Dudley M, Waters B, Kelk N, Howard J
Avoca Clinic, Department of Child and Adolescent Psychiatry, Prince of Wales Children's Hospital, Randwick, NSW.
Med J Aust. 1992 Jan 20;156(2):83-8. doi: 10.5694/j.1326-5377.1992.tb126417.x.
The study tested the hypotheses that (i) the rate of suicide by firearms among youth (aged 10-19 years) is increasing at a greater rate than rates of suicide by other methods; (ii) the rate of youth suicide in rural New South Wales is significantly higher than those in urban areas; and (iii) the increase in youth suicide by means of firearms is occurring at a greater rate in rural males aged 15-19 years than in other groups.
Data were obtained from the NSW Office of the Australian Bureau of Statistics concerning 735 youth suicides in NSW between 1964 and 1988. These were reviewed for information concerning residential area and method of death. Five five-year periods were used, and rates were calculated with population figures obtained in the census years for the same age and sex group.
From 1964 to 1988, suicide by firearms has risen most substantially, from 3.4 to 5.6 per 100,000 per year in 15-19-year-old males. There has also been a substantial increase in 15-19-year-old male suicides by hanging (0.7 to 3.4 per 100,000 per year). Poisoning suicides have declined among females and males in the past 15 years. Suicide rates in Sydney, Newcastle and Wollongong have remained stable. In rural cities, they have increased from 1.5 to 4.7 per 100,000 per year (F = 4.9, P less than 0.02) while in rural municipalities and shires they have increased from 1.3 to 6.4 (F = 14.6, P less than 0.0001). The suicide rate of 15-19-year-old males has shown a modest increase in Sydney and no change in Newcastle or Wollongong, but the rate for 15-19-year-old males in rural cities has more than doubled, from 5.1 to 12.5 (F = 7.7, P less than 0.003), while in rural municipalities and shires, the rate has increased more than fivefold, from 3.9 to 20.7 (F = 9.3, P less than 0.001). There has been no significant change in the suicide rates of 15-19-year-old females, or in 10-14-year-olds. The rate of suicide by firearms among 15-19-year-old males has not risen significantly in rural cities, but in rural municipalities and shires the rates have risen fivefold from 2.8 to 14.8 (F = 5.6, P less than 0.01).
Each hypothesis was confirmed. An increase of this magnitude is not an artefact of coroners' verdicts. The findings are believed to be due to ready access to firearms, the use of alcohol and drugs (particularly in firearms suicides) and increasing socioeconomic, health, and identity problems for rural youth, especially males.
本研究检验了以下假设：（i）青少年（10 - 19岁）中枪支自杀率的增长速度高于其他自杀方式的增长速度；（ii）新南威尔士州农村地区的青少年自杀率显著高于城市地区；（iii）15 - 19岁农村男性中枪支自杀率的增长速度高于其他群体。
数据来自澳大利亚统计局新南威尔士州办公室，涉及1964年至1988年新南威尔士州的735例青少年自杀案例。对这些案例进行审查，以获取有关居住地区和死亡方式的信息。采用了五个五年期，并根据人口普查年份中同一年龄和性别的人口数据计算比率。
1964年至1988年期间，枪支自杀率上升最为显著，15 - 19岁男性中从每年每10万人3.4例升至5.6例。15 - 19岁男性上吊自杀率也有大幅上升（从每年每10万人0.7例升至3.4例）。在过去15年中，男性和女性的中毒自杀率均有所下降。悉尼、纽卡斯尔和卧龙岗的自杀率保持稳定。在农村城市，自杀率从每年每10万人1.5例升至4.7例（F = 4.9，P < 0.02），而在农村自治市和郡，自杀率从1.3例升至6.4例（F = 14.6，P < 0.0001）。15 - 19岁男性在悉尼的自杀率略有上升，在纽卡斯尔或卧龙岗没有变化，但农村城市中15 - 19岁男性的自杀率增加了一倍多，从5.1例升至12.5例（F = 7.7，P < 0.003），而在农村自治市和郡，该比率增加了五倍多，从3.9例升至20.7例（F = 9.3，P < 0.001）。15 - 19岁女性以及10 - 14岁青少年的自杀率没有显著变化。15 - 19岁男性在农村城市中枪支自杀率没有显著上升，但在农村自治市和郡，该比率从2.8例升至14.8例，上升了五倍（F = 5.6，P < 0.01）。
每个假设均得到证实。如此幅度的增长并非死因裁判官裁决的人为因素。这些发现被认为是由于农村青少年，尤其是男性，容易获得枪支、使用酒精和毒品（特别是在枪支自杀中）以及社会经济、健康和身份问题日益增加所致。
