Indepth Interviews with 244 Female Suicide Attempters and Their Associates in Northern China

BACKGROUND: Attempted suicide, a deliberate self-directed behavior situated within the unique social world of an individual, is a major risk factor for suicide. Efforts aimed at addressing female suicide must be based on understanding their perceived causes and the meaning of this behavior. AIMS: This study describes the perceived causes of suicidal behaviors to determine preventive measures of female suicide in China. METHODS: An in-depth interview about the process and causes of suicidal behavior as well as a detailed structured and a standardized diagnostic interview were administered to 244 female attempters treated at general hospitals and, separately, to their relatives. RESULTS: The perceived three most frequent causes of the attempts were interpersonal conflict (87%), psychological problems (33%), and conflict between others that affected the subject (27%). On average 2.2 causes were identified for each case. The identification in the in-depth interviews of psychological problems as a cause of the attempt was concordant with the results of the independent psychiatric exam identifying a current DSM-IV mental disorder in 38% of cases (Kappa=0.64). CONCLUSIONS: Preventive measures of improving interpersonal and problem-solving skills should be developed and assessed for addressing female suicide in China besides expansion of psychiatric services.