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Prevalence of suicidal behaviour and associated factors in a large sample of Chinese adolescents

  • X. C. Liu (a1) (a2) (a3), H. Chen (a1), Z. Z. Liu (a1), J. Y. Wang (a4) and C. X. Jia (a1)...

Abstract

Aims.

Suicidal behaviour is prevalent among adolescents and is a significant predictor of future suicide attempts (SAs) and suicide death. Data on the prevalence and epidemiological characteristics of suicidal behaviour in Chinese adolescents are limited. This study was aimed to examine the prevalence, characteristics and risk factors of suicidal behaviour, including suicidal thought (ST), suicide plan (SP) and SA, in a large sample of Chinese adolescents.

Method.

This report represents the first wave data of an ongoing longitudinal study, Shandong Adolescent Behavior and Health Cohort. Participants included 11 831 adolescent students from three counties of Shandong, China. The mean age of participants was 15.0 (s.d. = 1.5) and 51% were boys. In November–December 2015, participants completed a structured adolescent health questionnaire, including ST, SP and SA, characteristics of most recent SA, demographics, substance use, hopelessness, impulsivity and internalising and externalising behavioural problems.

Results.

The lifetime and last-year prevalence rates were 17.6 and 10.7% for ST in males, 23.5 and 14.7% for ST in females, 8.9 and 2.9% for SP in males, 10.7 and 3.8% for SP in females, 3.4 and 1.3% for SA in males, and 4.6 and 1.8% for SA in females, respectively. The mean age of first SA was 12–13 years. Stabbing/cutting was the most common method to attempt suicide. Approximately 24% of male attempters and 16% of female attempters were medically treated. More than 70% of attempters had no preparatory action. Female gender, smoking, drinking, internalising and externalising problems, hopelessness, suicidal history of friends and acquaintances, poor family economic status and poor parental relationship were all significantly associated with increased risk of suicidal behaviour.

Conclusions.

Suicidal behaviour in Chinese adolescents is prevalent but less than that previously reported in Western peers. While females are more likely to attempt suicide, males are more likely to use lethal methods. Multiple child and family factors are associated with suicidal behaviour. These findings highlight the importance of early screening and intervention of suicidal behaviour in Chinese adolescents.

Copyright

Corresponding author

*Address for correspondence: Dr Xianchen Liu and Dr Cun-Xian Jia, School of Public Health, Shandong University, No.44, Wenhuaxi Rd, Lixia Dist. Jinan 250012, China. (Email: xliu69@uthsc.edu or jiacunxian@sdu.edu.cn)

