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Charcoal-burning has become a predominant method of suicide in many East-Asian countries since the 1990s. Background: To explore charcoal-burning suicide trends from 1996 to 2020 in Taiwan. Aims: Joinpoint regression models were applied to identify suicide trends over the study period. Decompositional analyses quantified the contributions of age, sex, suicide method, and area of residence to suicide rate trends, accounting for age and geographical distribution of the general population, with a focus on charcoal-burning suicide. Methods: There were three stages of suicide rate trends: increasing (1996-2006), descending (2006-2011), and levelling-off (2011-2020). Suicide by charcoal-burning accounted for 70% of the increasing suicide rates between 1996 and 2006 and 50% of the decreasing rates in the descending stage (2011-2020). During the levelling-off stage, suicide by charcoal-burning continued to decrease, albeit slowly. During the descending stage, there was a partial "substitution" of jumping for charcoal-burning. During the levelling-off stage, suicide by hanging partially "substituted" for suicide by charcoal-burning. Results: There were three stages of suicide rate trends: increasing (1996-2006), descending (2006-2011), and levelling-off (2011-2020). Suicide by charcoal-burning accounted for 70% of the increasing suicide rates between 1996 and 2006 and 50% of the decreasing rates in the descending stage (2011-2020). During the levelling-off stage, suicide by charcoal-burning continued to decrease, albeit slowly. During the descending stage, there was a partial "substitution" of jumping for charcoal-burning. During the levelling-off stage, suicide by hanging partially "substituted" for suicide by charcoal-burning. Limitations: Charcoal-burning remains the second most common method of suicide in Taiwan today. Charcoal-burning has been partially replaced in the last 10 years by jumping and hanging. Monitoring suicide methods and trends is essential for suicide prevention interventions.Conclusions: Charcoal-burning remains the second most common method of suicide in Taiwan today. Charcoal-burning has been partially replaced in the last 10 years by jumping and hanging. Monitoring suicide methods and trends is essential for suicide prevention interventions.

Introduction: From 2010 to 2021, suicide rates in 15-24 age group in Taiwan increased by 70%, with jumping being the most common method in 2021. We examined the link between the rise in youth suicides and the increase in high-rise buildings during this period., Methods: Spearman's correlation coefficients and negative binomial mixed-effects models were employed to assess the association between the increase in high-rise buildings and jumping suicides over time., Results: Spearman's correlation coefficients of high-rise buildings and jumping suicide rates in youth decreased from 0.692 (p < 0.001) in 2010 to 0.354 (p = 0.11) in 2021. Negative binomial mixed-effects models showed that although jumping suicide rates in youths increased over time, the increase in numbers of high-rise buildings was not related to rates of youth suicide by jumping. Conversely, in older age groups, the correlations were still prominent., Conclusion: Despite the rising trend in youth suicides by jumping over the past 11 years, our study refutes the intuitive notion that the increase in high-rise buildings contributes to this trend. It is imperative to identify and address other potential factors, such as academic stress and/or family disruptions, for effective prevention of youth suicide., (© 2024 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Background: Studies from Western countries indicated that older adults were more resilient than younger ones to deteriorating mental health during the COVID-19 pandemic. As high late-life suicide rates have been reported in East Asia, it is possible that the pandemic impact might differ between East and West. We investigated the pandemic impact on age-specific suicide patterns in Taiwan., Methods: Interrupted time-series analysis was used to model the overall, and age-stratified, monthly suicide rates before (January 1st, 2017 to December 31st, 2019) and after (January 1st 2020 to December 31st 2021) the COVID-19 outbreak. Associations between confirmed COVID-19 deaths and suicide rates were also assessed., Results: There was a significant decrease in overall suicide rates after the COVID-19 outbreak (p < 0.01) (annual average rates per 100,000 population of 16.4 prior, 15.2 after). The overall decrease was driven by fewer suicide deaths in the young- and older-middle-aged groups (25-44 and 45-64 years). However suicide rates in younger-age group (<25 years) were already increasing pre-pandemic, a trend which continued after the outbreak. Suicide rates for older people (≥65 years) also increased along with the increasing number of COVID-19 deaths during the pandemic period., Limitations: Under-reporting and/or misclassification of suicides were possible., Conclusions: The overall suicide rates in Taiwan did not change after the COVID-19 outbreak; however, suicide in older adults increased. Public health measures to reduce COVID-19 infections may have unintended and adverse consequences on the psychological wellbeing of older citizens., Competing Interests: Conflict of interest None declared., (Copyright © 2023. Published by Elsevier B.V.)

