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

Abstract

Background: There is a lack of evidence concerning the stressful life events experienced prior to suicide which may be associated with an increased suicide risk for Chinese rural elderly. The aim of this study was to identify the pattern of stressful life events prior to suicide among the elderly in China. Methods: A total of 12 counties were randomly selected using two-stage stratified cluster sampling method. Suicide cases aged 60 years and older (n =242) were collected from those counties from June 2014 to September 2015. Matched living controls were selected 1:1 with suicide cases by age, gender, and location. Data in the study were collected through face-to-face interviews by a psychological autopsy method. The Life Event Scale for the Elderly was used to measure the stressful life events prior to suicide/interviews. Results: Approximately 99.6% of suicide cases and 88.4% of controls experienced at least one stressful life event. The suicide group experienced more long-term stressful life events than recent stressful life events. The top three most frequent stressful life events for the suicide group were being diagnosed with chronic disease, hospitalization, and being diagnosed with terminal illness. More female suicide cases experienced the death of a spouse, while more males experienced hospitalization, diagnosis with terminal illness and family poverty. Experiencing at least one stressful life event, having unstable marital status, physical diseases and mental disorders were the factors that increased the risk of suicide.Conclusions: Stressful life events were common for the rural elderly, especially long-term stressful life events. The experience of at least one stressful life event can increase suicide risk for this population. More attention should be given to the rural elderly who experienced more long-term stressful life events and experienced health related life events.