Mo Qiqing, Ma Zhenyu, Wang Guojun, Jia Cunxian, Niu Lu, Zhou Liang
School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
Shenzhen Graduate School, Peking University, Shenzhen, Guangdong, China.
BMC Geriatr. 2020 Nov 16;20(1):473. doi: 10.1186/s12877-020-01874-4.
There is a lack of evidence concerning the stressful life events experienced prior to suicide which may be associated with an increased suicide risk among Chinese rural older adults. The aim of this study was to identify the pattern of stressful life events prior to suicide among the older adults in China.
Twelve counties were randomly selected using two-stage stratified cluster sampling method. Suicide cases aged 60 years and older (n = 242) were collected from those counties from June 2014 to September 2015. Matched living controls were selected 1:1 with suicide cases by age, gender, and location. Data were collected using face-to-face interviews by a psychological autopsy method. The Life Event Scale for the Elderly was used to measure the stressful life events prior to suicide/interviews.
Approximately 99.6% of suicide cases and 88.4% of controls experienced at least one stressful life event. The suicide group experienced more long-term stressful life events than recent stressful life events. The top three most frequent stressful life events for the suicide group were being diagnosed with chronic disease, hospitalization, and being diagnosed with terminal illness. More female suicide cases experienced the death of a spouse, while more males experienced hospitalization, diagnosis with terminal illness and family poverty. Experiencing at least one stressful life event, an unstable marital status, physical diseases and mental disorders were shown to increase the risk of suicide.
Stressful life events were common for the rural older adults, especially long-term stressful life events. The experience of at least one stressful life event can increase suicide risk among this population. More attention should be paid to the rural older adults who experienced more long-term stressful life events and health related life events.
缺乏关于中国农村老年人自杀前经历的应激性生活事件的证据，这些事件可能与自杀风险增加有关。本研究的目的是确定中国老年人自杀前应激性生活事件的模式。
采用两阶段分层整群抽样方法随机选取12个县。收集2014年6月至2015年9月这些县60岁及以上的自杀案例（n = 242）。按照年龄、性别和地点以1:1的比例为自杀案例选取匹配的在世对照。通过心理解剖法进行面对面访谈收集数据。使用老年人生活事件量表来测量自杀/访谈前的应激性生活事件。
约99.6%的自杀案例和88.4%的对照至少经历过一次应激性生活事件。自杀组经历的长期应激性生活事件多于近期应激性生活事件。自杀组最常见的三大应激性生活事件是被诊断患有慢性病、住院和被诊断患有绝症。更多女性自杀案例经历了配偶死亡，而更多男性经历了住院、被诊断患有绝症和家庭贫困。经历至少一次应激性生活事件、婚姻状况不稳定、身体疾病和精神障碍会增加自杀风险。
应激性生活事件在农村老年人中很常见，尤其是长期应激性生活事件。经历至少一次应激性生活事件会增加该人群的自杀风险。应更加关注经历更多长期应激性生活事件和与健康相关生活事件的农村老年人。
