Gender differences on suicide rate,attempted suicide rate,and fatality rate of seriously suicidal behaviors:evidence from suicide reporting system in a county in Shaan′xi Province

Abstract

Objective To explore the underlying mechanism of why the suicide rate in females is higher than in males in China. Methods A county-wide suicide reporting system was established in Shaan′xi Province,to monitor suicidal behaviors,including attempted and completed suicide.From Jan.1,2009 to Dec.31,2010,all patients over 10 years of age treated in 14 general hospitals in the county for suicidal behaviors or accidental self-harm were identified.For each identified cases,information including name,sex,age,specific characteristics of the self-harm (method,time,etc.) and outcome,was recorded on a standardized form by an interviewer.Death certifications provided by the county′s Center of Diseases Control (CDC) were used to identify all completed suicides (International Classification of Diseases,ICD codes X60-X84) occurred from Jan.1,2009 to Dec.31,2010. Results In the 2 years investigation periods,406 patients with suicidal behaviors were identified,in which 366 were suicide attempters.In the same two years,57 person in this county died by suicide.The annual attempted suicide rate in the county was 67.1 per 100 000 (366/545 339),and the ratio of attempted suicide rate of females (96.1/100 000,254/264 177) to males (39.5/100 000,111/281 162) was 2.44.The annual suicide rate was 10.5 per 100 000 (57/545 339).The rate of serious suicidal behavior was 77.6/100 000 (423/545 339),and the ratio of rates of serious suicidal behavior of females (107.5/100 000,284/264 177) to males (49.1/100 000,138/281 162) was 2.19.The ratio of annual rate of attempters to completes was 6.42∶1.Among all the 423 cases who committed suicidal behaviors,19.6% male cases (27/138) and 10.6% female cases (30/284) were died by suicide.Sixty-seven percent (244/366) attempters committed suicidal behaviors with pesticide. Conclusions The rate of serious suicidal behaviors is 2.19-fold higher in females than in males,but the fatality of suicidal behaviors is 1.85-fold higher in males than in females,which contribute to a higher suicide rates in females than males in China. Key words: Suicide,attempted; Suicide reporting system; Ratio of rates of attempted to completed suicide; Pesticides