A Case Control Study of Suicides in China with and Without Mental Disorder

Background: Chinese suicide samples have provided opportunities to study the differences between suicides with and without psychiatric diagnoses. Aims: To examine the differences between suicides with and without mental disorders. Methods: Sixty-six suicides and 66 living controls were studied with psychological autopsy interviews in rural China. Those who died by suicide with (n = 45) and without (n = 21) mental disorders were compared on demographic characteristics, suicidal behavior, social support, life events, and depressive symptoms (as measured by the Hamilton Depression Rating Scale, HAMD). Results: Suicides with and without psychiatric diagnoses had significant differences in many demographic and social factors. In comparison with suicides with psychiatric diagnoses, suicides without psychiatric diagnoses were younger, were better educated, had higher income, were more likely to kill themselves using pesticides or other poisons, were less likely to have a history of prior suicide attempt, had less long-term life events and more recent life events, and scored lower on HAMD. Conclusions: These two groups might be from two different populations. This finding has important implications for more effective and targeted suicide prevention strategies in China.