Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Institute of Health Information, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
J Affect Disord. 2022 Jul 1;308:147-154. doi: 10.1016/j.jad.2022.04.056. Epub 2022 Apr 13.
To explore changing patterns in suicides and provide suggestions for suicide prevention by reviewing all suicide deaths from 2002 to 2020 in Shanghai, China.
Suicide-death data were obtained from the Shanghai Death Surveillance System and analyzed in terms of year, sex, age group, area, suicide method, and depression diagnosis. Joinpoint regression analyses were conducted to examine time trends in suicide rates.
The age-adjusted suicide rate was 6.15/100,000 in 2002 and 5.10/100,000 in 2020. The change in this rate was U-shaped, with a downward trend before 2009 followed by an upward trend. The rate initially decreased by 6.33% annually (95% confidence interval [95%CI]: 4.25-8.37%) but, after 2009, increased by 2.60% annually (95%CI: 1.49-3.71%). Similar trends were found for men and women, the 0-29y and 30-49y age groups, and residents of central and suburban areas, respectively. In 2020, jumping from a high place was the leading suicide method (39.54%), and 22.54% of suicide victims had a diagnosis of depression.
Suicides may be misclassified in coding (however, provided misclassification rates remain stable, this should not influence overall trends). Suicides among temporary residents were not included because of inadequate stratified population data. The finding of a higher prevalence of depression may have been impacted by a higher detection rate.
The post-2002 decline in Shanghai suicide rates reversed in 2009, and the suicide pattern changed greatly from 2002 to 2020. With the current increasing trend in suicide rates, targeted suicide-prevention strategies featuring multi-departmental cooperation are necessary.
通过回顾 2002 年至 2020 年中国上海所有自杀死亡病例，探讨自杀模式的变化，并为预防自杀提供建议。
从上海死亡监测系统获取自杀死亡数据，并按年份、性别、年龄组、地区、自杀方法和抑郁诊断进行分析。采用 Joinpoint 回归分析来检测自杀率的时间趋势。
2002 年和 2020 年调整年龄后的自杀率分别为 6.15/100000 和 5.10/100000。该率呈 U 型变化，2009 年前呈下降趋势，随后呈上升趋势。自杀率最初每年下降 6.33%（95%置信区间[95%CI]：4.25-8.37%），但 2009 年后每年上升 2.60%（95%CI：1.49-3.71%）。这种趋势在男性和女性、0-29 岁和 30-49 岁年龄组以及中心和郊区居民中均有发现。2020 年，跳楼是主要的自杀方法（39.54%），22.54%的自杀者被诊断为抑郁症。
自杀可能在编码时被错误分类（但是，如果错误分类率保持稳定，则不应影响总体趋势）。由于分层人口数据不足，暂未将流动人口中的自杀纳入研究范围。抑郁症检出率较高可能会影响到抑郁症的高患病率。
2002 年后上海自杀率的下降趋势在 2009 年发生逆转，2002 年至 2020 年期间自杀模式发生了很大变化。鉴于当前自杀率呈上升趋势，有必要采取多部门合作的有针对性的自杀预防策略。
