported at least one suicide attempt (0.55%, 95% CI: 0.41-0.69%). Individuals with suicide attempt and suicide ideation had higher GHQ scores than those without suicidal behavior. The majority of study participants with suicide ideation or suicide attempt did not seek any help (77.5% and 79.7%, respectively). Among participants with suicidal behavior, seeking help from mental health professional was associated with a better mental health status (OR = 4.04, 95%CI: 1.17-10.16). DISCUSSION Only a small proportion of individuals with suicide behavior in south China had ever sought help. Seeking help was associated with a better mental health status.
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Affiliation(s)
- Cheng Wen
- Xiamen XianYue Hospital, Xiamen, Fujian, China
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Wei S, Yan H, Chen W, Liu L, Bi B, Li H, Hou J, Tan S, Chen X, Dong G, Qin X. Gender-specific differences among patients treated for suicide attempts in the emergency departments of four general hospitals in Shenyang, China. Gen Hosp Psychiatry 2013. [PMID: 23200697 DOI: 10.1016/j.genhosppsych.2012.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE We aimed to identify gender-specific characteristics of suicide attempters admitted to general hospital emergency departments in urban China. METHODS The Structured Clinical Interview for the DSM-IV, the Suicide Ideation Scale, the Hamilton Depression Rating Scale and a quality of life measure were administered to 239 suicide attempters who were treated consecutively in the emergency departments of four general hospitals randomly selected in Shenyang, China. RESULTS Among the 239 enrolled subjects, 53 (22.2%) were men, and 186 (77.8%) were women. Compared to women, men were more likely to be a minority, live with their families and/or suffer from substance-related disorders. Men were less likely to be living alone or cohabitating. Women were more likely to express suicide ideation compared with men. Thirty-seven (69.8%) men and 129 (69.4%) women had mental illness. The prevalence of psychiatric diagnosis was not significantly different between men and women (χ(2)=.004, df=1, P=.95). CONCLUSION The rate of attempted suicide is higher among women than among men in the emergency departments of urban China. Except for race, living situation and suicide ideation, there are few gender differences regarding socio-demographic and clinical characteristics in the current study that are not consistent with reports from other countries. However, similar to other studies, men are more likely to suffer from substance-related disorders than are women. The unique, gender-specific characteristics pertaining to suicide attempters in urban China emphasizes the need for gender-specific interventions in future clinical treatment.
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Affiliation(s)
- Shengnan Wei
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang 110001, PR China
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Chiu HFK, Xiang YT, Dai J, Chan SSM, Leung T, Yu X, Hou ZJ, Ungvari GS, Caine ED. The prevalence of sleep problems and their socio-demographic and clinical correlates in young Chinese rural residents. Psychiatry Res 2012; 200:789-94. [PMID: 22503354 DOI: 10.1016/j.psychres.2012.03.050] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 03/26/2012] [Accepted: 03/27/2012] [Indexed: 11/17/2022]
Abstract
This study aimed to determine the prevalence of basic forms of sleep disturbance (DIS: difficulty initiating sleep; DMS: difficulty maintaining sleep; and EMA: early morning awakening) as well as insomnia (defined as sleep disturbance accompanied by distress or daily functioning impairment), their socio-demographic and clinical correlates, and the treatment patterns in young Chinese rural people. A sample of 1642 subjects was recruited in Mianyang and interviewed using standardized instruments. Basic socio-demographic and clinical data were collected. The prevalence of at least one type of reported sleep disturbance was 8.0%, while the prevalence of at least one type of insomnia was 2.7%. In multivariate analyses, age between 30 and 34 years, having psychiatric disorders, poorer physical domain of quality of life (QOL), better social QOL domain, depressive symptoms and lower social support were independently associated with more frequent sleep disturbance. At the same time, age between 30 and 34 years, female sex, poorer physical QOL domain, better social QOL domain, depressive symptoms, lower life satisfaction, lower social support and more life events were independently associated with more frequent insomnia. Self-reported sleep disturbances are common among young Chinese residents. The low percentage of treated community residents might suggest a need to promote accessible and easily implemented interventions.
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Affiliation(s)
- Helen Fung-Kum Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Chiu H, Dai J, Xiang Y, Chan S, Leung T, Yu X, Hou Z, Ungvari G, Caine E. Suicidal thoughts and behaviors in older adults in rural China: a preliminary study. Int J Geriatr Psychiatry 2012; 27:1124-30. [PMID: 22252964 PMCID: PMC4733507 DOI: 10.1002/gps.2831] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 11/10/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND One purpose of this study was to examine the feasibility of conducting epidemiological survey on suicidal thoughts and behaviors (hereafter "suicidal thoughts/behaviors"; i.e., any suicidal ideation, serious ideation, planning, and attempts) among older adults in rural China. Another purpose was to investigate among older people in rural China the prevalence of suicidal thoughts/behaviors, as well as their sociodemographic and clinical correlates. METHODS A randomly selected sample of 263 subjects, 50 years or older, was recruited in a remote rural area of Southwestern China (Mianyang Region, Sichuan Province) and interviewed using structured instruments. Basic sociodemographic and clinical data were collected. RESULTS There was no refusal among approached subjects, and subjects were willing to answer questions on suicidal thoughts/behaviors. The lifetime prevalence of suicidal ideation, serious ideation, planning, and attempt was 28.9% (23.4%-34.4%), 19.7% (14.9%-24.6%), 11.4% (7.5%-15.3%), and 5.3% (2.6%-8.1%), respectively. The corresponding 12-month prevalence was 8.8% (5.3%-12.2%), 5.3% (2.6%-8.1%), 2.7% (0.7%-4.6%), and 0%, respectively. The 2-week prevalence was 3.4% (1.2%-5.6%), 2.3% (0.5%-4.1%), 2.3% (0.5%-4.1%), and 0%, respectively. Correlates of suicidal thoughts/behaviors of this group are similar to findings from other community studies, such as female gender, unmarried status, major medical conditions, insomnia, financial difficulties and lower education, depressive symptoms, recent stressful life events, greater life dissatisfaction. CONCLUSIONS Our findings suggest that larger scale epidemiological survey of suicidal thoughts/behaviors on older adults in rural China would be feasible. Suicidal thoughts/behaviors are common among older people in rural China, as seen in this preliminary study, which points to the need for further larger scale investigations.
