Suicide by charcoal burning in Taiwan: Implications for means substitution by a case-linkage study

Chian Jue Kuo, Yeates Conwell, Qin Yu, Chen Huan Chiu, Ying Yeh Chen, Shang Ying Tsai, Chiao Chicy Chen

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective: This study estimated the incidence of suicide mortality among suicide attempters in Taiwan and assessed the extent of means substitution among subjects with a non-fatal attempt and a subsequent fatal attempt during the study period. Methods: A total of 5,261 suicide attempters registered in a surveillance system of a metropolitan catchment area from 2004 to 2005 were followed through 2005. Linkage to the death certification system revealed that 72 died by suicide. The association of completed suicide with the suicide method used at index attempt was examined using Cox proportional hazards regression. Incidence rate for the subsequent lethal suicide was estimated based on life tables. Results: The 1-year incidence rate of suicide mortality was 0.017: 0.026 in males and 0.013 in females. There was a strong association between burning charcoal as the method used at the index attempt (relative hazard = 4.1, P <0.001) and completed suicides. Those who used the method of burning charcoal at the index attempt frequently used the same means in a subsequent attempt leading to suicide mortality. However, a majority of suicide completers (59.1%) who died by burning charcoal had used a different method at their index attempt. Conclusions: Persons who attempt suicide by charcoal burning are a high-risk group for completed suicide. Those who burned charcoal in a suicide attempt were likely to use the same method in a later lethal attempt, and charcoal burning was a frequent cause of death among those who used different methods in earlier attempts. Charcoal burning should be a target for suicide prevention efforts.

Original languageEnglish
Pages (from-to)286-290
Number of pages5
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume43
Issue number4
DOIs
Publication statusPublished - Apr 2008

Fingerprint

Charcoal
Taiwan
substitution
Suicide
suicide
suicide attempt
incidence
mortality
Mortality
Life Tables
cause of death
Incidence
Certification
certification
surveillance
agglomeration area
Cause of Death

Keywords

  • Attempted suicide
  • Charcoal burning
  • Means substitution
  • Surveillance

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Suicide by charcoal burning in Taiwan : Implications for means substitution by a case-linkage study. / Kuo, Chian Jue; Conwell, Yeates; Yu, Qin; Chiu, Chen Huan; Chen, Ying Yeh; Tsai, Shang Ying; Chen, Chiao Chicy.

In: Social Psychiatry and Psychiatric Epidemiology, Vol. 43, No. 4, 04.2008, p. 286-290.

Research output: Contribution to journalArticle

Kuo, Chian Jue ; Conwell, Yeates ; Yu, Qin ; Chiu, Chen Huan ; Chen, Ying Yeh ; Tsai, Shang Ying ; Chen, Chiao Chicy. / Suicide by charcoal burning in Taiwan : Implications for means substitution by a case-linkage study. In: Social Psychiatry and Psychiatric Epidemiology. 2008 ; Vol. 43, No. 4. pp. 286-290.
@article{df63246f407a43ebb2eed35389ba28b1,
title = "Suicide by charcoal burning in Taiwan: Implications for means substitution by a case-linkage study",
abstract = "Objective: This study estimated the incidence of suicide mortality among suicide attempters in Taiwan and assessed the extent of means substitution among subjects with a non-fatal attempt and a subsequent fatal attempt during the study period. Methods: A total of 5,261 suicide attempters registered in a surveillance system of a metropolitan catchment area from 2004 to 2005 were followed through 2005. Linkage to the death certification system revealed that 72 died by suicide. The association of completed suicide with the suicide method used at index attempt was examined using Cox proportional hazards regression. Incidence rate for the subsequent lethal suicide was estimated based on life tables. Results: The 1-year incidence rate of suicide mortality was 0.017: 0.026 in males and 0.013 in females. There was a strong association between burning charcoal as the method used at the index attempt (relative hazard = 4.1, P <0.001) and completed suicides. Those who used the method of burning charcoal at the index attempt frequently used the same means in a subsequent attempt leading to suicide mortality. However, a majority of suicide completers (59.1{\%}) who died by burning charcoal had used a different method at their index attempt. Conclusions: Persons who attempt suicide by charcoal burning are a high-risk group for completed suicide. Those who burned charcoal in a suicide attempt were likely to use the same method in a later lethal attempt, and charcoal burning was a frequent cause of death among those who used different methods in earlier attempts. Charcoal burning should be a target for suicide prevention efforts.",
keywords = "Attempted suicide, Charcoal burning, Means substitution, Surveillance",
author = "Kuo, {Chian Jue} and Yeates Conwell and Qin Yu and Chiu, {Chen Huan} and Chen, {Ying Yeh} and Tsai, {Shang Ying} and Chen, {Chiao Chicy}",
year = "2008",
month = "4",
doi = "10.1007/s00127-007-0300-2",
language = "English",
volume = "43",
pages = "286--290",
journal = "Social Psychiatry",
issn = "0037-7813",
publisher = "D. Steinkopff-Verlag",
number = "4",

