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      Rural/urban Background, Depression and Suicidal Ideation in Chinese College Students: A Cross-Sectional Study

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          Abstract

          Objectives

          The objective of this study was to examine, first, the relationship of having a rural vs. urban background with suicidal ideation in Chinese college students, and second, whether a potential relationship was mediated by depression.

          Methods

          A survey was conducted among 1,145 undergraduate students at a university in China. Suicidal ideation and depressive symptoms were measured by the revised Hopkins’ Symptom checklist (SCL-90-R). Associations between rural vs. urban background, depression and suicidal ideation were estimated by multivariable linear regression-based β coefficients, logistic regression-based odds ratios (ORs), and corresponding 95% confidence intervals (CIs). The magnitude of indirect effect and bias-corrected 95% CIs were obtained through bootstrap techniques.

          Results

          Rural background was positively associated with depression, which was in turn associated with suicidal ideation. The OR for rural status and suicidal ideation equaled 2.15 (95% CI = 1.36–3.41). This OR was slightly, though significantly (p<0.05) attenuated by additional adjustment for depressive symptoms (OR = 1.99, 95% CI = 1.15–3.44).

          Conclusion

          Having a rural background is a determinant of suicidal ideation in Chinese college students. Depression may only marginally mediate this association.

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          Most cited references36

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          Youth suicide risk and preventive interventions: a review of the past 10 years.

          MADELYN GOULD, TED GREENBERG, DREW M. VELTING … (2003)
          To review critically the past 10 years of research on youth suicide. Research literature on youth suicide was reviewed following a systematic search of PsycINFO and Medline. The search for school-based suicide prevention programs was expanded using two education databases: ERIC and Education Full Text. Finally, manual reviews of articles' reference lists identified additional studies. The review focuses on epidemiology, risk factors, prevention strategies, and treatment protocols. There has been a dramatic decrease in the youth suicide rate during the past decade. Although a number of factors have been posited for the decline, one of the more plausible ones appears to be the increase in antidepressants being prescribed for adolescents during this period. Youth psychiatric disorder, a family history of suicide and psychopathology, stressful life events, and access to firearms are key risk factors for youth suicide. Exciting new findings have emerged on the biology of suicide in adults, but, while encouraging, these are yet to be replicated in youths. Promising prevention strategies, including school-based skills training for students, screening for at-risk youths, education of primary care physicians, media education, and lethal-means restriction, need continuing evaluation studies. Dialectical behavior therapy, cognitive-behavioral therapy, and treatment with antidepressants have been identified as promising treatments but have not yet been tested in a randomized clinical trial of youth suicide. While tremendous strides have been made in our understanding of who is at risk for suicide, it is incumbent upon future research efforts to focus on the development and evaluation of empirically based suicide prevention and treatment protocols.
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            Suicide rates in China, 1995-99.

            Michael R Phillips, Xianyun Li, Yanping Zhang (2002)
            A wide range of suicide rates are reported for China because official mortality data are based on an unrepresentative sample and because different reports adjust crude rates in different ways. We aimed to present an accurate picture of the current pattern of suicide in China on the basis of conservative estimates of suicide rates in different population cohorts. Suicide rates by sex, 5-year age-group, and region (urban or rural) reported in mortality data for 1995-99 provided by the Chinese Ministry of Health were adjusted according to an estimated rate of unreported deaths and projected to the corresponding population. We estimated a mean annual suicide rate of 23 per 100,000 and a total of 287,000 suicide deaths per year. Suicide accounted for 3(.)6% of all deaths in China and was the fifth most important cause of death. Among young adults 15-34 years of age, suicide was the leading cause of death, accounting for 19% of all deaths. The rate in women was 25% higher than in men, mainly because of the large number of suicides in young rural women. Rural rates were three times higher than urban rates-a difference that remained true for both sexes, for all age-groups, and over time. Suicide is a major public-health problem for China that is only gradually being recognised. The unique pattern of suicides in China is widely acknowledged, so controversy about the overall suicide rate should not delay the development and testing of China-specific suicide-prevention programmes.
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              Aspects of suicidal behavior, depression, and treatment in college students: results from the spring 2000 national college health assessment survey.

              Jeremy Kisch, E. Leino, Morton Silverman (2005)
              The National College Health Assessment Survey (NCHA), sponsored by the American College Health Association, measured depression, suicidal ideation, and suicide attempts among 15,977 college students in the academic year 1999-2000. Similar to the National College Health Risk Behavior Survey, conducted by the Centers for Disease Control and Prevention in 1995, 9.5% of students reported that they had seriously considered attempting suicide and 1.5% of students reported that they had attempted suicide within the last school year. The NCHA findings show a relationship between suicidal behavior and depressed mood. Depressed mood, difficulties of sexual identity, and problematic relationships all increase the likelihood of vulnerability to suicidal behavior. Less than 20% of students reporting suicidal ideation or attempts were receiving treatment.
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                Author and article information

                Contributors
                Kenji Hashimoto: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2013
                Publication date (Electronic): 16 August 2013
                Volume: 8
                Issue: 8
                Electronic Location Identifier: e71313
                Affiliations
                [1 ]Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
                [2 ]Tongji Center of Injury Prevention, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
                [3 ]Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
                [4 ]Institute for Medical Sociology, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
                [5 ]Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
                Chiba University Center for Forensic Mental Health, Japan
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: HC JW. Performed the experiments: HM JW HC. Analyzed the data: JL AL HM. Contributed reagents/materials/analysis tools: HM JW HC. Wrote the paper: HM JL AL JW HC.

                Article
                Publisher ID: PONE-D-13-13658
                DOI: 10.1371/journal.pone.0071313
                PMC ID: 3745444
                PubMed ID: 23977015
                SO-VID: e308545c-d91e-4197-9246-6ec70342e2c6
                Copyright statement: Copyright @ 2013
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 27 March 2013
                Date accepted : 28 June 2013
                Page count
                Pages: 6
                Funding
                This research was funded by a grant support from National Natural Science Foundation of China, Project No: 81072371. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine
                Subject: Epidemiology
                Subject: Social Epidemiology
                Subject: Mental Health
                Subject: Psychiatry
                Subject: Adolescent Psychiatry
                Subject: Mood Disorders
                Subject: Psychology
                Subject: Behavior
                Subject: Psychological Stress
                Subject: Non-Clinical Medicine
                Subject: Health Care Policy
                Subject: Health Risk Analysis
                Subject: Psychological and Psychosocial Issues
                Subject: Socioeconomic Aspects of Health
                Subject: Public Health
                Subject: Behavioral and Social Aspects of Health
                Subject: Child Health
                Subject: Socioeconomic Aspects of Health
                Subject: Social and Behavioral Sciences
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Science Education
                Subject: Universities
                Subject: Sociology
                Subject: Demography
                Subject: Population Minorities
                Subject: Social Discrimination
                Subject: Suicide

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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