Lung F-W, Liao S-C, Wu C-Y, Lee M-B
Calo Psychiatric Center, Pingtung County, Taiwan; Taiwanese Society of Suicidology (TSOS), Taipei, Taiwan; Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan.
Taiwanese Society of Suicidology (TSOS), Taipei, Taiwan; Division of Psychosomatic Medicine, Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; National Suicide Prevention Center, Taiwanese Society of Suicidology in contract with Ministry of Health and Welfare, Executive Yuan, Taiwan.
Public Health. 2017 Jun;147:136-143. doi: 10.1016/j.puhe.2017.01.030. Epub 2017 Mar 30.
The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas.
Observational study.
A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas.
The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas.
Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan.
预防自杀项目的有效性是当今全球的一个重要问题。城市化和性别对自杀率的影响存在争议。因此，本研究针对性别和农村/城市地区的自杀率调整了潜在风险因素和长期变化。
观察性研究。
台湾行政院于2005年设立了自杀预防中心，并试图在每个城镇的社区开展自杀干预。该项目分为两个阶段，包括2005年至2008年的第一阶段和2009年至2013年的第二阶段。从台湾国家死亡率数据文件中提取了1991 - 2013年期间的数据，该数据涵盖了台湾的9个城市和14个农村地区的粗自杀率。进一步利用台湾两个地区（台北市和宜兰县）的自杀率来比较城乡差异。
结果显示，失业增加了台湾45 - 64岁男性和65岁以上女性的自杀率。高离婚率和失业率导致城市男性自杀率上升，而情绪困扰是农村男性自杀的主要原因。城市中男女自杀的主要方式都是跳楼，而农村男性最常见的自杀方式是溺水。
在干预项目实施后，台湾所有城乡地区的自杀行为开始减少。本研究显示了干预项目在降低台湾自杀率方面的累积效应。此外，在台湾进一步的预防策略中应考虑特定性别的自杀率以及城乡自杀方式的差异。
