1
|
Wang Y, Liu J, Chen S, Zheng C, Zou X, Zhou Y. Exploring risk factors and their differences on suicidal ideation and suicide attempts among depressed adolescents based on decision tree model. J Affect Disord 2024; 352:87-100. [PMID: 38360368 DOI: 10.1016/j.jad.2024.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/04/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Suicide has been recognized as a major global public health issue. Depressed adolescents are more prone to experiencing it. We explore risk factors and their differences on suicidal ideation and suicide attempts to further enhance our understanding of suicidal behavior. METHODS 2343 depressed adolescents aged 12-18 from 9 provinces/cities in China participated in this cross-sectional study. We utilized decision tree model, incorporating 32 factors encompassing participants' suicidal behavior. The feature importance of each factor was measured using Gini coefficients. RESULTS The decision tree model demonstrated a good fit with high accuracy (SI = 0.86, SA = 0.85 and F-Score (SI = 0.85, SA = 0.83). The predictive importance of each factor varied between groups with suicidal ideation and with suicide attempts. The most significant risk factor in both groups was depression (SI = 16.7 %, SA = 19.8 %). However, factors such as academic stress (SI = 7.2 %, SA = 1.6 %), hopelessness (SI = 9.1 %, SA = 5.0 %), and age (SI = 7.1 %, SA = 3.2 %) were more closely associated with suicidal ideation than suicide attempts. Factors related to the schooling status (SI = 3.5 %, SA = 10.1 %), total years of education (SI = 2.6 %, SA = 8.6 %), and loneliness (SI = 2.3 %, SA = 7.4 %) were relatively more important in the suicide attempt stage compared to suicidal ideation. LIMITATIONS The cross-sectional design limited the ability to capture changes in suicidal behavior among depressed adolescents over time. Possible bias may exist in the measurement of suicidal ideation. CONCLUSION The relative importance of each risk factor for suicidal ideation and attempted suicide varies. These findings provide further empirical evidence for understanding suicide behavior. Targeted treatment measures should be taken for different stages of suicide in clinical interventions.
Collapse
Affiliation(s)
- Yang Wang
- College of Management, Shenzhen University, Shenzhen, China
| | - Jiayao Liu
- College of Management, Shenzhen University, Shenzhen, China
| | - Siyu Chen
- College of Management, Shenzhen University, Shenzhen, China
| | - Chengyi Zheng
- College of Management, Shenzhen University, Shenzhen, China
| | - Xinwen Zou
- School of Business Informatics and Mathematics, University of Mannheim, Mannheim, Germany
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
| |
Collapse
|
2
|
Liao M, Luo N, Rand K, Yang Z. Urban/rural differences in preferences for EQ-5D-5L health states: a study of a multi-ethnic region in China. Qual Life Res 2023:10.1007/s11136-023-03394-1. [PMID: 36944783 DOI: 10.1007/s11136-023-03394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study aimed to compare health preferences for EQ-5D-5L health states between urban and rural populations in China. METHODS This study used pooled secondary data from two EQ-5D-5L valuation studies. Participants were recruited from Guizhou province and Chongqing municipality, China using quota sampling. Each participant was interviewed face-to-face to value a set of 15 or 16 out of 30 EQ-5D-5L health states using time trade-off (TTO) methods including composite TTO and other two variants. Regression analysis was used to compare health state preferences between urban and rural participants. RESULTS A total of 597 participants (urban: 55.44%; rural: 44.56%) completed the valuation interviews. Both univariate and multivariable linear regression analyses showed that rural participants tended to value health states lower than urban participants regardless of severity of health states. The unadjusted and adjusted overall mean differences between the two groups were - 0.041 (95% confidence interval [CI] - 0.077, - 0.004, p-value = 0.031) and - 0.040 (95% CI - 0.078, - 0.002, p-value = 0.038), respectively. Predictions for the 3125 health states based on rural participants' health preferences were lower than those based on urban participants' health preferences. CONCLUSION There were small, yet statistically significant, differences in EQ-5D-5L health states preferences between urban and rural populations in China. Future study aiming at establishing a national value set should pay more attention to the sample representativeness.
