Abstract
BackgroundSuicide is a major public health issue in China. Studies of suicide risk factors have reported both inconsistent and inconclusive results. This review aimed to determine suicide risk factors in China.MethodsMedline/PubMed, EMBASE, CNKI (China National Knowledge Infrastructure) and VIP (Chinese Journal of Science and Technology of VIP) were searched for relevant reports. Two investigators independently assessed the eligibility of identified studies and extracted data. Pooled odds ratios (and 95% confidence intervals) were calculated for each factor with Revman 5.0.ResultsForty-four studies with 192,362 subjects were included. The pooled results indicated that mood disorders and stressful life events (physical illness, suicide of relatives) increased the risk of suicide ideation among the entire population. Socio-family environment (single or remarried parent, study pressure and academic achievement) and unhealthy behaviors (smoking, alcohol drinking, and drug use) were risk factors for suicide ideation among youth. Unhealthy behaviors (smoking and alcohol drinking), mood disorders, and stressful life events (suicide of relatives) were the main risk factors for attempted suicide. Persons living in rural areas, and those with lower education, mood disorders, and/or a history of negative life events had a higher risk of completed suicide. In China, before 2000, females had a significantly higher rate of completed suicide than males, while after 2000, no significant gender difference was found.ConclusionsSocio-family environment, lifestyle, life events and psychiatric/psychological factors are associated with suicidal behaviors in China. Further case–control or cohort studies are needed to better understand suicide behaviors in China. Meanwhile, there is an urgent need for comprehensive studies of suicide interventions among high-risk populations.
Highlights
Suicide is a major public health issue in China
This result is consistent with that of Zhang et al [5], who found that the female suicide rate decreased more than the male suicide rate during the period between 1987 and −2008 (20.4 to 6.2/100,000 vs. 14.9 to 7.0/100,000, respectively) [5],which is due to the economic development over the past decades resulting in increase of female social status in China, in rural areas [5]
Our meta-analysis indicated that people living in rural areas and those with less education have a higher risk of completed suicide
Summary
Suicide is a major public health issue in China. This review aimed to determine suicide risk factors in China. Suicide is an important global public health problem. According to the World Health Organization (WHO), approximately one million people committed suicide, and 10–20 times that number attempted suicide worldwide in 2000 [1]. Suicide is one of the three leading causes of death among people aged 15–34 years [2] and suicide rates have increased by 60% over the last 45 years [3]. China has long been recognized as having a high suicide rate, with 21 percent of the world’s population, but 30–40 percent of the world’s suicides [4]. In China, females had consistently higher suicide rates than males [5]. The suicide rate in China has substantially decreased over the last 20 years, with the 2008 national suicide rate being approximately 63 percent lower than the 1987 rate (17.65 vs. 6.60/100,00, respectively)
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