}

TY - JOUR

T1 - Suicide by charcoal burning in Taiwan

T2 - Implications for means substitution by a case-linkage study

AU - Kuo, Chian Jue

AU - Conwell, Yeates

AU - Yu, Qin

AU - Chiu, Chen Huan

AU - Chen, Ying Yeh

AU - Tsai, Shang Ying

AU - Chen, Chiao Chicy

PY - 2008/4

Y1 - 2008/4

N2 - Objective: This study estimated the incidence of suicide mortality among suicide attempters in Taiwan and assessed the extent of means substitution among subjects with a non-fatal attempt and a subsequent fatal attempt during the study period. Methods: A total of 5,261 suicide attempters registered in a surveillance system of a metropolitan catchment area from 2004 to 2005 were followed through 2005. Linkage to the death certification system revealed that 72 died by suicide. The association of completed suicide with the suicide method used at index attempt was examined using Cox proportional hazards regression. Incidence rate for the subsequent lethal suicide was estimated based on life tables. Results: The 1-year incidence rate of suicide mortality was 0.017: 0.026 in males and 0.013 in females. There was a strong association between burning charcoal as the method used at the index attempt (relative hazard = 4.1, P <0.001) and completed suicides. Those who used the method of burning charcoal at the index attempt frequently used the same means in a subsequent attempt leading to suicide mortality. However, a majority of suicide completers (59.1%) who died by burning charcoal had used a different method at their index attempt. Conclusions: Persons who attempt suicide by charcoal burning are a high-risk group for completed suicide. Those who burned charcoal in a suicide attempt were likely to use the same method in a later lethal attempt, and charcoal burning was a frequent cause of death among those who used different methods in earlier attempts. Charcoal burning should be a target for suicide prevention efforts.

AB - Objective: This study estimated the incidence of suicide mortality among suicide attempters in Taiwan and assessed the extent of means substitution among subjects with a non-fatal attempt and a subsequent fatal attempt during the study period. Methods: A total of 5,261 suicide attempters registered in a surveillance system of a metropolitan catchment area from 2004 to 2005 were followed through 2005. Linkage to the death certification system revealed that 72 died by suicide. The association of completed suicide with the suicide method used at index attempt was examined using Cox proportional hazards regression. Incidence rate for the subsequent lethal suicide was estimated based on life tables. Results: The 1-year incidence rate of suicide mortality was 0.017: 0.026 in males and 0.013 in females. There was a strong association between burning charcoal as the method used at the index attempt (relative hazard = 4.1, P <0.001) and completed suicides. Those who used the method of burning charcoal at the index attempt frequently used the same means in a subsequent attempt leading to suicide mortality. However, a majority of suicide completers (59.1%) who died by burning charcoal had used a different method at their index attempt. Conclusions: Persons who attempt suicide by charcoal burning are a high-risk group for completed suicide. Those who burned charcoal in a suicide attempt were likely to use the same method in a later lethal attempt, and charcoal burning was a frequent cause of death among those who used different methods in earlier attempts. Charcoal burning should be a target for suicide prevention efforts.

KW - Attempted suicide

KW - Charcoal burning

KW - Means substitution

KW - Surveillance

UR - http://www.scopus.com/inward/record.url?scp=41549152996&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=41549152996&partnerID=8YFLogxK

U2 - 10.1007/s00127-007-0300-2

DO - 10.1007/s00127-007-0300-2

M3 - Article

C2 - 18075708

AN - SCOPUS:41549152996

VL - 43

SP - 286

EP - 290

JO - Social Psychiatry

JF - Social Psychiatry

SN - 0037-7813

IS - 4

ER -