Collapse
Affiliation(s)
- Meixia Liao
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nan Luo
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Kim Rand
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Maths in Health B.V., Rotterdam, The Netherlands
| | - Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Guiyang, China.
| |
Collapse
|
3
|
Gearing RE, Brewer KB, Cheung M, Leung P, Chen W, He X. Suicide in China: Community Attitudes and Stigma. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:809-832. [PMID: 33535898 DOI: 10.1177/0030222821991313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
China accounts for an estimated third of the world's suicides, yet individuals experiencing suicidality typically do not seek out or receive treatment. This study examines community perceptions and public stigma toward suicide. In Shanghai, China 186 adults were recruited to participate in a survey with an experimental vignette describing a suicidal individual, manipulated on gender and age, followed by questions eliciting attitudes toward suicide. Most participants agreed that the suicidal subject had a serious problem, with seriousness of the problem decreasing with participant's age. Participants reported moderate levels of public stigma. More stigma was found toward adolescent subjects rather than adult. Male subjects were perceived as being more likely to change than females. The public's accurate view of suicide without biases could help prevent suicide from getting worse. Public perceptions regarding a suicidal individual's likelihood to change could lead to stigma reduction, which can subsequently help with effective crisis intervention.
Collapse
Affiliation(s)
- Robin E Gearing
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MH-RITES Center), University of Houston, Graduate College of Social Work, Houston, Texas, United States
| | - Kathryne B Brewer
- College of Health and Human Services, University of New Hampshire, Durham, New Hampshire, United States
| | - Monit Cheung
- Graduate College of Social Work, University of Houston, Houston, Texas, United States
| | - Patrick Leung
- Graduate College of Social Work, University of Houston, Houston, Texas, United States
| | - Wanzhen Chen
- University of Science and Technology, East China University of Science and Technology, Shanghai, China
| | - Xuesong He
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| |
Collapse
|
4
|
Fekih-Romdhane F, Amri A, Cheour M. Suicidal ideation, suicide literacy and stigma, disclosure expectations and attitudes toward help-seeking among university students: The impact of schizotypal personality traits. Early Interv Psychiatry 2022; 16:659-669. [PMID: 34477298 DOI: 10.1111/eip.13211] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/06/2021] [Accepted: 08/15/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Similarly to patients with schizophrenia, non-clinical individuals with schizotypal traits have been reported to show an increased risk for suicide-related outcomes. We aimed to assess suicidal ideation, and to determine factors that may have associations with help-seeking attitudes in high schizotypal individuals as compared to low schizotypal individuals. METHOD We carried out a cross-sectional survey. The Schizotypal Personality Questionnaire, the attitudes toward seeking professional psychological help scale-short form, the disclosure expectations scale, the scale of suicide ideation, the stigma of suicide scale-short form, the literacy of suicide scale, and the depression anxiety stress scales were administered to 504 college students. A total of 51 students were classified in the high-schizotypy group, and 50 were classified in the low-schizotypy group. RESULTS High-schizotypal students experienced significantly more suicidal ideation, had greater literacy of suicide, had more glorification of suicide, had higher anticipated risks of disclosure and more negative help-seeking attitudes than low-schizotypal students. After controlling for sociodemographic (age, gender, income and tobacco use) and psychosocial variables (personal psychiatric history, family history of suicide, personal history of suicide attempt[s]), depression and suicide ideation), disclosure expectations had both a significant negative independent effect through anticipated risks, and a positive independent effect through anticipated benefits, on high-schizotypal students' help-seeking attitudes. CONCLUSION The apprehension and reluctance to seek help found in high-schizotypal students highlight an urgent need to further understand barriers to help-seeking among at-risk adolescents, and what may motivate them to reach out for support when they are more at-risk for suicide.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Amani Amri
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| |
Collapse
|
5
|
Godi S, Neredumilli P. A cross-sectional study of attitude toward suicide among medical and nonmedical groups from South India. ARCHIVES OF MENTAL HEALTH 2022. [DOI: 10.4103/amh.amh_99_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
6
|
Risk factors for suicide in psychiatric emergency patients in Beijing, China: A large cross-sectional study. Psychiatry Res 2021; 304:114067. [PMID: 34303942 DOI: 10.1016/j.psychres.2021.114067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/14/2021] [Indexed: 11/20/2022]
Abstract
Psychiatric emergency patients constitute a population at high risk of suicidal thoughts and behaviors (STB). However, the risk factors for STB in this population have not been clearly defined. This study aimed to explore the risk factors for STB in psychiatric emergency patients in China. A cross-sectional analysis was conducted at the emergency department of psychiatry, Anding Hospital, Capital Medical University from 2015 to 2017. The Chinese suicide risk factors scale was used to test the STB of the patients. Multivariable logistic regression analysis was used to determine the risk factors of STB. A total of 12,345 patients were included. Their average age was 36 years. According to the suicide risk scale, 3436 cases (27.83%) were at risk of STB, mainly young adults. The multivariable analysis showed that urban residence, years of education, living in Beijing, ethnic Han, living alone, unemployment, poor relationship with parents, one or more siblings, visit time in the night, family history, disease course, total duration, the total number of psychiatric hospitalizations, a clear diagnosis, Brief Psychiatric Rating Scale total score ≥28.5, Hamilton Depression Rating Scale total score ≥20, and Young Mania Rating Scale total score ≥12 were independent risk factors for STB.
