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A cross-ethnic comparison on incidence of suicide

Published online by Cambridge University Press:  22 September 2010

I. C. Liu ,
S. F. Liao ,
W. C. Lee ,
C. Y. Kao ,
R. Jenkins  and
A. T. A. Cheng
I. C. Liu
Affiliation:
Department of Psychiatry, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, Taipei County, Taiwan
S. F. Liao
Affiliation:
Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
W. C. Lee
Affiliation:
Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
C. Y. Kao
Affiliation:
Division of Indigenous Health, Department of Public Health, Tzu Chi University, Hualien County, Taiwan
R. Jenkins
Affiliation:
Institute of Psychiatry, King's College, University of London, London, UK
A. T. A. Cheng*
Affiliation:
Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
*
*Address for correspondence: Professor A. T. A. Cheng, Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan. (Email: bmandrew@gate.sinica.edu.tw)
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Abstract

Background

Suicide rates vary widely across nations and ethnic groups. This study aims to explore potential factors contributing to inter-ethnic differences in suicide rates.

Method

Study subjects came from a case-control psychological autopsy study conducted in Taiwan, including 116 consecutive suicides from two aboriginal groups and Taiwanese Han; 113 of them each matched with two living controls. Gender-, age- and method-specific suicide rates, population attributable fraction (PAF) of suicide for five major risk factors, help-seeking before suicide and emergency medical aid after suicide were compared between the three ethnic groups.

Results

One aboriginal group (the Atayal) had significantly higher adjusted rate ratios (RR) of suicide than the other aboriginal group (the Ami) [RR 0.20, 95% confidence intervals (CI) 0.12–0.34] and the Han (RR 0.26, 95% CI 0.16–0.40). Such differences can be explained by higher PAFs of suicide for three major risk factors (substance dependence, PAF 47.6%, 95% CI 25.5–64.2; emotionally unstable personality disorder, PAF 52.7%, 95% CI 32.8–69.0; family history of suicidal behaviour, PAF 43.5%, 95% CI 23.2–60.2) in this group than in the other two groups. This higher suicide rate was substantially reduced from 68.2/100 000 per year to 9.1/100 000 per year, comparable with the other two groups, after stepwise removal of the effects of these three risk factors. Suicide rates by self-poisoning were also significantly higher in this group than in the other two groups.

Conclusions

Higher rates of specific risk factors and use of highly lethal pesticides for suicide contributed to the higher suicide rate in one ethnic group in Taiwan. These findings have implications for developing ethnicity-relevant suicide prevention strategies.

Keywords

Ethnicityincidencepopulation attributable fractionsuicide
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1213 - 1221
Copyright
Copyright © Cambridge University Press 2010

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