National Case-control Study of Suicide and Accidental Death

Objective:Describe the current status and characteristics of suicide in the country.Methods:A survey instrument that uses the psychological autopsy method and took and average of 3 hours to complete was independently administered to family members and associates 895 suicides and 701 accidental deaths from 20 rural and 3 urban Disease Surveillance Points from around the country. Results:The suicides had the following characteristics: 67% died by ingesting poisons (in most cases the poison was stored in the home); 63% had a mental illness at the time of death (most commonly depression); 27% had made a prior suicide attempt; 91% had never seen a mental health professional; in the prior year 40% had serious financial difficulties, 38% had had a serious illness, and 35% had had marital conflicts; 25% experienced an acute interpersonal conflict in the two days prior to death; and 10% committed suicide in the presence of someone else. Compared to persons who died by accidental death, persons who die by suicide are more likely to be female, to be older, have a lower educational level, to have a lower family income and to have experienced more acute and chronic negative life events. Conclusions:Suicidal behavior in China is outcome of the interaction of a number of factors. The proportion of suicides with mental illness is lower than in other countries; a substantial subgroup of suicides are impulsive.