Characteristics of Chinese Suicide Attempters: An Emergency Room Study

Abstract

Studying the characteristics of attempted suicide is helpful in knowing the background of some completed suicides and improving prevention or intervention strategies. This current study analyzed data of 74 suicide attempters and 92 accident injured patients admitted to 6 hospital emergency rooms in an area of North-eastern China and found both similarities and differences between Chinese and Western suicide attempters. The data show that more women than men attempted suicide. Perhaps because of the unavailability of firearms to Chinese civilians, pesticide was the most lethal means of suicidal behavior. The stressful life events that account for the majority of suicidal incidents were mostly familial or marital problems. Compared with accident victims, these Chinese suicide attempters were younger, poorer, more likely to believe in a religion/superstition, more likely to perceive gender inequality, and less likely to experience support from either family or community. The traditional culture downplaying the status of women coupled with a belief in the transmigration of life may play an important role in the suicide of Chinese young women.Suicide in China has been a focus of study in recent years partially because of its uniqueness in the demographic structure of the rates-more women than men, more rural people than urban residents, and an astonishing prevalence among youth ages 15-34 (Phillips et al., 2002;Zhang et al., 2004). An optimal way to obtain first-hand knowledge about risk factors and cultural influences would be directly interviewing serious attempters of suicide. In this current study, we try to understand the characteristics and risk factors of Chinese suicide through assessing the overall background of a sample of serious attempters.In the West, it has been estimated that the ratio of suicide attempts to completed suicides is between 6-8 to 1 and 8-25 to 1 (Maris et al., 2000;McIntosh, 1998), and some overlap has been observed between attempts and completed suicides in terms of psychiatric diagnoses and care, history of previous suicide attempts, social disadvantage, and exposure to stressful life events (Beautrais, 2001). However, in the West there are also some differences between suicide attempts and completed suicides. For example, more men than women kill themselves via suicide, but more women than men attempt suicide (Maris et al., 2000). Although only about Few studies have been published on suicide attempters in China. One study (Ran et al., 2003) was based on data collected from a psychiatric elderly sample. To know more about the Chinese suicide, we need also to study the attempters from a general population, because a much lower percentage of completed suicides in China have been observed with psychiatric disorders than that found in the West (Phillips et al., 2002;Zhang et al., 2004). This current research project explores the characteristics of Chinese suicide attempters from non-psychiatric populations Method RespondentsRespondents were consecutively sampled serious attempters...

Suicide and poverty in low-income and middle-income countries: a systematic review

“…4 Poverty is increasingly understood by researchers to be more than simply a lack of resource or income, and can include cultural, social, and environmental dimensions, such as shame 70 and religious beliefs. 65 Second, publication bias may have hindered the results, with studies reporting negative and null results being less likely to be published. Third, the exclusion of qualitative studies may have limited understanding of how the experience of poverty may be related to SIB, and the role of cultural, social and environmental factors.…”

“…However, where multivariate analysis was performed in two Indian studies, only null associations were found for value of livestock and value of agricultural produce amongst farmers 61 and for monthly household income. 56 Of the eleven studies on non-fatal SIB, six 35,41,42,48,57,65 using bivariate analysis reported a positive association and four 37,55,57,58 a null association. However, all studies 34,37,38,41,48,57,64 performing multivariate analysis found a positive association except one 34 which found a null association between perceived financial status and suicide attempts in China.…”

“…Eight studies [59][60][61][62][63][64][65][66] were of low quality due to problems with risk of bias: performance, attrition and detection bias (interrupted-time series); selection bias, unclear case definitions, detection bias, lack of adjustment for confounding factors (case-control studies); detection bias, lack of adjustment for confounding factors (cross sectional and ecological studies). Table 4 summarises the relationships between SIB and poverty reported in 37 included studies (full details in appendix).…”

Predicting Suicide Risks Among Outpatient Adolescents Using the Family Environment Scale: Implications for Practice and Research

“…Suicide risk was found to increase among children and adolescents in inpatient settings when they perceive their family systems as rigid, less adaptable to change, lacking problem-solving skills, and possessing less effective styles of communication (Adams et al 1994). Inpatient populations were reportedly more depressed and anxious when familial self-disclosure was lower (Horesh and Apter 2006), family systems were less supportive (Zhang et al 2006), and exhibited hostile and conflictual interactions (Gunter et al 1999). The qualitative study of Bartimole (2009) found evidence from teens who survived suicide attempts that being loved and valued by their families played a significant role in turning their direction away from suicide.…”

Understanding Self-Harm in Victims of Intimate Partner Violence: A Qualitative Analysis of Calls Made by Victims to a Crisis Hotline in China

“…A recent interview study found that Chinese women with prior self-harm perceived more gender inequality than women without prior self-harm behavior (Zhang, Jia, Jiang, & Sun, 2006). A surge of feminist activities following the 1996 Fourth World Conference on Women in Beijing led to major reforms of the China Marriage Law in 2001, including the prohibition of violence between husband and wife (Article 3), and the granting of immediate divorce (Article 31) and financial compensation to victims of spousal violence (Article 46).…”