Study On Suicidal Attitude,Suicidal Ideation And Mental Health Of Urban Inhabitants Living In Shenyang City, China

IntroductionSuicidal behavior is one of the social and public health problems,and has attracted increasing attention.About 1 million people die of suicide in the world each year.The number of attempted suicide is of 10 to 20 times more than one of suicide deaths.Each year suicide deaths in China account for about 30 percent all over the world.Suicide is in the fifth place among the causes of death in China.Recent research shows that the number of suicide deaths is about 287 000 people each year in China.The suicide rate is about 23/100 000.There are about 2 500 000～5 000 000 people receiving treatment for their attempted suicide.Suicide is the primary cause of death in the population aged 15～34 years,accounting for 19%of all death.As an important social and public health problem,suicide is influencing the development of society and economy with increasing severity.Problems pressing for solution are how to control suicidal behavior and to implement related strategy effectively.The purposes of this investigation were to understand better the Shenyang residents' suicidal attitude,suicidal ideation,and mental health condition,to provide theoretical evidence for enacting suicide prevention strategy,and to make it more possible for suicidal behaviors' interventions.We investigated dwellers in Shenyang on the population's attitude towards committing suicide,suicide ideation and mental health, aimed to get suicide attitude,mental health,suicide ideation rates,and the distributional characteristic of social demography in Shenyang city.We analyzed the relationships among suicide ideation,suicide attitude,impulsiveness,aggressiveness,quality of life, life events,and social support.We acquired the suicide ideation rates in different population and the risk factors of suicidal behavior.The rate of suicide ideation, suicide attitude of the residents and their mental health condition,obtained in the study, provided theoretical basis for intervention of suicidal behavior and the development of strategies and measures to intervene with suicidal behavior.Subjects and Methods1,Research subjectsWe adopted an integrated system-stratified-random sampling method,randomly selected 2 communities from 7 districts of Shenyang.According to the number of community residents and the ratio required in the investigation,we sampled the family with system sampling method,registered the family structure table,and then determined the family member as the research subject with a random number table.2,Research methodsA common survey instrument was used to question all of the informants who were older than 15 years old.The informants should have lived in those communities at least 3 months during the past half year.3,Research contentThe questionnaire provided by the Beijing Psychological Crisis Research and Intervention Center,includes three parts:general household survey,informed consent and "Attitude toward suicide and mental health status questionnaires"(version of the community-Ⅳ)."Attitude towards suicide and mental health status questionnaire"(version of the community-Ⅳ) is constituted of the preamble and 15 constituent scales part of the preamble asked general information of the subjects;The main contents in the questionnaire include suicide attitude,social distance from the experience of suicide, impulsiveness,aggressiveness,quality of life,life events,social support,friends and relatives of suicide experience at home,storage of toxic substances.4,Statistical analysis methodsEpiData3.1 software was used to input and check the survey data and SAS 8.2 statistical software was used to sort,descript and analyze the data.We used Alpha-related analysis to examine internal consistency reliability of the scale and factor analysis to examine a collection of scale validity,discriminate validity and construct validity.Quantitative data were analyzed using t-test,ANOVA or nonparametric test.Categorical data were analyzed byχ~2 test and nonparametric test. The risk factors to population suicide ideation were selected and analyzed by non-conditio al logistic regression model.ResultsThe relia(?)lity and validity of Suicide Attitude and Mental Health Questionnaire were good for(?)e urban and rural residents living in Shenyang.The residents were lack of understandi(?) o(?) suicidal behavior.For 3 suicidal knowledge-related items,the number of those w(?)o eorrectly answered all three issues accounted for 17.59 percent, and ones who answ(?) correctly two items were 34.36 percent.Question 10 had the highest proportion o(?) orrect answers(62.70%),Question 30 had the lowest proportion of correct answer(35.0(?)%).Shenyang urban an(?) rural residents had a one-sided look at suicide.Insomnia, Mahjong-playing and the vel of education had greater impact on suicide attitudes. The source of health care,sex marital status,drinking alcohol,physical illness,the per capita annual income,the sourc(?) f income;Religious beliefs,smoking,and the types of work had no effects on suicide a itude.Compared with those with normal sleep,the insomnia with less discriminatio against suicide inclined to consider that suicide is unpreventable and uncontrolla(?) and suicide could affect others' behavior.The number of education years had r ega(?) e correlations with the score of unpreventability of suicide,uncontrollability of(?)uicide(?)nd the change of others' behavior by suicide and social importance of suici(?).The resid(?) vith more education years believed that suicide could be prevented(?)d self-contr(?)lle(?),and they had lower discrimination against suicide behavior and(?)nsidered sui(?) le to be of less social importance,while those with fewer education(?)rs had the op(?)te view.The toxic substances w(?) not kept safely There were 21.98 percent of residents had kept toxic substances at h(?)e.For the toxic(?)ubstances 22.52 percent were kept where it is accessible to children,only 3.41 percent(?) ere locked.Residents had low social listance and restri(?)ions from those with suicidal behavior.The score of social dist ce and restrictions fr(?)m those with suicidal behavior is only higher than that of hyper(?)sion,and lower thin that of gay people,people infected with HIV,drug users,ment(?)atient,and equal to(?) of the crime,depressed and alcohol abuse groups.The restricti(?) of jobs area abou(?) the suicidal attempt was lower than that of hypertension and thos(?)hose family members died of suicide,and higher than depressed people,people infected with HIV,drug users and mental patient, and equal to crime,gay people,alcohol abuse groups.After adjusting sex ratio,,the suicide idea rate was 7.40%in urban residents of Shenyang.In the 45 cases of suicide ideation which had less suicide idea frequency and shorter duration,of which 32 cases had not considered specific plans,35 cases had not been prepared to commit suicide,30 cases had never sought for help.The main reasons for suicide ideation were family disputes,depression and physical disease.The degree of intention to die in 27 cases was less than 50 points.Impulsiveness and aggressiveness were positively correlated to the intensity of suicide idea.The suicide idea group had higher scores in physical impulse and cognitive-behavioral impulse than those without suicide idea,and had higher scores in physical attack,hostility and self-attacks.Quality of life and social support were negatively correlated with suicide ideation intensity.The suicide idea group had lower scores than those without suicide idea in Quality of life,subjective support and objective support.Other latitudes scores had no significant difference.Race,marital status,duration of residence,nature of work,medical sources, insomnia,and physical disease were social risk factors that affect suicide ideation,and impulsivity,the quality of life,social support and aggressiveness were psychological factors that affect the suicide ideation.Multivariate analysis results showed that age, type of work,insomnia,life events,social support and quality of life were risk factors to suicide ideation.Conclusion1,Shenyang urban residents were lack of understanding suicidal behavior,and their attitudes towards suicide varied with characteristics of social culture.2,Years of education affected people's attitude towards suicide.The residents with more education years believed that suicide could be prevented and self-controlled,and they had lower discrimination against suicide behavior and considered suicide to be of less importance,while those with less education years had the opposite view.3,With adjusted gender ratio,the suicide ideation rate was 5.66 percent in the last year from the date of the study survey,the suicide ideation rate was 3.67 percent in the last month,the suicide ideation rate of those that had suicide ideation at least once throughout their lives was 7.40 percent,the Beck suicide ideation rate was 2.54 percent in the last week,Beck depression suicide ideation rate was 4.83 percent,when they were facing the most depressing moment.4,Impulsiveness and aggressiveness were positively correlated with the intensity of suicide idea.Quality of life and social support were negatively correlated with suicide ideation intensity.5,Age,type of work,insomnia,life events,quality of life,and social support were risk factors to suicide ideation.