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Risk factors for suicide in China's youth: a case-control study

Published online by Cambridge University Press:  10 September 2007

X. Y. Li ,
M. R. Phillips ,
Y. P. Zhang ,
D. Xu  and
G. H. Yang
X. Y. Li*
Affiliation:
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
M. R. Phillips
Affiliation:
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
Y. P. Zhang
Affiliation:
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
D. Xu
Affiliation:
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
G. H. Yang
Affiliation:
Institute of Basic Medical Sciences, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
*
*Address for correspondence: Dr X. Y. Li, Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing 100096, People's Republic of China. (Email: [email protected])
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Abstract

Background

Suicide is the most common cause of death among youth in China.

Method

A case-control psychological autopsy study in 23 geographically representative disease surveillance points around China collected information from family members and close associates of 114 persons aged 15–24 years who died by suicide (cases) and 91 who died of other injuries (controls).

Results

Among the 114 suicides 61% were female, 88% lived in rural villages, 70% died by ingesting pesticides (most commonly stored in the home), 24% previously attempted suicide, and 45% met criteria of a mental illness at the time of death. Multivariate logistic regression identified several independent risk factors: severe life events within 2 days before death (OR 31.8, 95% CI 2.6–390.6), presence of any depressive symptoms within 2 weeks of death (OR 21.1, 95% CI 4.6–97.2), low quality of life in the month before death (OR 9.7, 95% CI 2.8–34.1), and acute stress at time of death (moderate: OR 3.1, 95% CI 0.8–11.9; high: OR 9.1, 95% CI 1.2–66.8). A significant interaction between mental illness at time of death and gender indicated that diagnosis was an important predictor of suicide in males (OR 14.0, 95% CI 2.6–76.5) but not in females (OR 0.3, 95% CI 0.0–3.6). Prior suicide attempt was related to suicide in the univariate analysis (OR 57.5) but could not be included in the multivariate model because no controls had made prior attempts.

Conclusions

Suicide prevention efforts for youth in China must focus on restricting access to pesticides, early recognition and management of depressive symptoms and mental illnesses, improving resiliency, and enhancing quality of life.

Keywords

Case-control studyChinarisk factorssuicideyouth
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 3 , March 2008 , pp. 397 - 406
Copyright
Copyright © Cambridge University Press 2007

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