Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-25T08:10:48.718Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  12 October 2017

X. C. Liu ,
H. Chen ,
Z. Z. Liu ,
J. Y. Wang  and
C. X. Jia
X. C. Liu*
Affiliation:
Shandong University School of Public Health, Jinan 250012, China School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China The University of Tennessee Health Science Center, Memphis, TN 38163, USA
H. Chen
Affiliation:
Shandong University School of Public Health, Jinan 250012, China
Z. Z. Liu
Affiliation:
Shandong University School of Public Health, Jinan 250012, China
J. Y. Wang
Affiliation:
Zhejiang Cancer Hospital, Hangzhou 310022, China
C. X. Jia*
Affiliation:
Shandong University School of Public Health, Jinan 250012, China
*
*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: [email protected] or [email protected])
*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: [email protected] or [email protected])
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Adolescentsepidemiologyrisk factorssuicidal behaviour
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 3 , June 2019 , pp. 280 - 289
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, TM (1991). Manual for the Youth Self-Report and 1991 Profile. Department of Psychiatry, University of Vermont: Burlington, VT.Google Scholar
Beck, AT, Weissman, A, Lester, D, Trexler, L (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting and Clinical Psychology 42, 861–865.Google Scholar
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, 53–58.Google Scholar
Eysenck, SBG, Easting, G, Pearson, PR (1984). Age norms for impulsiveness, venturesomeness and empathy in children. Personality and Individual Differences 5, 315–321.Google Scholar
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, 386–405.Google Scholar
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, 1191–1198.Google Scholar
Hawton, K, Saunders, KE, O'Connor, RC (2012). Self-harm and suicide in adolescents. Lancet 379, 2373–2382.Google Scholar
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, 78–89.Google Scholar
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, 1–174.Google Scholar
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, 381–389.Google Scholar
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, 330–337.Google Scholar
Liu, XC, Tein, JY (2005). Life events, psychopathology, and suicidal behavior in Chinese adolescents. Journal of Affective Disorders 86, 195–203.Google Scholar
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, 200–203.Google Scholar
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, 708–715.Google Scholar
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, 1565–1577.Google Scholar
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, 207–216.Google Scholar
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, 667–677.Google Scholar
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, 340–350.Google Scholar
McLoughlin, AB, Gould, MS, Malone, KM (2015). Global trends in teenage suicide: 2003–2014. QJM 108, 765–780.Google Scholar
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, 1122–1128.Google Scholar
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, 97–107.Google Scholar
Phillips, MR, Li, X, Zhang, Y (2002 a). Suicide rates in China, 1995–99. Lancet 359, 835–840.Google Scholar
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, 1728–1736.Google Scholar
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, 533–542.Google Scholar
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, 161–168.Google Scholar
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, 264–277.Google Scholar
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, 291–298.Google Scholar
Wang, CW, Chan, CL, Yip, PS (2014). Suicide rates in China from 2002 to 2011: an update. Social Psychiatry and Psychiatric Epidemiology 49, 929–941.Google Scholar
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, 1765–1773.Google Scholar
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, 560–568.Google Scholar
Zhao, S, Zhang, J (2015). Suicide risks among adolescents and young adults in rural China. International Journal of Environmental Research and Public Health 12, 131–145.Google Scholar