Background: The global age-standardized suicide rate fell by 32.7% between 1990 and 2016. The decrease was largely due to suicide rate reductions in China and India. High-income Asian regions did not see such reductions. The aim of the current study was to explore recent suicide rate trends in Hong Kong and Taiwan to decompose which factors - age, period or cohort - explain suicide rate changes in these two regions., Methods: Official mortality data for 1979-2018 in Hong Kong and Taiwan were collected. We utilized Web Tool from the NIH (National Institute of Health, USA) to analyze the Age-Period-Cohort (APC) effects., Results: We found marked age-effect that suicide rates increased with age in both genders in both places. Period effect related to the dissemination of charcoal burning suicide was found during 1999-2003 in Hong Kong and 2004-2008 in Taiwan. Increasing suicide rates in the middle- and young-age male cohorts were found in both regions. No increase in suicide risks in young female cohorts was observed. Older cohorts in Hong Kong and older female cohorts in Taiwan also had high suicide rates, but older male cohorts in Taiwan had low rate., Limitations: The interpretations and observations at the population level might not hold at the individual level., Conclusions: The high suicide risk in middle- and young male cohorts in both regions contribute to the persistent high suicide rates in these two regions. Special attention should be turn to the factors underlying such increasing trends., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Repeat self-harm is an important risk factor for suicide. Few studies have explored risk factors for non-fatal repeat self-harm in Asia., Aims: To investigate the risk of non-fatal repeat self-harm in a large cohort of patients presenting to hospital in Taipei City, Taiwan., Method: Prospective cohort study of 7601 patients with self-harm presenting to emergency departments (January 2004-December 2006). Survival analysis was used to examine the rates, timing and factors associated with repeat self-harm., Results: In total 778 (10.2%) patients presented to hospital with one or more further episodes of self-harm. The cumulative risk of non-fatal repetition within 1 year of a self-harm episode was 9.3% (95% CI 8.7-10.1). The median time to repetition within 1 year was 105 days. Females had a higher incidence of repeat self-harm than males (adjusted hazard ratio 1.25, 95% CI 1.05-1.48) but males had shorter median time to repetition (107 v. 80 days). Other independent risk factors for repeat self-harm within 1 year of an index episode were: young age, self-harm by medicine overdose and increasing number of repeat episodes of self-harm., Conclusions: The risk of non-fatal repeat self-harm in Taipei City is lower than that seen in the West. Risk factors for repeat non-fatal self-harm differ from those for fatal self-harm. The first 3 months after self-harm is a crucial period for intervention.

