Understanding the unique characteristics of suicide in China: national psychological autopsy study.
OBJECTIVE
To compare the characteristics of suicides in the four main demographic groups: urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China.


METHODS
A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country.


RESULTS
Pesticide ingestion accounted for 58% (519) of all suicides and 61% (318/519) of deaths were due to unsuccessful medical resuscitation. A substantial proportion (37%) of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% (76/563) received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion (79%), the lowest prevalence of mental illness (39%), and the highest acute stress from precipitating life events just prior to the suicide.


CONCLUSIONS
Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.
Yang
Gong-Huan
GH
Chinese Academy of Preventive Medicine, Beijing, China. capmdspz@public.bta.net.cn
Phillips
Michael R
MR
Zhou
Mai-Geng
MG
Wang
Li-Jun
LJ
Zhang
Yan-Ping
YP
Xu
Dong
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D012424:Rural Population; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data* / Q000639:trends; D014505:Urban Population