Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Jia, Cun-Xian; Wang, Lin-Lin; Xu, Aiqiang; Dai, Ai-ying; Qin, Ping

doi:10.1027/0227-5910/a000271

Cited by 26 publications

(27 citation statements)

References 24 publications

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“…Elderly suicide victims were more likely to experience life events, have an unstable marital status, physical diseases, and mental disorders. These risk factors have also been reported in previous studies [24][25][26]. The elderly were living in worse conditions and this seemed to increase the risk of suicide.…”

Section: Discussionsupporting

confidence: 80%

The pattern of life events preceding suicide among the elderly in rural China: a national case-control psychological autopsy study

Wang

Jia

et al. 2019

Preprint

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Background Life events associated with an increased risk of suicide and prior to the suicide in China different from those in Western countries. But there is a lack of summary of the elderly life event patterns on Chinese suicide. The aim of this study was to identify the pattern of life events which precede suicide among the elderly in a Chinese culture context.Methods A two-stage stratified cluster sampling method was used in order to select research sites and 12 counties were randomly selected to recruit cases within three provinces. A case-control psychological autopsy study was then adopted. The study population consisted of 242 suicide cases each with an age of 60 and above, and 242 age-, sex-, and location-matched community living controls. During face-to-face interviews, the information from subjects and proxy informants was obtained by standardized trained investigators. Life events were measured using a 46-item Life Event Scale for the Elderly (LESE).Results About 99.6% of suicides and 88.4% of controls resulted from the experience of at least one life event. The elderly who had committed suicide experienced more long-term life events. The top three most frequent life events were being diagnosed with chronic disease, hospitalization, and being diagnosed with terminal illness. Women more often experienced the death of spouse, while men experienced more hospitalization, and were more likely to be diagnosed with terminal illness and suffer family poverty. The risk of suicide among the elderly who experience life events was 12.8 times higher than that in people who did not experience life events. The elderly who were having unstable marital status, suffering from physical diseases and diagnosed with mental disorders, are more likely to commit suicide.Conclusions Understanding the pattern of life events which precede suicides among the elderly in rural China plays an important role in the prevention of suicide. Several different long-term life events can lead to suicidal behavior, and the effect of life events on suicide is cumulative. Being diagnosed with a serious disease may be one of the risk signals for suicide among the elderly.

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Section: Discussionsupporting

confidence: 80%

The pattern of life events preceding suicide among the elderly in rural China: a national case-control psychological autopsy study

Wang

Jia

et al. 2019

Preprint

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“…We also found that the prevalence rate of mental disorder was 47.4% in the suicide cases. Some other studies also showed that mental disorders can be found about 40–70% of all suicides in China . However, the prevalence rate of mental disorder among suicides in the West countries was over 90% .…”

Section: Discussionmentioning

confidence: 92%

“…Some other studies also showed that mental disorders can be found about 40-70% of all suicides in China. 5,34 However, the prevalence rate of mental disorder among suicides in the West countries was over 90%. 35 One possible explanation for the differences is that suicides in China are more strongly related to social stresses or cultural differences.…”

Section: Discussionmentioning

confidence: 99%

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Insomnia symptom, mental disorder and suicide: A case-control study in Chinese rural youths

Sun

Zhang

Liu

2015

Sleep and Biological Rhythms

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Insomnia has been reported as a risk factor of suicidal behaviors, but few studies have examined the association among insomnia, mental disorder and suicide, especially among Chinese populations. In this study, we examined the effect of insomnia symptoms on completed suicide in a large sample of suicides and their controls in Chinese rural youths. Subjects were 388 consecutively recruited suicides and 416 community living controls aged 15–34 years in the rural areas of three provinces in China. Established psychological autopsy method was used for the data collection. Insomnia symptoms were assessed with sleep questions in the Hamilton Depression Rating Scale (HAMD) about insomnia, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) and early morning awakening (EMA). The results showed that DIS (OR=12.01, p<0.001), DMS (OR=12.82, p<0.001) or EMA (OR=12.08, p<0.001) was significantly associated with increased risk of suicide even after mental disorder was controlled for. Our study showed that insomnia can be an independent risk factor for suicide. Mental disorders mediated the association between insomnia and suicide. Insomnia should be assessed and treated for individuals at risk of suicide.

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“…Associations between the number of physical illnesses and both nonfatal suicidal behaviour and suicide were shown in a Hong Kong-based study (Tsoh et al., 2005 ). Increased odds of suicide were found among older adults with one and two physical illnesses in a Chinese study (Jia, Wang, Xu, Dai, & Qin, 2014 ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

Fässberg

Cheung

Canetto

et al. 2015

Aging & Mental Health

299

194

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Objectives: To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Method: Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Results: Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Conclusion: Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults.

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Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Abstract: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

Cited by 26 publications

References 24 publications

The pattern of life events preceding suicide among the elderly in rural China: a national case-control psychological autopsy study

The pattern of life events preceding suicide among the elderly in rural China: a national case-control psychological autopsy study

Insomnia symptom, mental disorder and suicide: A case-control study in Chinese rural youths

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

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