Risk factors for suicide in China: a national case-control psychological autopsy study

Phillips, Michael R.; Yang, Gonghuan; Zhang, Yanping; Wang, Lijun; Ji, Huiyu; Zhou, Maigeng

doi:10.1016/s0140-6736(02)11681-3

Cited by 795 publications

(730 citation statements)

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“…With a control group of deceased individuals, the sources of information used to assess risk factors are informants who have recently experienced the death of a family member or close associate -and are therefore more comparable to the sources of information in the suicide group than if living controls were used." 64 …”

Section: Bias: Describe Any Efforts To Address Potential Sources Of Bmentioning

confidence: 99%

“…For instance, in casecontrol studies information bias can occur, but may be reduced by selecting an appropriate control group, as in the first example. 64 Differences in the medical surveillance of participants were a problem in the second example. 65 Consequently, the authors provide more detail about the additional data they collected to tackle this problem.…”

Section: Explanationmentioning

confidence: 99%

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Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

et al. 2007

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Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalizability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies.The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers.This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated web site (http://www.strobe-statement.org) should be helpful resources to improve reporting of observational research. (Epidemiology 2007;18: 805-835) R ational health care practices require knowledge about the etiology and pathogenesis, diagnosis, prognosis and treatment of diseases. Randomized trials provide valuable evidence about treatments and other interventions. However, much of clinical or public health knowledge comes from observational research. 1 About nine of ten research papers published in clinical speciality journals describe observational research. 2,3 The STROBE StatementReporting of observational research is often not detailed and clear enough to assess the strengths and weaknesses of the investigation. 4,5 To improve the reporting of observational research, we developed a checklist of items that should be addressed: the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement (Table 1). Items relate to title, abstract, introduction, methods, results and discussion sections of articles. The STROBE Statement has recently been published in several journals. 6 Our aim is to ensure clear presentation of what was planned, done, and found in an observational study. We stress that the recommendations are not prescriptions for setting up or conducting studies, nor do they dictate methodology or mandate a uniform presentation.STROBE provides general reporting recommendations for descriptive observational studies and studies that investigate 805associations between expos...

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Section: Bias: Describe Any Efforts To Address Potential Sources Of Bmentioning

confidence: 99%

Section: Explanationmentioning

confidence: 99%

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

et al. 2007

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“…Substantial geographic and temporal variation in suicide rates (Liu KY, 2009, Judd, Cooper, Fraser, & Davis, 2006; Middleton, Gunnell, Frankel, Whitley, & Dorling, 2003; Taylor, Page, Morrell, Harrison, & Carter, 2005) cannot be fully explained by varying rates of mental illnesses and different patterns of other frequently reported risk factors (Moscicki, 1997; Phillips et al, 2002b). Another important component in the complex causal network for suicide is the normative cultural attitudes about suicide, which vary by community, by population cohort, and over time (Salander-Renberg, et al, 2008; Goldsmith et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

The Acceptability of Suicide Among Rural Residents, Urban Residents, and College Students from Three Locations in China

Phillips

2010

Crisis

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Background Community attitudes about suicide and their relationship to suicidal behavior have not been adequately investigated in low- and middle-income countries. Aims Compare acceptability of suicide in different population cohorts in China, identify factors that affect the degree of acceptability, and assess the relationship of cohort-specific acceptability of suicide and suicide rates. Methods A multi-stage stratified random sample of 608 rural residents, 582 urban residents and 629 college students were administered a 25-item scale in which respondents stated the likelihood they would consider suicide (on a 5-point Likert scale) if they experienced a variety of stressors ranging from ‘being disciplined at work’ to ‘developing a chronic mental illness’. The internal consistency and test-retest reliability for the scale are excellent (Cronbach’s α =0.92, ICC=0.75). Results College students had the most permissive attitudes about suicide and urban residents were significantly more accepting of suicide as a response to serious life stressors than rural residents. Multivariate analysis found that the overall acceptability score was higher in women, decreased with age, and increased with years of education. Conclusions There was no clear relationship between cohort-specific acceptance of suicide and reported rates of suicide, highlighting the complexity of the relationship between attitudes about suicide (of which acceptability is only one component) and suicidal behavior.

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“…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…”

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Characteristics of Chinese Suicide Attempters: An Emergency Room Study

et al. 2006

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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...

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Risk factors for suicide in China: a national case-control psychological autopsy study

Cited by 795 publications

References 14 publications

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

The Acceptability of Suicide Among Rural Residents, Urban Residents, and College Students from Three Locations in China

Characteristics of Chinese Suicide Attempters: An Emergency Room Study

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