Collapse
|
7
|
Li F, Jia H, Liu J, Liu S, Lu X, Yip PSF. Self-Stigma and Its Relationship With Rates of Depression Diagnosis. CRISIS 2021; 43:190-196. [PMID: 33944611 DOI: 10.1027/0227-5910/a000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Self-stigma about suicide might impede people seeking help from mental health professionals. There is little research about self-stigma expressed by suicide decedents. Aims: We aimed to explore (a) self-stigma about suicide through examination of suicide notes; and (b) whether the expression of self-stigma was associated with the formal diagnoses of depression. Method: Data were extracted from notes left by people who died by suicide in two major Chinese cities (Shanghai, 2004-2017; Wuhan, 2005-2019). Note content was examined and self-stigma items were coded. Demographics associated with self-stigma were reported. Rates of depression were compared between note-leavers who expressed self-stigma, and those who did not. Results: Notes were left by 567 suicide decedents (representing about 19% all suicides). Approximately 25% notes contained at least one self-stigma item. Older people made fewer self-stigma references, as did people from Wuhan. Depression was not associated with self-stigma. Limitations: Not all people dying from suicide leave notes, and suicide notes variably report self-stigma, thus self-stigma about suicide may be underestimated. Conclusion: Self-stigma items varied across regions and age groups, but not with depression. Therefore, self-stigma expressed by suicide decedents may not reflect help-seeking behaviours from professional mental health services.
Collapse
Affiliation(s)
- Feng Li
- School of Humanities, Southeast University, Nanjing, PR China
| | - Haipeng Jia
- Criminal Detective Department, Qiaokou District of Wuhan Municipal Public Security Bureau, Wuhan, PR China
| | - Jinchen Liu
- College of Life Science, Lanzhou University, PR China
| | - Sihai Liu
- Criminal Detective Department, Jiang'an District of Wuhan Municipal Public Security Bureau, Wuhan, PR China
| | - Xuesong Lu
- Criminal Science Institute, Pudong District of Shanghai Municipal Public Security Bureau, Shanghai, PR China
| | - Paul S F Yip
- HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PR China
| |
Collapse
|
8
|
Kim H, Choi SH, Lee SE, Lee CW, Maeng S, Kim WH, Bae JN, Lee JS. Variables Affecting Attitudes Toward Suicide Among the Adolescent Population. J Nerv Ment Dis 2021; 209:59-64. [PMID: 33141783 DOI: 10.1097/nmd.0000000000001258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Past research has supported the positive association between prosuicide attitudes and suicidal behavior. The aim of the present study was to determine the factor structure of adolescents' attitudes toward suicide and to explore correlates associated with their attitudes. A questionnaire was distributed to 1292 adolescents at eight middle schools to assess their demographic information, clinical variables, and attitudes toward suicide. After factor analysis, we reached a four-factor solution of the attitudes toward suicide. Significantly more females, nonreligious adolescents, those with a lower socioeconomic status, those with higher levels of depressive symptoms, and those with a history of suicidal ideation/plans had more understanding attitudes toward suicide. Depressive adolescents were also more permissive and believed that suicides were unpreventable and that loneliness led to suicide. In conclusion, adolescents' attitudes toward suicide were significantly associated with not only various sociodemographic correlates but also the severity of depressive symptoms and their own experiences of suicidality.
