A Study of the Characteristics of Suicide Notes in China

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Abstract

Abstract. Background: Suicide notes in China are rarely studied and seldom available. Aims: This study examines the characteristics of suicide note leavers and analyzes the contents of their suicide notes for the period of 2004–2016 in Pudong, Shanghai, which has more than 5.5 million inhabitants. Method: The characteristics of the note leavers ( n = 458) and those who left no notes ( n = 1949) were compared. Four major groupings of the suicide note content were identified, namely, addressees, mandates/requests, expressions, and difficulties. Results: Only 19.0% of the deceased left suicide notes and they were characterized by having no diagnosed psychiatric illnesses, being in debt, having a high education level, having made no previous suicide attempts, and having used suicide methods that required preparation. Wanting to hide their suicide information was not uncommon for these individuals (9.7%). Adolescents were likely to mention a negative interpersonal relationship with someone (27.4%). Illnesses/pain was frequently mentioned by adults (33.4%) and older people (61.5%). Limitations: Many features of suicide notes, e.g., interpersonal features of suicides, were not examined. Conclusion: Education level might be a key factor influencing the likelihood of leaving suicide notes. Most people who left suicide notes showed a negative attitude toward suicidal behavior. The myth of an afterlife should also be addressed.

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Mortality registration and surveillance in China: History, current situation and challenges

Gonghuan Yang, Jianping Hu, Ke Rao … (2005)

Background Mortality statistics are key inputs for evidence based health policy at national level. Little is known of the empirical basis for mortality statistics in China, which accounts for roughly one-fifth of the world's population. An adequate description of the evolution of mortality registration in China and its current situation is important to evaluate the usability of the statistics derived from it for international epidemiology and health policy. Current situation The Chinese vital registration system currently covers 41 urban and 85 rural centres, accounting for roughly 8 % of the national population. Quality of registration is better in urban than in rural areas, and eastern than in western regions, resulting in significant biases in the overall statistics. The Ministry of Health introduced the Disease Surveillance Point System in 1980, to generate cause specific mortality statistics from a nationally representative sample of sites. Currently, the sample consists of 145 urban and rural sites, covering populations from 30,000 – 70,000, and a total of about 1 % of the national population. Causes of death are derived through a mix of medical certification and 'verbal autopsy' procedures, applied according to standard guidelines in all sites. Periodic evaluations for completeness of registration are conducted, with subsequent corrections for under reporting of deaths. Conclusion Results from the DSP have been used to inform health policy at national, regional and global levels. There remains a need to critically validate the information on causes of death, and a detailed validation exercise on these aspects is currently underway. In general, such sample based mortality registration systems hold much promise as models for rapidly improving knowledge about levels and causes of mortality in other low-income populations.

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Sentiment Analysis of Suicide Notes: A Shared Task

John P. Pestian, Pawel Matykiewicz, Michelle Linn-Gust … (2012)

This paper reports on a shared task involving the assignment of emotions to suicide notes. Two features distinguished this task from previous shared tasks in the biomedical domain. One is that it resulted in the corpus of fully anonymized clinical text and annotated suicide notes. This resource is permanently available and will (we hope) facilitate future research. The other key feature of the task is that it required categorization with respect to a large set of labels. The number of participants was larger than in any previous biomedical challenge task. We describe the data production process and the evaluation measures, and give a preliminary analysis of the results. Many systems performed at levels approaching the inter-coder agreement, suggesting that human-like performance on this task is within the reach of currently available technologies.

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Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

Ian Rockett, Eric Caine, Hilary S. Connery … (2018)

Objective A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods. Methods This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011–2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. Results A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43–49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11–44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11–2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10–1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06–66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19–3.18) and depression (OR, 1.48; 95% CI, 1.17–1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Conclusions Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.

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Author and article information

Contributors

Paul S. F. Yip

Journal

Journal ID (publisher): cri

Title: Crisis

Publisher: Hogrefe Publishing

ISSN (Print): 0227-5910

ISSN (Electronic): 2151-2396

Publication date (Electronic): May 29, 2019

Publication date (Print): 2020

Volume: 41

Issue: 1

Pages: 32-38

Affiliations

[ ¹ ]Social Work and Social Administration Department, The University of Hong Kong, Hong Kong SAR

[ ² ]Criminal Science Institute, Pudong District of Shanghai Municipal Public Security Bureau, Shanghai, PR China

[ ³ ]HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR

Author notes

Paul S. F. Yip, Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, Hong Kong SAR, sfyip@ 123456hku.hk

Article

ApaID ID: cri_41_1_32

DOI: 10.1027/0227-5910/a000601

PubMed ID: 31140317

SO-VID: 6d1bfc78-8d20-4136-bb54-8ba3a5dc554b

History

Date received : April 4, 2018

Date revision received : February 3, 2019

Date accepted : February 14, 2019

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A Study of the Characteristics of Suicide Notes in China

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Hogrefe Psychology

Most cited references 13

Mortality registration and surveillance in China: History, current situation and challenges

Sentiment Analysis of Suicide Notes: A Shared Task

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

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