The pattern of stressful life events prior to suicide among the older adults 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 among Chinese rural older adults. The aim of this study was to identify the pattern of stressful life events prior to suicide among the older adults in China. Methods Twelve 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 were collected using 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, an unstable marital status, physical diseases and mental disorders were shown to increase the risk of suicide. Conclusions Stressful life events were common for the rural older adults, especially long-term stressful life events. The experience of at least one stressful life event can increase suicide risk among this population. More attention should be paid to the rural older adults who experienced more long-term stressful life events and health related life events.

Management of suicide and self-harm risk by the National Mental Health Helpline in the State of Qatar

“…Stressful life events have been associated with an increased risk of suicide. 3 , 7 , 8 , 36 This reflects the importance of paying more attention to stressful life events while undertaking risk assessment and management.…”

The forensic analysis of homemade explosive suicides: Case report and systematic review of the literature

“…In suicides, the application of the psychological autopsy method can be helpful in determining the manner of death, and in particular, it is necessary to search the scene for the presence of any letters or writings that may be linked to the self-damaging event. In the context of suicides, a crucial role is played by the analysis of the setting and the anamnestic collection of any previous pathologies both of a psychiatric and organic nature with the interview of family members through collaborations with expert psychologists or forensic psychiatrists [36][37][38]. In this case, the analysis of the setting revealed that the family members knew that the man was building explosives and pyrotechnic articles in his home but had never filed a report with the judicial authorities.…”

What do older people who have attempted suicide experience? Study protocol for a qualitative meta-synthesis among older adults, family caregivers and healthcare professionals

“…The highest suicide rate within the Australian population is among men aged 85 and above, at a rate of 38.3 suicides per 100 000 individuals 9. In 2016, China’s age-standardised suicide rate was 8 per 100 000 individuals; however, suicide rates among the age groups of 60–69, 70–79 and 80 and above were 23.4, 44.0 and 61.3, respectively—approximately 3–8 times higher than the general population’s suicide rate 10. A meta-analysis indicated that among China’s older population, the proportion of individuals with suicidal ideation ranges from 2.2% to 21.5% 11.…”