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Research Trends

Physical Illnesses and Medically Serious Suicide Attempts in Rural China

Published Online:March 19, 2019https://doi.org/10.1027/0227-5910/a000597

Abstract

Abstract.Background: Physical illness is a strong correlate of suicidal behavior. However, its impact on attempted suicide in rural China is under-studied. Aims: This study was designed to assess the influence of physical illness on risk of suicide attempts and to identify distinguishing characteristics among medically serious suicide attempters with physical illnesses from those without. Method: Participants were medically serious suicide attempters identified through hospital emergency rooms (n = 659) as well as age- and gender-matched community controls (n = 659) from Shandong Province, China. Face-to-face interviews with the respondents were conducted with a semistructured protocol that included sociodemographic and psychological measures. Results: Physical illness was a significant risk factor for medically serious suicide attempts (OR = 1.739, 95% CI = 1.182–2.560). Older age was a significant risk factor, while female gender, no religion, and non-peasant occupations were significant protective factors for suicide attempts with physical illness. Limitations: Samples from only one province may not completely represent all serious suicide attempters in China. Furthermore, we did not assess the severity and the degree to which their physical illness limited the functioning of the individual. Conclusion: Physical illness is an important risk factor for suicide attempts in rural China. More efforts are needed to specifically target older people, males, those with religious beliefs, and peasant workers with physical illness.

References

  • Beautrais, A. L. (2004). Further suicidal behavior among medically serious suicide attempters. Suicide and Life-Threatening Behavior, 34(1), 1–11. 10.1521/suli.34.1.1.277772 First citation in articleCrossref Medline, Google Scholar

  • Bergman Levy, T., Barak, Y., Sigler, M., & Aizenberg, D. (2011). Suicide attempts and burden of physical illness among depressed elderly inpatients. Archives of Gerontology and Geriatrics, 52(1), 115–117. 10.1016/j.archger.2010.02.012 First citation in articleCrossref Medline, Google Scholar

  • De Leo, D., Scocco, P., Marietta, P., Schmidtke, A., Bille-Brahe, U., Kerkhof, A. J., … Bjerke, T. (1999). Physical illness and parasuicide: Evidence from the European Parasuicide Study Interview Schedule (EPSIS/WHO-EURO). International Journal of Psychiatry in Medicine, 29(2), 149–163. 10.2190/E87K-FG03-CHEE-UJD3 First citation in articleCrossref Medline, Google Scholar

  • Druss, B., & Pincus, H. (2000). Suicidal ideation and suicide attempts in general medical illnesses. Archives of Internal Medicine, 160(10), 1522–1526. 10.1001/archinte.160.10.1522 First citation in articleCrossref Medline, Google Scholar

  • Duberstein, P. R., Conwell, Y., Conner, K. R., Eberly, S., & Caine, E. D. (2004). Suicide at 50 years of age and older: Perceived physical illness, family discord and financial strain. Psychological Medicine, 34(1), 137–146. 10.1017/S0033291703008584 First citation in articleCrossref Medline, Google Scholar

  • Goodwin, R. D., Marusic, A., & Hoven, C. W. (2003). Suicide attempts in the United States: The role of physical illness. Social Science & Medicine (1982), 56(8), 1783–1788. 10.1016/S0277-9536(02)00174-0 First citation in articleCrossref Medline, Google Scholar

  • Gu, J., & Chen, Y. (1993). Instruction manual for the structured clinical interview for DSM-III-R (Chinese edition). Kaohsiung, Taiwan: Kaohsiung Medical College. First citation in articleGoogle Scholar

  • Hultcrantz, M., Svensson, T., Derolf, Å. R., Kristinsson, S. Y., Lindqvist, E. K., Ekbom, A., … Björkholm, M. (2015). Incidence and risk factors for suicide and attempted suicide following a diagnosis of hematological malignancy. Cancer Medicine, 4(1), 147–154. 10.1002/cam4.316 First citation in articleCrossref Medline, Google Scholar

  • Jia, C.-X., Wang, L.-L., Xu, A.-Q., Dai, A.-Y., & Qin, P. (2014). Physical illness and suicide risk in rural residents of contemporary China: A psychological autopsy case-control study. Crisis, 35(5), 330–337. 10.1027/0227-5910/a000271 First citation in articleLink, Google Scholar

  • Jiang, H., Niu, L., Hahne, J., Hu, M., Fang, J., Shen, M., & Xiao, S. (2018). Changing of suicide rates in China, 2002-2015. Journal of Affective Disorders, 240, 165–170. 10.1016/j.jad.2018.07.043 First citation in articleCrossref Medline, Google Scholar

  • Judd, F., Jackson, H., Fraser, C., Murray, G., Robins, G., & Komiti, A. (2006). Understanding suicide in Australian farmers. Social Psychiatry and Psychiatric Epidemiology, 41(1), 1–10. 10.1007/s00127-005-0007-1 First citation in articleCrossref Medline, Google Scholar

  • Kavalidou, K., Smith, D. J., & O'Connor, R. C. (2017). The role of physical and mental health multimorbidity in suicidal ideation. Journal of Affective Disorders, 209, 80–85. 10.1016/j.jad.2016.11.026 First citation in articleCrossref Medline, Google Scholar