Collapse
Affiliation(s)
| | - Seo-Hyun Choi
- Department of Psychiatry, Inha University Hospital, Incheon
| | | | | | - Seri Maeng
- Department of Psychiatry, Inha University Hospital, Incheon
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon
| | - Jae Nam Bae
- Department of Psychiatry, Inha University Hospital, Incheon
| | - Jeong Seop Lee
- Department of Psychiatry, Inha University Hospital, Incheon
| |
Collapse
|
9
|
Colucci E, Lester D. A cross-cultural study of attitudes toward suicide among young people in India, Italy and Australia. Int J Soc Psychiatry 2020; 66:700-706. [PMID: 32552260 DOI: 10.1177/0020764020926551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND An understanding of the cultural aspects of suicidal behavior is essential for the development of culturally appropriate suicide prevention and intervention strategies. AIMS This study explored the attitudes toward youth suicide in 686 Italian, Indian and Australian undergraduate students (18-24 years old). METHOD A 21-item suicide attitude inventory titled Attitude towards Youth Suicide (AtYS) scale, included in this paper, was used in the three samples. RESULTS Four factors were extracted, labeled negative attitudes toward suicide, belief that suicide was not preventable, suicide as acceptable and normal, and the existence of risk signs for suicide. Country differences were found for all four subscales, with Indian students having the most negative attitudes toward suicide. Sex differences were found in all three countries with women, on the whole, having less negative attitudes toward suicide, more belief in the preventability of suicide in India and more belief in risk signs for suicide in Italy. CONCLUSION Attitudes are linked to suicide in a complex manner. More quantitative and qualitative studies, including in lower-income and non-English speaking Western societies, are needed.
Collapse
|
10
|
Abstract
In many societies suicide was and is an extremely controversial topic. This review article outlines the historical background of social condemnation of suicidal thoughts and actions in the western world. It summarizes current research results about the consequences of suicide stigma for affected persons and its relevance for suicide prevention. Finally, the next steps in research and prevention are discussed. Over time and in different cultures, the societal judgement of suicide has greatly varied. During antiquity, some philosophers viewed suicide negatively and by the fifth century AD suicide was widely condemned by societies across the western world. Until today suicide remains a taboo topic in Germany and other countries. Current research showed that the social condemnation of suicidal thoughts and behavior (i.e. suicide stigma) is an additional stressor among persons who experience or have experienced suicidality and their relatives. Furthermore, suicide stigma is considered to be a central barrier to seeking help for and disclosure of suicidality. Despite its relevance for suicide prevention, only a few interventions to reduce suicide stigma among members of the general public and to support affected persons in dealing with suicide stigma exist.
Collapse
Affiliation(s)
- N Oexle
- Klinik für Psychiatrie und Psychotherapie II, Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg, Deutschland. .,Sektion Public Mental Health, Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg, Parkstraße 11, 89073, Ulm, Deutschland.
| | - L Mayer
- Klinik für Psychiatrie und Psychotherapie II, Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg, Deutschland
| | - N Rüsch
- Klinik für Psychiatrie und Psychotherapie II, Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg, Deutschland
| |
Collapse
|
11
|
Adjaottor E, Ahorsu D. Attitudes toward suicide: A comparison between urban and rural dwellers in Ghana. SOCIAL HEALTH AND BEHAVIOR 2020. [DOI: 10.4103/shb.shb_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
12
|
Stecz P, Slezáčková A, Millová K, Nowakowska-Domagała K. The Predictive Role of Positive Mental Health for Attitudes Towards Suicide and Suicide Prevention: Is the Well-Being of Students of the Helping Professions a Worthwhile Goal for Suicide Prevention? JOURNAL OF HAPPINESS STUDIES 2020; 21:1965-1984. [PMID: 32834767 PMCID: PMC7380145 DOI: 10.1007/s10902-019-00163-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study evaluates the potential value of eudaimonic well-being in assessing pro-preventive orientation towards suicide and recognizing suicide as a solution. The aim was to integrate positive and negative conceptualizations of mental health for predicting attitudes towards suicide, and towards suicide prevention, among students of the helping professions. The study participants (166 women and 73 men, mean age 22.84 ± 5.15) answered a set of questionnaires, including a Questionnaire on Attitudes Towards Suicide, Goldberg Health Questionnaire (GHQ-28), Psychological Well-Being Scale (PWB-42) and Centrality of Religiosity Scale. Multiple regression analysis showed that environmental mastery, purpose in life and positive relationships, controlled for religiousness and psychological problems related to general mental health, predicted the variability of attitudes towards suicide and pro-preventive orientation. Sociodemographic variables were not related to attitudes towards suicide. Our findings suggest that positive mental health, represented jointly by low mental health problems and eudaimonic components of happiness, plays a role in predicting pro-preventive attitudes. Therefore, improving positive mental health among students in the helping professions, these being the future gatekeepers, could be considered an auxiliary strategy for suicide prevention.
