1 Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
2 Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
J Geriatr Psychiatry Neurol. 2019 Nov;32(6):319-326. doi: 10.1177/0891988719862625.
The most frequently used means of committing suicide was pesticide poisoning in rural China, yet little is known about the characteristics and risk factors for suicides committed with pesticides compared to those committed via other means in older adults.
The participants were 242 older adults (aged 60 or older) who had committed suicide in the rural areas of 3 provinces (Shandong, Hunan, and Guangxi) in China. This study was conducted using the psychological autopsy (PA) method.
In univariate analyses, no statistically significant differences were found between those who committed suicide with pesticide or with other means in terms of demographic and clinical variables except age, prevalence of mental disorders, suicidal intent, number of recent life events, social support, hopelessness, impulsivity, and depressive symptoms ( > .05); age, history of suicide attempts, having pesticides available at home, the total number of life events, and the number of long-term life events were significantly different ( < .05) between the 2 groups. In multivariate logistic regression model, the factors associated with committing suicide with pesticides were the availability of pesticides at home (odds ratio [OR] = 3.48, 95% confidence interval [CI]: 1.99-6.08) and the number of long-term life events (OR = 0.87, 95% CI: 0.78-0.97).
The older adults who committed suicide by pesticides and those using other means are probably the same population. The main determinant of choosing pesticides as suicide means was likely the availability of pesticides at home. Suicide risk among older adults might be reduced by placing appropriate restrictions on access to pesticides.
在中国农村,最常见的自杀方式是农药中毒,但对于老年人来说,与其他自杀方式相比,使用农药自杀的特点和风险因素知之甚少。
参与者是 242 名来自中国 3 个省份(山东、湖南和广西)农村地区的老年自杀者(年龄在 60 岁及以上)。本研究采用心理解剖(PA)方法进行。
在单因素分析中,除年龄、精神障碍患病率、自杀意图、近期生活事件数量、社会支持、绝望感、冲动性和抑郁症状外(>.05),使用农药或其他方式自杀的患者在人口统计学和临床变量方面无统计学差异;两组之间年龄、自杀未遂史、家中有农药、生活事件总数和长期生活事件数量存在显著差异(<.05)。在多因素逻辑回归模型中,与使用农药自杀相关的因素是家中有农药(优势比[OR]=3.48,95%置信区间[CI]:1.99-6.08)和长期生活事件数量(OR=0.87,95%CI:0.78-0.97)。
使用农药和其他方式自杀的老年人可能属于同一人群。选择农药作为自杀手段的主要决定因素可能是家中农药的可获得性。通过适当限制农药的获取,可能会降低老年人的自杀风险。