The Different Character Between High-planned And Low-planned Suicide Decedents In Countryside:a Study With The Psychological Autopsy Method

Background: Suicide as a major public health problem has been widespread concerned around the world. The level of premeditations or plans of acts of suicides are heterogeneous. Researchers can classify suicide by level of plan into low-planned, Intermediate-planned and high-planned suicides. to find the difference and help choose different prevention trategies,which are of great value. However, few researches have been focused on the reports to research the different character between high-planned and low-planned suicide decedents in Chinese countryside using psychological autopsy. Objective: In this study, we investigate the level of plan of 200 suicidesobjectively by planned subscale of Beck Suicide Intent Scale (SIS) in Countryside of Zhuanghe City, Liaoning Province using psychological autopsy to analyze the different character between high-planned and low-planned suicide according the various factors to help suicidal preventers choose different prevention strategies.Methods: This study selected completed suicide as the target person of suicide groups. They were committed suicide from January 1, 2007 to December 31, 2008 in countryside of Zhuanghe City, Liaoning Province. Two informants were interviewed for each case. Finally, the subjects were 200 cases of completed suicide in this study. The total number of interviews is 400(200×2). Suicides were classified by planned subscale of SIS into low-planned, Intermediate-planned and high-planned, according to the principle of approximate equal of the member of each team, then differentiated the characters between the different levels of planned suicides, especially differentiated between low-planned and high-planned suicides.Results: (1) There are no significant differences of factors of gender, age, educated levels, married status, economic status and history of attempted suicide between low-planned and high-planned suicides(p>0.05). (2) Ingestion is significantly more common in low-planned than high-planned suicides (p﹤0.05). But violent methods are more common in high-planned than low-planned suicides (p﹤0.05). Low-planned suicides who chose ingestion predominantly more commonly stored their pesticide in their house than high-planned suicides who chose ingestion(p﹤0.05). (3)The prevalence of serious or chronic physical diseases in high-planned suicides is more than that in low-planned suicides(p﹤0.05).(4) The prevalence of mental disease(p﹤0.05)including mood disorder(p﹤0.01)in high-planned suicides is more than that in low-planned suicides.(5) The number of people who have experienced negative life events(p﹤0.01), The number of negative life events(p﹤0.001), the mental effect of negative life events (p﹤0.001),chronic stress score(p﹤0.001)and acute stress score(p﹤0.001) in high-planned suicides in recent years is more than that in low-planned suicides. In the chart there are the marked trends of these changes. But there are no significant differences of those factors in recent month. The differences chiefly appear in chronic negative life events (more than 1 month). In the chart there are also the marked trends of these changes. (6) There are no significant differences of Impulsivity ,Hopelessness and Social Support between low-planned and high-planned suicides(p>0.05). (7) Through unordered multinomial logistic regression models analyzed, individuals who suffered from serious or chronic physical diseases, mental disease and have experienced chronic and acute stress are more likely to carry out low-planned rather than high-planned suicide.Conclusions: There are a lot of significant differences between low-planned and high-planned suicides. It is suggested that different prevention strategies should be adopted between the two different planned suicides. For low-planned suicides, we can restrict the accessibility of pesticides, restrict pesticides storing in the home to prevent the suicide. For high-planned suicides, we can target to individuals who have high risk factors such as suffered from serious or chronic physical diseases, mental disease and experienced chronic negative life events to suffer serious chronic and acute stress and their caregivers or doctors to improve risk-recognition through education, other strategies including improving the ability of diagnosis and treatment of mental disease in Basic Medical Institutions, and restricting the occurring of violent act of suicide. Furthermore, surprisingly, there is no correlation between impulsivity and low-planned suicide. Suicide planning and trait impulsivity may be different dimensions.