Collapse
Affiliation(s)
- Patryk Stecz
- Department of Preventive and Addiction Psychology, Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Smugowa 10/12, 91-433 Lodz, Poland
| | - Alena Slezáčková
- Department of Psychology, Faculty of Arts, Masaryk University, Arna Novaka 1, 602 00 Brno, Czech Republic
| | - Katarína Millová
- Institute of Psychology, Academy of Sciences of the Czech Republic, Veveří 97, 602 00 Brno, Czech Republic
| | - Katarzyna Nowakowska-Domagała
- Department of Preventive and Addiction Psychology, Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Smugowa 10/12, 91-433 Lodz, Poland
| |
Collapse
|
13
|
Zhong BL, Chan SSM, Liu TB, Chiu HFK. Nonfatal Suicidal Behaviors of Chinese Rural-to-Urban Migrant Workers: Attitude Toward Suicide Matters. Suicide Life Threat Behav 2019; 49:1199-1208. [PMID: 30315652 DOI: 10.1111/sltb.12519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/15/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine the attitude toward suicide (ATS) and its influence on nonfatal suicidal behaviors of Chinese rural-to-urban migrant workers (MWs). METHOD Altogether, 3031 MWs completed the positive ATS Scale and structured questions regarding lifetime suicide ideation, plan, and attempt. Mental health help-seeking behaviors of MWs were also investigated. RESULTS Overall, MWs held a more negative ATS than the Chinese general population. The lifetime prevalence of suicide ideation, plan, and attempt was 5.5%, 1.3%, and 1.1%, respectively. After controlling for lifetime depressive disorders and other covariates, a negative ATS was still significantly associated with lower risk of lifetime suicide ideation (OR = 0.32), plan (OR = 0.22), and attempt (OR = 0.26). MWs with a negative ATS were more likely to talk to others and seek help by online/telephone consultation for their mental health and suicidal problems (p < .05). A more positive ATS was significantly associated with male gender, low education level, ethnic minority of Miao, low monthly income, and originating from western China. CONCLUSIONS The majority of MWs hold a negative ATS, which significantly contributes to their relatively low risk of nonfatal suicidal behaviors. The more help-seeking from others and online/telephone consultation in MWs with a negative ATS may lower their risk of nonfatal suicidal behaviors.
Collapse
Affiliation(s)
- Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China.,Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sandra Sau Man Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tie-Bang Liu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Helen Fung-Kum Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
14
|
Lee JW. The Relationship between Personal Values and Attitudes of the General Public towards Suicide. ACTA ACUST UNITED AC 2019. [DOI: 10.21032/jhis.2019.44.2.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
15
|
Li M, Katikireddi SV. Urban-rural inequalities in suicide among elderly people in China: a systematic review and meta-analysis. Int J Equity Health 2019; 18:2. [PMID: 30606191 PMCID: PMC6319001 DOI: 10.1186/s12939-018-0881-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 10/24/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND China has an unusual pattern of suicides, with overall suicide rates in rural areas higher than urban areas. While suicide rates have decreased dramatically, older people increasingly contribute to the overall burden of suicide. However, it is unclear if elderly people within rural areas experience greater suicide risk than those in urban areas. We aimed to systematically review the incidence of suicide in rural and urban China among the elderly (aged over 60 years), with a view to describing the difference in rates between rural and urban areas and trends over time. METHODS Chinese and English language articles were searched for using four databases: EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (EBSCOhost) and CNKI (in Chinese). Articles describing completed suicide among elderly people in both rural and urban areas in mainland China were included. The adapted Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. One reviewer (ML) assessed eligibility, performed data extraction and assessed risk of bias, with areas of uncertainty discussed with the second reviewer (SVK). Random effects meta-analysis was conducted. Suicide methods in different areas were narratively summarised. RESULTS Out of a total 3065 hits, 24 articles were included and seven contributed data to meta-analysis. The sample size of included studies ranged from 895 to 323.8 million. The suicide rate in the general population of China has decreased in recent decades over previous urban and rural areas. Suicide rates amongst the elderly in rural areas are higher than those in urban areas (OR = 3.35; 95% CI of 2.48 to 4.51; I2 = 99.6%), but the latter have increased in recent years. Insecticide poisoning and hanging are the most common suicide methods in rural and urban areas respectively. Suicide rates for these two methods increase with age, being especially high in elderly people. CONCLUSIONS The pattern of suicide in China has changed in recent years following urbanisation and aging. Differences in suicide rates amongst the elderly exist between rural and urban areas. Addressing the high suicide rate amongst the elderly in rural China requires a policy response, such as considering measures to restrict access to poisons.
Collapse
Affiliation(s)
- Meizhi Li
- Department of Public Health, University of Glasgow, Glasgow, UK. .,The Second Xiangya Hospital of Central South University, Changsha, China.
| | | |
Collapse
|