The Epidemiological Study of Suicide in New Taipei City

• Main Authors: Tu, Huitzu, 涂慧慈
• Other Authors: See, Laichu
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/v23zr4

碩士 === 輔仁大學 === 公共衛生學系碩士班 === 101 === Background: Suicide (including suicide ideation, attempted suicide, and suicide death) is an important public health issue. However, few studies have included these three groups to examine the rate of this phenomenon and epidemiologic characteristics. Aims: (1) To estimate New Taipei City’s suicide rate (including ideation, attempted and death). (2) To explore the epidemiological characteristics among the three suicide groups. Materials and Methods: Secondary data analysis was performed based on the data from the Taiwan National Suicide Report System and records from the Taiwan Death Registry. The inclusion criteria were those who committed suicide in 2010 and lived in New Taipei City. The denominator of the suicide rate was the population size in New Taipei City in December 2010. Risk factors for suicide action and suicide death were examined using the chi-square test, Fisher’s exact test, analysis of variance (ANOVA), univariation, and logistic regression multivariation. Results: (1) Suicide rate: There were 6,006 individuals who committed suicide in New Taipei City in 2010, corresponding to an overall suicide rate of 154.1/105 with a 95% confidence interval between 41.8/105 and 158.0/105. The rate of suicide ideation, attempted and death were 25.6/105, 112.1/105, 16.4/105, respectively. The proportion of suicide ideation, attempted and death were 16.6%, 72.8%, 10.6%, respectively. Gender and age were significant factors affecting suicide. Males were less likely to commit suicide than females, with a risk ratio (RR) of 0.59. Individuals who were 20-39 years old (RR=4.86), 40-64 years old (RR=3.71) and 65 years old or above (RR=3.22) had a higher risk to commit suicide than individuals who were 19-year-old or below. (2) The epidemiological characteristics of suicide: Among the 6006 individuals who committed suicide in New Taipei City in 2010, the proportion of suicide ideation in females (79.2%) was higher than that in males (63.4%). However, the proportions of attempted suicides (males: 18.5% vs. females: 15.7%) and suicide death (males: 18.1% vs. 5.0%) were higher in males than those in females. The mean age was 40.7 years (SD=15.4 years). When breaking down by three suicide groups, the mean age was highest in suicide death group (47.9 years old), followed by the suicide ideation group (42.7 years old), and those in the attempted suicide group (39.3 years). Among individuals who committed suicide in year 2010, 16.4% had suicide ideation or had attempted suicide before. The death rate due to suicide in this sample was lower among those who had suicide ideation or attempted suicide before (6.4%) than those who did not (10.5%). Regarding suicide movitations, emotional/interpersonal problems (47.0%) was the main reason for committing suicide, followed by work/money (14.2%), physical illness (6.1%). There was significant difference in distribution of suicide reasons by gender or by age group. In females, the first three main reasons for committing suicide were: emotional/interpersonal problems (53.7%), unknown or unwilling to tell (32.8%), work/money issue (12.3%). In males, the first three main reasons of committing suicide were: unknown or unwilling to tell (41.8%), emotional/interpersonal problems (35.2%), work/money issue (17.3%). Among the elderly, the first three main reasons of committing suicide were: unknown or unwilling to tell (40.0%), physical illness (29.9%), and emotional/interpersonal problems (28.8%). Factors triggering suicidal actions were: reason of suicide, age, and gender. Individuals suffering from physical illness reason (aOR=0.65) or work/money reason (adjusted odds ratios, aOR, 0.35) had a lower likelihood to take suicidal action than those who did not. Individuals who were 65 years or above (aOR = 1.58), 20-39 years old (aOR = 1.92) had higher likelihood to take suicidal actions than those who were 19 years or less. Males were less likely to try suicide than females were (aOR= 0.81). Among those who took suicide actions (n=5002), about half of the individuals attempted poisoning by solid or liquid substances (55.0%), followed by cutting/piercing (26.3%), and poisoning by other gases and vapors (9.5%). There was a gender differences in the suicide methods. More males used radical means to kill themselves, such as poisoning by other gases and vapors (males 16.6% vs, females 5.5%), hanging and suffocation/firearms and explosives (males 8.4% vs. females 2.4%), poisoning by cooking gas (males 5.2% vs. females 1.2%), jumping from high places (males 4.9% vs. females 3.1%). More females used gentle means to kill themselves: poisoning by solid or liquid substances (males 43.5% vs. females 61.3%), cutting/piercing (males 19.5% vs. females 30.1%). Factors determining whether an individual died or not after committing suicide included suicide means, suicide reasons, age, and gender. Hanging and suffocation/firearms and explosives were the most fatal means with the aOR of 27.03, followed by poisoning by other gases and vapors (aOR = 6.81), jumping from high places (aOR = 6.15), poisoning by cooking gas (OR = 5.42), drowning/submersion (aOR = 2.50). Poisoning by solid or liquid substances, cutting/piercing were the less fatal means with the aOR=0.07, 0.10, respectively. Regarding to the suicide reasons, unknown or unwilling to tell had the higher aOR of death (12.93), but emotional/interpersonal problems had a lower risk of death (OR = 0.35). The risk of death increased with age, whereas the aORs were 2.77 for aged 20-39 years, 3.90 for aged 40-64-year-old and 7.23 for aged 65-year-old or above. Males (aOR=1.65) had a higher likelihood of death than females did. Conclusions: (1) The overall suicide rate was 154.1/105 for New Taipei City in 2011. The suicide ideation rate was 25.6/105, attempted suicide rate was 112.1/105, and suicide death rate was 16.4/105. (2) The proportion of suicide ideation, attempted and death was 16.6%, 72.8%, and 10.6%, respectively. (3) Suicide reason was the most important factor determining whether or not an individual tried to commit suicide. Suicide means was the most important factors determining whether or not an individual died after the suicide action. Because distribution of suicide reasons and suicide means varied with gender and age, the rate of suicide ideation, attempted and death differed with gender and age.