Page Andrew, Liu Shiwei, Gunnell David, Astell-Burt Thomas, Feng Xiaoqi, Wang Lijun, Zhou Maigeng
Centre for Health Research, Western Sydney University, Penrith, NSW, Australia.
National Center for Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
J Affect Disord. 2017 Jan 15;208:418-423. doi: 10.1016/j.jad.2016.10.047. Epub 2016 Nov 2.
Despite recent declines, suicide remains a priority for China. Ease of availability of high-lethality suicide methods, such as pesticides and firearms, contributes to the overall incidence and is an important target for suicide prevention. This study investigates whether changes in the distribution of methods of suicide have contributed to the recent reduction in suicide in China.
Suicide rates (2006-2013) were calculated using the Chinese Disease Surveillance Points system, stratified by gender, age group, and urban-rural residence, to investigate trends in suicide over the study period. Multilevel negative binomial regression models were used to investigate associations between socio-demographic factors and method-specific suicide.
The most common method of suicide in China for both males and females was pesticide poisoning, followed by hanging. All methods declined over the study period, with the exception of suicide by jumping in males. Suicide rates for pesticide poisoning and for hanging increased exponentially with age in those aged over ≥45 years in both sexes. Pesticide poisoning declined from 55% to 49% of all suicides, while hanging increased from 27% to 31%.
This was an ecological study of a time series of suicide rates, with risk factor adjustment being limited to population-level point estimates derived from a single census.
Suicide by pesticide poisoning and hanging remain the leading methods of suicide in China. Changes to the safe use of pesticides and targeted prevention initiatives to restrict access, along with socio-economic development and urbanisation, are likely contributors to declines in suicide by pesticide poisoning.
尽管近期自杀率有所下降，但自杀仍是中国的一个优先关注问题。高致死性自杀方法（如农药和枪支）的容易获取导致了总体自杀发生率上升，是自杀预防的一个重要目标。本研究调查自杀方法分布的变化是否促成了中国近期自杀率的下降。
使用中国疾病监测点系统计算2006 - 2013年的自杀率，按性别、年龄组和城乡居住地分层，以调查研究期间的自杀趋势。采用多水平负二项回归模型研究社会人口学因素与特定方法自杀之间的关联。
在中国，男性和女性最常见的自杀方法都是农药中毒，其次是上吊。在研究期间，所有自杀方法的发生率均有所下降，但男性跳楼自杀除外。在45岁及以上人群中，无论男女，农药中毒和上吊的自杀率均随年龄呈指数增长。农药中毒自杀占所有自杀的比例从55%降至49%，而上吊自杀的比例从27%升至31%。
这是一项对自杀率时间序列的生态学研究，危险因素调整仅限于从一次人口普查得出的人群水平点估计值。
农药中毒和上吊自杀仍是中国主要的自杀方式。农药安全使用的改变以及限制获取的针对性预防举措，连同社会经济发展和城市化，可能是农药中毒自杀率下降的原因。