  • Kontaxakis, V. P., Christodoulou, G. N., Mavreas, V. G., & Havaki-Kontaxaki, B. J. (1988). Attempted suicide in psychiatric outpatients with concurrent physical illness. Psychotherapy and Psychosomatics, 50(4), 201–206. 10.1159/000288121 First citation in articleCrossref Medline, Google Scholar

  • Lawrence, R. E., Brent, D., Mann, J. J., Burke, A. K., Grunebaum, M. F., Galfalvy, H. C., & Oquendo, M. A. (2016). Religion as a risk factor for suicide attempt and suicide ideation among depressed patients. The Journal of Nervous and Mental Disease, 204(11), 845–850. 10.1097/NMD.0000000000000484 First citation in articleCrossref Medline, Google Scholar

  • Liu, Y.-Y., Wang, X.-T., Qiu, H.-M., Xu, A.-Q., & Jia, C.-X. (2017). Functional and dysfunctional impulsivity and attempted suicide in rural China: A paired case-control study. Psychiatry Research, 253, 22–27. 10.1016/j.psychres.2017.03.025 First citation in articleCrossref Medline, Google Scholar

  • Lu, D., Fall, K., Sparén, P., Ye, W., Adami, H. O., Valdimarsdóttir, U., & Fang, F. (2013). Suicide and suicide attempt after a cancer diagnosis among young individuals. Annals of Oncology, 24(12), 3112–3117. 10.1093/annonc/mdt415 First citation in articleCrossref Medline, Google Scholar

  • Mento, C., Presti, E. L., Mucciardi, M., Sinardi, A., Liotta, M., & Settineri, S. (2016). Serious suicide attempts: Evidence on variables for manage and prevent this phenomenon. Community Mental Health Journal, 52(5), 582–588. 10.1007/s10597-015-9933-x First citation in articleCrossref Medline, Google Scholar

  • Merrill, J., & Owens, J. (1990). Age and attempted suicide. Acta Psychiatrica Scandinavica, 82(5), 385–388. 10.1111/j.1600-0447.1990.tb01407.x First citation in articleCrossref Medline, Google Scholar

  • Qin, P., Hawton, K., Mortensen, P. B., & Webb, R. (2014). Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study. British Journal of Psychiatry the Journal of Mental Science, 204(6), 430–435. 10.1192/bjp.bp.113.128785 First citation in articleCrossref Medline, Google Scholar

  • Qin, P., Webb, R., Kapur, N., & Sørensen, H. T. (2013). Hospitalization for physical illness and risk of subsequent suicide: A population study. Journal of Internal Medicine, 273(1), 48–58. 10.1111/j.1365-2796.2012.02572.x First citation in articleCrossref Medline, Google Scholar

  • Rasic, D. T., Belik, S.-L., Bolton, J. M., Chochinov, H. M., & Sareen, J. (2008). Cancer, mental disorders, suicidal ideation and attempts in a large community sample. Psycho-oncology, 17(7), 660–667. 10.1002/pon.1292 First citation in articleCrossref Medline, Google Scholar

  • Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., Asmundson, G. J. G., Goodwin, R. D., Kubzansky, L., … Stein, M. B. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30(3), 208–225. 10.1016/j.genhosp​psych.2007.12.006 First citation in articleCrossref Medline, Google Scholar

  • Sareen, J., Cox, B. J., Stein, M. B., Afifi, T. O., Fleet, C., & Asmundson, G. J. G. (2007). Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. Psychosomatic Medicine, 69(3), 242–248. 10.1097/PSY.0b013e31803146d8 First citation in articleCrossref Medline, Google Scholar

  • Scott, K. M., Bruffaerts, R., Tsang, A., Ormel, J., Alonso, J., Angermeyer, M. C., … Von Korff, M. (2007). Depression-anxiety relationships with chronic physical conditions: Results from the World Mental Health Surveys. Journal of Affective Disorders, 103(1–3), 113–120. 10.1016/j.jad.2007.01.015 First citation in articleCrossref Medline, Google Scholar

  • Scott, K. M., Hwang, I., Chiu, W. T., Kessler, R. C., Sampson, N. A., Angermeyer, M., … De, G. R. (2010). Chronic physical conditions and their association with first onset of suicidal behavior in the world mental health surveys. Psychosomatic Medicine, 72(7), 712–719. 10.1097/PSY.0b013e3181e3333d First citation in articleCrossref Medline, Google Scholar

  • Webb, R. T., Kontopantelis, E., Doran, T., Qin, P., Creed, F., & Kapur, N. (2012). Suicide risk in primary care patients with major physical diseases: A case-control study. Archives of General Psychiatry, 69(3), 256–264. 10.1001/archgenpsychia​try.2011.1561 First citation in articleCrossref Medline, Google Scholar

  • World Health Organization. (2014). Preventing suicide: A global imperative. Geneva, Switzerland: Author. First citation in articleGoogle Scholar

  • Wiktorsson, S., Berg, A. I., Wilhelmson, K., Mellqvist, M. F., Van, K. O., Duberstein, P., & Waern, M. (2016). Assessing the role of physical illness in young old and older old suicide attempters. International Journal of Geriatric Psychiatry, 31(7), 771–774. 10.1002/gps.4390 First citation in articleCrossref Medline, Google Scholar