title: Negative life events and attempted suicide in rural China.
abstract: OBJECTIVE
  This study aimed to examine the association between negative life events (NLEs) and attempted suicide in rural China.
  
  
  METHODS
  Six rural counties were selected from disease surveillance points in Shandong province, China. A total of 409 suicide attempters in rural areas between October 1, 2009, and March 31, 2011, and an equal number of matched controls were interviewed. We compared negative life events experienced within 1 month, 1-3 months, 3-6 months, and 6-2 months prior to attempted suicide for cases and prior to interview for controls. We used multivariate logistic regression to examine the association between NLEs and attempted suicide.
  
  
  RESULTS
  Suicide attempters experienced more NLEs within the last year prior to suicide attempt than controls prior to interview (83.1% vs. 33.5%). There was a significant dose-response relationship between NLEs experienced within the last year and increased risk of attempted suicide. Timing of NLEs analysis showed that NLEs experienced in the last month and 6-12 months prior to suicide attempt were significantly associated with elevated risk of attempted suicide, even after adjusting for mental disorders and demographic factors. Of NLEs, quarrelling with spouse, quarrelling with other family members, conflicting with friends or neighbors, family financial difficulty, and serious illness were independently related to attempted suicide.
  
  
  CONCLUSIONS
  NLEs are significantly associated with increased risk for attempted suicide in rural China. Stress management and intervention may be important to prevent suicidal behavior in rural China.
authors.affiliation: Department of Epidemiology and Health Statistics, Shandong University School of Public Health, Jinan, China.
authors.forename: Wen-Chao
authors.initials: WC
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Health Statistics, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention Research, Jinan, China.
authors.forename: Cun-Xian
authors.initials: CX
authors.lastname: Jia
authors.affiliation: Shandong Center for Disease Prevention and Control, Jinan, China.
authors.forename: Ji-Yu
authors.initials: JY
authors.lastname: Zhang
authors.affiliation: Ji'nan Shizhongqu Center for Disease Prevention and Control, Jinan, China.
authors.forename: Lin-Lin
authors.initials: LL
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, Shandong University School of Public Health, Jinan, China; University of Tennessee Health Science Center, Memphis, Tennessee, United States of America.
authors.forename: Xian-Chen
authors.initials: XC
authors.lastname: Liu
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D013406:Suicide, Attempted / Q000523:psychology*