References

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Achenbach, TM (1991). Manual for the Youth Self-Report and 1991 Profile. Department of Psychiatry, University of Vermont: Burlington, VT.
Beck, AT, Weissman, A, Lester, D, Trexler, L (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting and Clinical Psychology 42, 861865.
Chen, H, Wang, XT, Bo, QG, Zhang, DM, Qi, ZB, Liu, XC, Jia, CX (2017). Menarche, menstrual problems and suicidal behavior in Chinese adolescents. Journal of Affective Disorders 209, 5358.
Eysenck, SBG, Easting, G, Pearson, PR (1984). Age norms for impulsiveness, venturesomeness and empathy in children. Personality and Individual Differences 5, 315321.
Gould, MS, Greenberg, T, Velting, DM, Shaffer, D (2003). Youth suicide risk and preventive interventions: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry 42, 386405.
Hawton, K, Hall, S, Simkin, S, Bale, L, Bond, A, Codd, S, Stewart, A (2003). Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. Journal of Child Psychology and Psychiatry 44, 11911198.
Hawton, K, Saunders, KE, O'Connor, RC (2012). Self-harm and suicide in adolescents. Lancet 379, 23732382.
Hu, J, Dong, Y, Chen, X, Liu, Y, Ma, D, Liu, X, Zheng, R, Mao, X, Chen, T, He, W (2015). Prevalence of suicide attempts among Chinese adolescents: a meta-analysis of cross-sectional studies. Comprehensive Psychiatry 61, 7889.
Kann, L, McManus, T, Harris, WA, Shanklin, SL, Flint, KH, Hawkins, J, Queen, B, Lowry, R, Olsen, EO, Chyen, D, Whittle, L, Thornton, J, Lim, C, Yamakawa, Y, Brener, N, Zaza, S (2016). Youth risk behavior surveillance – United States, 2015. MMWR Surveillance Summaries 65, 1174.
Kokkevi, A, Rotsika, V, Arapaki, A, Richardson, C (2012). Adolescents’ self-reported suicide attempts, self-harm thoughts and their correlates across 17 European countries. Journal of Child Psychology and Psychiatry 53, 381389.
Lin, L, Zhang, J, Zhou, L, Jiang, C (2016). The relationship between impulsivity and suicide among rural youths aged 15–35 years: a case-control psychological autopsy study. Psychology Health and Medicine 21, 330337.
Liu, XC, Tein, JY (2005). Life events, psychopathology, and suicidal behavior in Chinese adolescents. Journal of Affective Disorders 86, 195203.
Liu, XC, Guo, CQ, Liu, LQ, Sun, LM (1997). Reliability and validity of the youth self-report (YSR) of Achenbach's child behavior checklist (CBCL). Chinese Mental Health Journal 11, 200203.
Liu, XC, Kurita, H, Guo, CQ, Miyake, Y, Ze, J, Cao, H (1999). Prevalence and risk factors of behavioral and emotional problems among Chinese children aged 6 through 11 years. Journal of the American Academy of Child and Adolescent Psychiatry 38, 708715.
Liu, XC, Kurita, H, Uchiyama, M, Okawa, M, Liu, LQ, Ma, DD (2000). Life events, locus of control and behavioral problems among Chinese adolescents. Journal of Clinical Psychology 56, 15651577.
Liu, XC, Yang, YY, Liu, ZZ, Chen, H, Fan, F, Jia, CX (2017). Psychometric assessment of the Chinese adolescent daytime sleepiness scale (CADSS). Sleep and Biological Rhythms 15, 207216.
Madge, N, Hewitt, A, Hawton, K, de Wilde, EJ, Corcoran, P, Fekete, S, van Heeringen, K, De Leo, D, Ystgaard, M (2008). Deliberate self-harm within an international community sample of young people: comparative findings from the child & adolescent self-harm in Europe (CASE) study. Journal of Child Psychology and Psychiatry 49, 667677.
McKinnon, B, Gariepy, G, Sentenac, M, Elgar, FJ (2016). Adolescent suicidal behaviours in 32 low- and middle-income countries. Bulletin of the World Health Organization 94, 340350.
McLoughlin, AB, Gould, MS, Malone, KM (2015). Global trends in teenage suicide: 2003–2014. QJM 108, 765780.
Olfson, M, Gameroff, MJ, Marcus, SC, Greenberg, T, Shaffer, D (2005). Emergency treatment of young people following deliberate self-harm. Archives of General Psychiatry 62, 11221128.
Ougrin, D, Tranah, T, Stahl, D, Moran, P, Asarnow, JR (2015). Therapeutic interventions for suicide attempts and self-harm in adolescents: systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry 54, 97107.
Phillips, MR, Li, X, Zhang, Y (2002 a). Suicide rates in China, 1995–99. Lancet 359, 835840.
Phillips, MR, Yang, G, Zhang, Y, Wang, L, Ji, H, Zhou, M (2002 b). Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet 360, 17281736.
Price, JH, Khubchandani, J (2017). Latina adolescents health risk behaviors and suicidal ideation and suicide attempts: results from the national youth risk behavior survey 2001–2013. Journal of Immigrant and Minority Health 19, 533542.
Safer, DJ (1996). A comparison of studies from the United States and Western Europe on psychiatric hospitalization referrals for youths exhibiting suicidal behavior. Annals Clinical Psychiatry 8, 161168.
Silverman, MM, Berman, AL, Sanddal, ND, O'Carroll, PW, Joiner, TE (2007). Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 2: suicide-related ideations, communications, and behaviors. Suicide and Life-Threatening Behavior 37, 264277.
Tepper, P, Liu, XC, Guo, C, Zhai, J, Liu, T, Li, C (2008). Depressive symptoms in Chinese children and adolescents: parent, teacher, and self reports. Journal of Affective Disorders 111, 291298.
Wang, CW, Chan, CL, Yip, PS (2014). Suicide rates in China from 2002 to 2011: an update. Social Psychiatry and Psychiatric Epidemiology 49, 929941.
Wang, SY, Li, YH, Chi, GB, Xiao, SY, Ozanne-Smith, J, Stevenson, M, Phillips, MR (2008). Injury-related fatalities in China: an under-recognised public-health problem. Lancet 372, 17651773.
Zhang, J, Sun, L, Liu, Y, Zhang, J (2014). The change in suicide rates between 2002 and 2011 in China. Suicide and Life-Threatening Behavior 44, 560568.
Zhao, S, Zhang, J (2015). Suicide risks among adolescents and young adults in rural China. International Journal of Environmental Research and Public Health 12, 131145.

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