Phillips Michael R, Li Xianyun, Zhang Yanping
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing 100096, People's Republic of China.
Lancet. 2002 Mar 9;359(9309):835-40. doi: 10.1016/S0140-6736(02)07954-0.
A wide range of suicide rates are reported for China because official mortality data are based on an unrepresentative sample and because different reports adjust crude rates in different ways. We aimed to present an accurate picture of the current pattern of suicide in China on the basis of conservative estimates of suicide rates in different population cohorts.
Suicide rates by sex, 5-year age-group, and region (urban or rural) reported in mortality data for 1995-99 provided by the Chinese Ministry of Health were adjusted according to an estimated rate of unreported deaths and projected to the corresponding population.
We estimated a mean annual suicide rate of 23 per 100,000 and a total of 287,000 suicide deaths per year. Suicide accounted for 3(.)6% of all deaths in China and was the fifth most important cause of death. Among young adults 15-34 years of age, suicide was the leading cause of death, accounting for 19% of all deaths. The rate in women was 25% higher than in men, mainly because of the large number of suicides in young rural women. Rural rates were three times higher than urban rates-a difference that remained true for both sexes, for all age-groups, and over time.
Suicide is a major public-health problem for China that is only gradually being recognised. The unique pattern of suicides in China is widely acknowledged, so controversy about the overall suicide rate should not delay the development and testing of China-specific suicide-prevention programmes.
由于官方死亡率数据基于非代表性样本，且不同报告以不同方式调整粗死亡率，因此中国报告的自杀率范围很广。我们旨在根据不同人群队列自杀率的保守估计，呈现中国当前自杀模式的准确情况。
根据未报告死亡的估计率，对中国卫生部提供的1995 - 1999年死亡率数据中按性别、5岁年龄组和地区（城市或农村）报告的自杀率进行调整，并推算至相应人口。
我们估计年自杀率平均为每10万人23例，每年自杀死亡总数为28.7万例。自杀占中国所有死亡人数的3.6%，是第五大重要死因。在15 - 34岁的年轻人中，自杀是主要死因，占所有死亡人数的19%。女性自杀率比男性高25%，主要原因是农村年轻女性自杀人数众多。农村自杀率是城市的三倍——这种差异在所有年龄组、男女两性以及不同时间段都存在。
自杀是中国一个主要的公共卫生问题，只是逐渐得到认可。中国独特的自杀模式已得到广泛认可，因此关于总体自杀率的争议不应拖延针对中国的自杀预防项目的制定和测试。
