A Survey on Suicide in China during the Past Decade (1998)

SUMMARY Using the method of document metrology, the authors reviewed the literature published in the past decade on suicidal behaviour (suicide and parasuicide) including epidemiological data, clinical characteristics of suicide and social factors presumably contributing to suicidal behaviour. Between 1986 and 1996, 211 papers were published about suicide and parasuicide in Chinese Journals, 76 % of which were clinical observations, controlled studies or epidemiological surveys. Mortality of completed suicide varied according to the regions sampled, in rural areas it was 3,21-21.01 / 100,000 (median. 17.9) as compared to 2.78-.43 / 100,000 (median . 6.60) in urban or suburban areas. The age at which suicidal behaviour occurred ranged from 7 to 95 years. Young adults (aged 20-29) had the highest rate of suicide while the elderly (over 60 years) had the lowest rate. More female than male attempted/committed suicide (m/f : 0. 4-0.8 / 1. 0); however, the prevalence of completed suicide showed no predominance with respect to sex. Well-educated people were more likely to attempt/commit suicide than poorly educated ones. Common causative factors of suicidal behaviour included interpersonal conflicts, the presence of psychiatric disorders and difficulties related to chronic somatic ailments. Poisoning, hanging and drowning were the three most common methods for committing suicide. Key words: suicide, parasuicide, epidemiology, causative factors, Chinese INTRODUCTION Suicide is a critical social issue which as been intensively studied for more than 100 years in most developed countries. A subspecialty, suicidology, has been developed over the past decades with its own scientific journals. In China suicidology started in the 1940s with an epidemiological study but until the 1980s there was not even a symposium organized an the subject (Da Dan, 1995). Recently. more and more attention ha-q been paid to suicide but still few specialized institutes exist for its prevention and treatment. Systematic documentation on suicide is lacking. In this paper we review the literature on suicide published in China during the past decade. Our aim is to take stock of the advances psychiatric research has made and to provide a background for further development in this held. METHOD All scientific documents related to the keyword 'suicide' in the CD Database of Chinese Biological Medicine between 1986 and 1996 were examined in our survey. We used document metrology (Qiu Yunping, 1986) to identify all relevant documents on the epidemiology of suicidal behavior (suicide and parasuicide) and also on causative factors and various forms of suicidal behaviour. RESULTS DATA BASE We reviewed 211 papers related to suicide which were published in 96 Chinese journals during the period of 1986-1996. The yearly distribution of the number of papers was uneven during the period examined. One hundred and sixteen (76 %) of them were clinical observations including controlled clinical and epidemiological studies, while the rest were case reports and basic research papers. We found 50 review papers an suicide in mainland China. MORTALITY DUE TO SUICIDE Mortality due to suicide varied with the site sampled. In rural areas it was 3.21-1.01 per 100,000 population (median =17.9) compared to 2.78-9.43/100,000 (median =6.60) in urban or sub-urban areas (Liu Xianchen et al, 1994; Hu et al, 1992; Chen & Gao, 1993; Liu Jianbuo et al, 1994; Liu Keli et al, 1996; Wang Yuting & Wang, 1994). Five to ten percent of patients who attempted suicide died from their self-inflicted injuries in emergency departments (Ren & Xu, 1993; Xu Chunsheng et al, 1993; Yang Jiwei et al, 1995; Wang Ruiru & Zhang, 1994; Zhao & Qi, 1996). SEX AND SUICIDAL BEHAVIOUR More women attempted suicide or parasuicide in both urban and rural areas with a male--female ratio of 0. …