Research report
Suicidal ideation and attempts among rural Chinese aged 16–34 years — Socio-demographic correlates in the context of a transforming China

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Abstract

Background

The distinctive epidemiologic profile of suicide in China, with notably high rates among rural young adult females, invites examination of possible underlying risk factors. Although there are accumulating data regarding the epidemiology of suicide among youth and young adults in China, there are meager data on suicidal ideation and attempts despite its importance.

Methods

Our study in 2005–06 sought to identify all potentially suitable rural participants, aged 16–34 years, from 10 representative villages in rural Sichuan Province. We conducted structured interviews regarding a range of socio-demographic characteristics and suicidal morbidity.

Results

1654 of a potential 3008 participants participated; lifetime and one-year prevalence were: suicidal ideation (18.8% and 5.2%), serious ideation (8.6% and 2.3%), planning (5.8% and 1.5%), and attempt (2.7% and 0.5%). Comparisons among strata of socio-demographic characteristics showed more prevalent suicidal ideation associated with: female gender, lower education, poorer financial perception, greater rurality of residence, and marital status of “never married” or “others”. Suicidal attempt was associated with: female gender and a marital status of “others”.

Limitations

The study was carried out in one province and caution is required when considering other rural regions of China. There were a substantial number of unapproachable subjects because of their migrant work at distant sites.

Conclusions

Our results revealed an apparently higher prevalence for suicide ideation and planning compared with residents of other countries, but a lower prevalence for attempts. These data suggests that the relatively high rate of suicide in rural China reflects an elevated case fatality ratio due to chosen methods. The results also revealed unique patterns for correlates with the occurrence of ideation and attempts.

Section snippets

Sampling

The study was approved by the Survey and Behavioral Ethics Committee of The Chinese University of Hong Kong. The Study involved collaboration with the Mianyang Center for Disease Control and Prevention (CDC) and its regional CDCs. The project was conducted in the vicinity of Mianyang Region, Sichuan Province (Southwestern China). We chose to study rural regions in the vicinity of Mianyang, Sichuan Province, in the southwestern part of China. This area is typical of many rural regions in China,

Participation

Fig. 1 depicts the study's sampling results.

Distribution of socio-demographic features

Table 1 shows the distribution of socio-demographic features of the sample.

Prevalence of suicidal ideation and attempts

Table 2 shows the prevalence of lifetime and one-year outcomes with rates for female and male included. The figures indicated that female rate is generally higher than male rate across all suicidal measures.

Associations of lifetime suicidal ideation, serious ideation, plan and attempts with socio-demographic characteristics

Univariate findings are presented in Table 3. The univariate analysis revealed that female gender (OR = 1.48), lowest education level (OR = 1.86), ‘other’ marital status (OR = 

Comparison of prevalence with other studies

Based on data collected from nine countries/regions with items similar to ours Weissman et al. reported lifetime prevalence of suicide ideation, ranging from 2.09% to 18.51%, and lifetime prevalence of suicide attempt, ranging from 0.72% to 5.93% (Weissman et al., 1999). In comparison to the above data, the lifetime prevalence of suicide ideation of our sample (18.8%) was at the higher end; while our prevalence of suicide attempt (2.8%) was at the low end of the data reported by Weissman et al.

Role of fund source

This work was supported in part by an unrestricted educational grant from Lundbeck Export A/S (H. Chiu, PI); by Direct Grant 2041160 from The Chinese University of Hong Kong (S. Chan, PI); and by grant D43 TW05814 from the Fogarty International Center of NIH (E.D. Caine, PI). All the funding sources listed had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Conflict of interest

All the authors declare that they have no conflict of interest.

Acknowledgements

We thank Mianyang CDC and its regional CDCs, the key coordinator Zhou Yun (Mianyang CDC) as well numerous staff from the CDCs including our interviewers, and local helpers from health system and villages, for data collection and cleaning. We also thank Tony Leung, Anthony Beckman, Arthur Watts and Xin Tu for their assistance with data management and data analysis.

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