title: Indepth interviews with 244 female suicide attempters and their associates in northern China: understanding the process and causes of the attempt.
abstract: BACKGROUND
  Attempted suicide, a deliberate self-directed behavior situated within the unique social world of an individual, is a major risk factor for suicide. Efforts aimed at addressing female suicide must be based on understanding their perceived causes and the meaning of this behavior.
  
  
  OBJECTIVE
  This study describes the perceived causes of suicidal behaviors to determine preventive measures of female suicide in China.
  
  
  METHODS
  An in-depth interview about the process and causes of suicidal behavior as well as a detailed structured and a standardized diagnostic interview were administered to 244 female attempters treated at general hospitals and, separately, to their relatives.
  
  
  RESULTS
  The perceived three most frequent causes of the attempts were interpersonal conflict (87%), psychological problems (33%), and conflict between others that affected the subject (27%). On average 2.2 causes were identified for each case. The identification in the in-depth interviews of psychological problems as a cause of the attempt was concordant with the results of the independent psychiatric exam identifying a current DSM-IV mental disorder in 38% of cases (Kappa=0.64).
  
  
  CONCLUSIONS
  Preventive measures of improving interpersonal and problem-solving skills should be developed and assessed for addressing female suicide in China besides expansion of psychiatric services.
authors.affiliation: WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital, Beijing, China. xianyunl@public3.bta.net.cn
authors.forename: Xianyun
authors.initials: X
authors.lastname: Li
authors.forename: Michael R
authors.initials: MR
authors.lastname: Phillips
authors.forename: Alex
authors.initials: A
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*; D055815:Young Adult