Abstract
Background: Late-life suicide is a severe public health problem in rural China; however, knowledge regarding the specific characteristics and risk factors for completed suicide via violent and non-violent methods among elderly individuals in rural China is limited.Methods: Subjects aged 60 years or older were selected from rural areas in Shandong, Hunan, and Guangxi provinces in China. This study was a 1:1 matched case-control design conducted by using the psychological autopsy method.Results: According to the univariate analyses, the presence of mental disorder, higher degree of depression, loneliness, lack of social support, hopelessness, impulsivity, and increased quantity of life events were associated with suicide in both violent and non-violent methods. For violent suicide, another risk factor was the lack of pesticides at home. For non-violent suicide, other risk factors were not currently married, family suicide history, and alcohol use disorder (P < 0.05). Variables that remained in the logistic regression model were the severity of depressive symptoms for both violent and non-violent suicide. For non-violent suicide, the degree of hopelessness was another independent risk factor. In addition, violent suicides were more likely to lack pesticides at home, choose the spring season and have an increased quantity of life events than those who died by suicide via non-violent methods.Conclusion: The major risk factor for both violent and non-violent suicide was the severity of depressive symptoms. Suicide prevention measures that focus on depression among this vulnerable population are urgently needed. Moreover, the characteristics of suicides via violent methods differed from those via non-violent methods among elderly individuals. Suicide prevention efforts should be tailored to the specific characteristics of the different suicide methods utilized by older adults in rural areas.
Highlights
Suicide represents a severe public health problem in China and worldwide
Suicide cases were more likely to have a larger impact on life events than living controls in both the violent and non-violent groups. Those who died by suicide via non-violent methods were more likely to store pesticides at home than those who died by suicide via violent methods (38.5 vs. 63.9%; P < 0.001)
We found that 60.3% of the suicides occurred between 6:00 a.m. and 1:59 p.m., and 87.6% of the suicides occurred at home, but there were no significant factors identified for violent suicide methods; this result highly differed from former research investigating younger individuals who died by suicide in rural China that showed that most suicides occurred at nighttime and that suicides via violent methods were more likely to occur outside than inside [43]
Summary
Suicide represents a severe public health problem in China and worldwide. Late-life suicide is a multidimensional behavior that has special characteristics and risk factors. Research has found that unemployment, not married, mental disorders, and depressive symptoms were independent risk factors related to suicide in older adults in rural China [4]. Feeling left behind can elevate suicide risk due to increasing life stresses, mental disorders, and depressive symptoms and decreasing social support [4]. Investigating the specific characteristics of suicide methods among older adults is critical for suicide prevention. Late-life suicide is a severe public health problem in rural China; knowledge regarding the specific characteristics and risk factors for completed suicide via violent and non-violent methods among elderly individuals in rural China is limited
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
