Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study
Objectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters.Design A surveillance study of incidence and mortality. Linked data from two public...
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BMJ Publishing Group
2015-02-01
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| Series: | BMJ Open |
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| author | Aiqiang Xu Mei Wang Xiaolei Guo Cunxian Jia Jiandong Sun Jiyu Zhang |
| author_facet | Aiqiang Xu Mei Wang Xiaolei Guo Cunxian Jia Jiandong Sun Jiyu Zhang |
| author_sort | Aiqiang Xu |
| collection | DOAJ |
| description | Objectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters.Design A surveillance study of incidence and mortality. Linked data from two public health surveillance systems were analysed.Setting Three selected counties in Shandong, China.Participants All residents in the three selected counties.Outcome measures Incidence rate (per 100 000 person-years) and case fatality rate (%).Methods Records of suicide deaths and hospitalisations that occurred among residents in selected counties during 2009–2011 (5 623 323 person-years) were extracted from electronic databases of the Disease Surveillance Points (DSP) system and the Injury Surveillance System (ISS) and were linked by name, sex, residence and time of suicide attempt. A multiple logistic regression model was developed to examine the factors associated with a higher or lower fatality rate.Results The incidence of SSAs was estimated to be 46 (95% CI 44 to 48) per 100 000 person-years, which was 1.5 times higher in rural versus urban areas, slightly higher among females, and increased with age. Among all SSAs, 51% were hospitalised and survived, 9% were hospitalised but later died and 40% died with no hospitalisation. Most suicide deaths (81%) were not hospitalised and most hospitalised SSAs (85%) survived. The fatality rate was 49% overall, but was significantly higher among attempters living in rural areas, who were male, older, with lower education or with a farming occupation. With regard to the method of suicide, fatality was lowest for non-pesticide poisons (7%) and highest for hanging (97%).Conclusions The incidence of serious suicide attempts is substantially higher in rural areas than in urban areas of China. The risk of death is influenced by the attempter's sex, age, education level, occupation, method used and season of year. |
| format | Article |
| id | doaj-art-a462d41e79404afabed7c2ffd89d0899 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2015-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a462d41e79404afabed7c2ffd89d08992025-02-04T12:30:11ZengBMJ Publishing GroupBMJ Open2044-60552015-02-015210.1136/bmjopen-2014-006762Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance studyAiqiang Xu0Mei Wang1Xiaolei Guo2Cunxian Jia3Jiandong Sun4Jiyu Zhang5Shandong University, Jinan, Shandong, ChinaClinical Pharmacology & Toxicology, St. Joseph`s Healthcare Hamilton, Hamilton, Ontario, CanadaShandong Center for Disease Control and Prevention, Jinan, ChinaDepartment of Epidemiology, Shandong University School of Public Health, Jinan, ChinaQueensland University of Technology, Brisbane, Queensland, AustraliaShandong Provincial Centre for Disease Control and Prevention, Jinan, Shandong, ChinaObjectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters.Design A surveillance study of incidence and mortality. Linked data from two public health surveillance systems were analysed.Setting Three selected counties in Shandong, China.Participants All residents in the three selected counties.Outcome measures Incidence rate (per 100 000 person-years) and case fatality rate (%).Methods Records of suicide deaths and hospitalisations that occurred among residents in selected counties during 2009–2011 (5 623 323 person-years) were extracted from electronic databases of the Disease Surveillance Points (DSP) system and the Injury Surveillance System (ISS) and were linked by name, sex, residence and time of suicide attempt. A multiple logistic regression model was developed to examine the factors associated with a higher or lower fatality rate.Results The incidence of SSAs was estimated to be 46 (95% CI 44 to 48) per 100 000 person-years, which was 1.5 times higher in rural versus urban areas, slightly higher among females, and increased with age. Among all SSAs, 51% were hospitalised and survived, 9% were hospitalised but later died and 40% died with no hospitalisation. Most suicide deaths (81%) were not hospitalised and most hospitalised SSAs (85%) survived. The fatality rate was 49% overall, but was significantly higher among attempters living in rural areas, who were male, older, with lower education or with a farming occupation. With regard to the method of suicide, fatality was lowest for non-pesticide poisons (7%) and highest for hanging (97%).Conclusions The incidence of serious suicide attempts is substantially higher in rural areas than in urban areas of China. The risk of death is influenced by the attempter's sex, age, education level, occupation, method used and season of year.https://bmjopen.bmj.com/content/5/2/e006762.full |
| spellingShingle | Aiqiang Xu Mei Wang Xiaolei Guo Cunxian Jia Jiandong Sun Jiyu Zhang Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study BMJ Open |
| title | Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study |
| title_full | Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study |
| title_fullStr | Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study |
| title_full_unstemmed | Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study |
| title_short | Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China: a public health surveillance study |
| title_sort | incidence and fatality of serious suicide attempts in a predominantly rural population in shandong china a public health surveillance study |
| url | https://bmjopen.bmj.com/content/5/2/e006762.full |
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