Hou Hao, Yu Bin, He Chenlu, Li Guiyuan, Pei Yifei, Wang Jingjing, Tang Jie, Chen Xinguang, Gao Xiuyin, Wang Wei
School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China; School of Public Health, Wuhan University, Wuhan 430064, Hubei, China.
School of Public Health, Wuhan University, Wuhan 430064, Hubei, China.
J Affect Disord. 2023 May 15;329:235-242. doi: 10.1016/j.jad.2023.02.110. Epub 2023 Feb 26.
The overall suicide rate in China has dropped substantially since the 1990s, but a slowdown in the decrease and even a reversing trend was observed in specific groups in recent years. This study aims to investigate the latest suicide risk in mainland China by using the age-period-cohort (APC) analysis.
This population-based multiyear cross-sectional study included Chinese ages 10 to 84 years using data from the China Health Statistical Yearbook (2005-2020). Data were analyzed by the APC analysis and intrinsic estimator (IE) technique.
The data satisfactorily fit the constructed APC models. The cohort effect indicated a high risk of suicide among people birth in 1920-1944 and a sharp decline in the 1945-1979 cohort. The lowest risk occurred in the 1980-1994 cohort before a sharp increase in generation Z (birth years in 1995-2009). The period effect showed a declining trend since 2004. The age effect indicated that the suicide risk increased over time, except for a gradual decline from age 35 to 49. The suicide risk increased greatly in adolescents and reached the highest among the elderly.
The aggregated population-level data and the non-identifiability of the APC model could result in bias in the accuracy of results in this study.
This study successfully updated the Chinese suicide risk from the age, period and cohort perspective using the latest available data (2004-2019). The findings enhance the understanding of suicide epidemiology and provide evidence supporting policies and strategies at the macro-level for suicide prevention and management. Immediate action is needed to focus on a national suicide prevention strategy that targets generation Z, adolescents and the elderly which will require a collaborative effort by government officials, public/community health planners and health care agencies.
自20世纪90年代以来，中国的总体自杀率大幅下降，但近年来在特定群体中出现了下降放缓甚至逆转的趋势。本研究旨在通过年龄-时期-队列（APC）分析来调查中国大陆的最新自杀风险。
这项基于人群的多年横断面研究纳入了年龄在10至84岁的中国人，使用了《中国卫生统计年鉴》（2005 - 2020年）的数据。数据通过APC分析和内在估计器（IE）技术进行分析。
数据令人满意地拟合了构建的APC模型。队列效应表明，1920 - 1944年出生的人群自杀风险较高，而1945 - 1979年队列中的自杀风险急剧下降。1980 - 1994年队列的自杀风险最低，随后Z世代（出生年份为1995 - 2009年）的自杀风险急剧上升。时期效应显示自2004年以来呈下降趋势。年龄效应表明，自杀风险随时间增加，但35至49岁年龄段除外，该年龄段自杀风险逐渐下降。青少年的自杀风险大幅增加，在老年人中达到最高。
汇总的人群水平数据以及APC模型的不可识别性可能导致本研究结果准确性的偏差。
本研究利用最新可得数据（2004 - 2019年）成功地从年龄、时期和队列角度更新了中国的自杀风险。这些发现增进了对自杀流行病学的理解，并为宏观层面的自杀预防和管理政策及策略提供了支持证据。需要立即采取行动，重点关注针对Z世代、青少年和老年人的国家自杀预防战略，这将需要政府官员、公共/社区卫生规划者和医疗保健机构的共同努力。
