Suicide risk for China's youth

Suicide is more common in Chinese women than men

Suicide is the most common cause of death among young adults in China, according to research.

Rates in women are 25% higher than in men, a reversal of the usual pattern where most countries report higher suicide rates among the male population.

Suicide is also three times more frequent in rural populations compared with urban ones, perhaps because of the ready availability of highly potent pesticides.

Suicide accounted for 19% of deaths among people aged 15 to 34 years over a four-year period.

There is little argument about the public health importance of suicide and about China's unique pattern of suicide

Dr Michael Philips, Beijing Hui Long Guan Hospital

Figures indicate it was the leading cause of death for women, and the second most important cause of death for men in that age group, after car accidents.

Among women aged 15 to 34 in rural areas, suicides accounted for almost a third of all deaths, and the rate of death by suicide was more than seven times greater than from medical complications during pregnancy and childbirth.

Numbers debate

It has been difficult for researchers to obtain a true picture of suicide rates in China because official data is based on unrepresentative samples of the population, and because different reports adjust basic rates in different ways.

This study, by researchers from the Suicide Research and Prevention Center at the Beijing Hui Long Guan Hospital, China, tried to present an accurate picture on the basis of conservative estimates of suicide rates in different population groups.

They looked at deaths from 1995 to 1999. Suicide rates for gender, age and region were adjusted, taking into account an estimated rate of unreported deaths.

It was estimated that there was an average annual suicide rate of 23 per 100,000 and a total of 287,000 suicides per year.

The researchers, led by Dr Michael Philips, estimated suicide accounted for 3.6% of all deaths in China and that it was the fifth most important cause of death among the whole population.

Writing in the Lancet, they said: "There remains controversy about the absolute numbers of suicides in China, but there is little argument about the public health importance of suicide and about China's unique pattern of suicide.

'Acknowledge the problem'

"Given the size of this public health problem, developing and testing China-specific preventative interventions for high-risk groups are urgent tasks."

The researchers say the Chinese Ministry of Health, in conjunction with the World Health Organization, had taken the first steps towards developing a national "suicide-prevention programme".

Professor Rachel Jenkins, from the Institute of Psychiatry in London, wrote in a commentary in the journal: "The study by Phillips and colleagues is important, not so much for its rather more conservative estimate of China's suicide rate, as for its being a key step along the path to encouraging China, and other countries, to have a complete vital registration system.

"Also, it highlights suicide as a leading cause of death among the young and a major cause of death in all age-groups, and the need to acknowledge and address suicide as a serious public health problem."