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Affiliation(s)
- H.F.K. Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J. Dai
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China,Shenzhen Institute of Mental Health, Shenzhen, China,Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, and VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA
| | - Y.T. Xiang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China,Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - S.S.M. Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - T. Leung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - X. Yu
- Institute of Mental Health, Peking University, Beijing, China
| | - Z.J. Hou
- Sichuan College of Traditional Chinese Medicine, Mianyang, Sichuan, China
| | - G.S. Ungvari
- Graylands Hospital & School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - E.D. Caine
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, and VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA
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Zhao J, Yang X, Xiao R, Zhang X, Aguilera D, Zhao J. Belief system, meaningfulness, and psychopathology associated with suicidality among Chinese college students: a cross-sectional survey. BMC Public Health 2012; 12:668. [PMID: 22898096 PMCID: PMC3491076 DOI: 10.1186/1471-2458-12-668] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 08/07/2012] [Indexed: 11/15/2022] Open
Abstract
Background Research suggests that Chinese religious believers are more likely to commit suicide than those identifying as non-religious among rural young adults, contrary to findings in Western countries. However, one cannot conclude that religiosity is associated with elevated suicide risk without examining the effect of political and religious beliefs in a generally atheist country like China where political belief plays a dominant role in the belief system of young adults. The present study investigated the effects of political and religious belief on suicidality with meaningfulness and psychopathology as potential mediators in a large representative sample of Chinese college students. Methods A cross-sectional survey was conducted among 1390 first-year college students randomly sampled from 10 colleges and universities in mainland China. Results A total of 1168 respondents (84.0%) provided complete data on all variables. Lifetime prevalence of suicidal ideation, plan, and attempt were 45.1%, 6.8%, and 1.9% respectively, with one-year suicidal ideation showing at 19.3%. Female gender was associated with elevated risk of suicidality. Political belief but not religious belief was associated with decreased suicide risk. A significant interactive effect of political belief and religious belief was found, indicating that for political believers, being religious was associated with decreased suicide risk; for non-political believers, being religious was associated with increased suicide risk. Multi-group structural equation modeling showed that meaningfulness completely mediated and psychopathology partially mediated the effect of belief system on suicidality. Gender differences were found in pathways of political belief by religious beliefs to suicidality and political belief to psychopathology. The coefficients were significant for males but not for females. Conclusions In less religious societies, political belief may serve as a means of integration as does religious affiliation in religious societies. Males were more likely to benefit from the protective effect of a belief system on suicidality than females.
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Affiliation(s)
- Jiubo Zhao
- Department of Psychology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou Dadao North Road 1838, Guangzhou, China
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Dai J, Chiu HFK, Hou ZJ, Caine ED. Conducting Community Research in Rural China -Addressing the Methodological Challenges of Recruiting Participants in Rapidly Changing Social Environments. Asia Pac Psychiatry 2012; 4:95-103. [PMID: 22662022 PMCID: PMC3363287 DOI: 10.1111/j.1758-5872.2012.00182.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND: The paper addressed a unique challenge for public health and community research in rural China, i.e., the very large percentage of young adults that comprises a highly mobile working population that has been an essential component of the country's economic transformation. Fluid local demographic patterns potentially have a substantial impact on sample representativeness and data validity. METHODS: This report is based upon a cross sectional survey with face-to-face interviews of residents aged 16-34 years in rural communities of Mianyang, Sichuan Province, China. Two waves of fieldwork and other strategies were adopted in response to recruitment challenges. RESULTS: 1654 of 3008 potential participants took part in the study; this constituted 98% of those individuals approached and 55% of the persons enumerated in the local household registration system (hukou). Analyses revealed substantial differences among those who were interviewed during September and October 2005, versus those seen during the Chinese Lunar New Year of 2006 when many migrant workers and students returned to their homes. Both groups together differed from those who were unavailable during either recruiting episode. DISCUSSION AND CONCLUSIONS: We discuss potential responses to associated methodological challenges, including, (1) permanent hukou mismatches; (2) temporary hukou mismatches; (3) difficulties faced by potential participants to fully understand the purpose of research, the informed consent process, and specific research questions; and (4) appreciation of the importance of local social networks, as they pertain in particular to rural China. These findings underscore that there may be a need to make "on-the-ground" adjustments to varying local conditions to maximize sample representativeness and data validity.
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Affiliation(s)
- Jing Dai
- Shenzhen Institute of Mental Health, Shenzhen, Guangdong, China
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