自杀率、自杀未遂率和自杀行为致死率的性别差异

摘要

Objective To explore the underlying mechanism of why the suicide rate in females is higher than in males in China.Methods A county-wide suicide reporting system was established in Shaan'xi Province,to monitor suicidal behaviors,including attempted and completed suicide.From Jan.I,2009 to Dec.31,2010,all patients over 10 years of age treated in 14 general hospitals in the county for suicidal behaviors or accidental self-harm were identified.For each identified cases,information including name,sex,age,specific characteristics of the self-harm (method,time,etc.) and outcome,was recorded on a standardized form by an interviewer.Death certifications provided by the county's Center of Diseases Control (CDC) were used to identify all completed suicides (International Classification of Diseases,ICD codes X60-X84) occurred from Jan.1,2009 to Dec.31,2010.Results In the 2 years investigation periods,406 patients with suicidal behaviors were identified,in which 366 were suicide attempters.In the same two years,57 person in this county died by suicide.The annual attempted suicide rate in the county was 67.1 per 100 000 (366/545 339),and the ratio of attempted suicide rate of females (96.1/100 000,254/264 177) to males (39.5/100 000,111/281 162) was 2.44.The annual suicide rate was 10.5 per 100 000 (57/545 339).The rate of serious suicidal behavior was 77.6/100 000 (423/545 339),and the ratio of rates of serious suicidal behavior of females (107.5/100 000,284/264 177) to males (49.1/100 000,138/281 162) was 2.19.The ratio of annual rate of attempters to completes was 6.42:1.Among all the 423 cases who committed suicidal behaviors,19.6％ male cases (27/138) and 10.6％ female cases (30/284) were died by suicide.Sixty-seven percent (244/366) attempters committed suicidal behaviors with pesticide.Conclusions The rate of serious suicidal behaviors is 2.19-fold higher in females than in males,but the fatality of suicidal behaviors is 1.85-fold higher in males than in females,which contribute to a higher suicide rates in females than males in China.%目的 初步探讨我国女性自杀率高于男性的原因.方法 依据2009年1月至2010年12月某县自杀行为医院报告系统登记的年龄≥10岁的自杀或误服者资料(包括姓名、性别、年龄、自杀或误服方式、是否死亡等)及该县全死因报告系统中自杀死亡者资料,监测该县自杀未遂和自杀死亡发生情况.结果 两年共报告因自杀行为到医院救治的患者406例,其中366例自杀未遂.同期有57例自杀死亡.该县年均自杀未遂率67.1/10万(366/545 339),女性自杀未遂率(96.1/10万,254/264 177)是男性(39.5/10万,111/281 162)的2.44倍；年均自杀率10.5/10万(57/545 339)；自杀行为发生率77.6/10万(423/545 339),女性(107.5/10万,284/264 177)是男性(49.1/10万,138/281 162)的2.19倍.自杀未遂/死亡比为6.42:1.所有423例实施了自杀行为者中,19.6％(27/138)的男性自杀死亡,10.6％ (30/284)的女性自杀死亡.66.7％(244/366)的自杀未遂者服用农药自杀.结论 女性自杀行为发生率是男性的2.19倍,而男性自杀行为致死率不到女性的2倍,导致女性自杀率高于男性.