Taiwan experienced both a significant decrease and a significant increase in the suicide rate during the period 1986-1999, which provides a unique opportunity to examine the substitution hypothesis in suicide research: that is, whether a reduction in the use of a certain method of suicide would be offset by a parallel increase in the use of other methods. We also explored whether such method substitution, if it existed, differed across urban and rural settings. Data on age-, sex-, method-, and urban-/rural-specific suicide rates for the period 1986-1999 in Taiwan were obtained and the year of 1993 is found to be the inflection point. We analyzed using Poisson regression to estimate the average annual percentage change (AAPC) for periods of decline (1986-1993) and increase (1993-1999) in suicides. The rapid decline in suicide by solid/liquid poisoning (mostly using pesticides) during a period of accelerated economic development (1986-1999) in Taiwan was found to be associated with the increased use of alternative methods. An interaction model found a marked decrease in solid/liquid poisoning suicide in both urban and rural Taiwan over the period of decline (1986-1993). The extent of the decrease was greater in rural areas but was accompanied by a rise in the use of several other suicide methods. However, the net effect was still a marked reduction in the suicide rate. A general increase in suicide among all age groups, for all methods, in both rural and urban settings, and for both sexes was found during the period when the suicide rate increased (1993-1999). We conclude that restricting access to the means of pesticide suicides reduces not only the method-specific suicide rate but also the overall suicide rate; nonetheless, suicide method substitution is not an all-or-nothing phenomenon. Stratified analyses by geographical (i.e. urban/rural) area can help to disentangle the patterns in each subgroup, which will improve our understanding of the phenomenon and make suicide prevention efforts more focused and effective., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

We investigated the association of the intensity of newspaper reporting of charcoal burning suicide with the incidence of such deaths in Taiwan during 1998-2002. A counting process approach was used to estimate the incidence of suicides and intensity of news reporting. Conditional Poisson generalized linear autoregressive models were performed to assess the association of the intensity of newspaper reporting of charcoal burning and non-charcoal burning suicides with the actual number of charcoal burning and non-charcoal burning suicides the following day. We found that increases in the reporting of charcoal burning suicide were associated with increases in the incidence of charcoal burning suicide on the following day, with each reported charcoal burning news item being associated with a 16% increase in next day charcoal burning suicide (p<.0001). However, the reporting of other methods of suicide was not related to their incidence. We conclude that extensive media reporting of charcoal burning suicides appears to have contributed to the rapid rise in the incidence of the novel method in Taiwan during the initial stage of the suicide epidemic. Regulating media reporting of novel suicide methods may prevent an epidemic spread of such new methods.

Background: Taipei has seen a substantial increase in suicide rates during the past decade, with a significant rise between 2004 and 2006, the time of this study period., Methods: A decompositional analytic method was used to quantify the relative contributions of age, sex and case fatality of methods to attempts and suicides., Results: From 2004 to 2006, the rate of fatal and non-fatal suicide attempts combined for population aged 15 years or above in Taipei increased by 37.3%, while the suicide rate increased by 29.2%. Three factors in these analyses contributed to the increase in suicide rates: (1) an increase in number of attempts, (2) a greater proportion of men among fatal and non-fatal attempts and (3) an increase in the use of a lethal method-burning of charcoal to produce carbon monoxide. The authors estimated that 74.5% and 25.6% among men and women, respectively, of the overall increased suicide mortality were attributable to increased 'charcoal burning suicides.', Conclusions: The rise in suicide rate reflected an increase in attempts and an influx of working-age men joining the pool of people attempting suicide. The much larger size of the attempter pool had the effect of reducing the case fatality even as the suicide rate climbed. The increase in the number of suicide attempts and the rise in the suicide rate were age-, sex-, and method-specific. These results strongly support the concept that reducing the total number of attempts is a central element to curbing suicides.

Background: Most previous studies of long-term mortality risk following self-harm have been conducted in Western countries with few studies from Asia., Aims: To investigate suicide and non-suicide mortality after non-fatal self-harm in Taipei City, Taiwan., Method: Prospective cohort study (median follow-up 3.3 years) of 7601 individuals presenting to hospital with self-harm (January 2004 to December 2006). Standardised mortality ratios (SMRs) for suicide and non-suicide mortality were calculated., Results: Suicide risk in the year following self-harm was over 100 times higher than in the general population (SMR = 119.6, 95% CI 99.6-142.5). Males and middle-aged and older adults had the highest subsequent risk of suicide. Compared with people who took an overdose, individuals who used hanging or charcoal burning in their index episode had the highest risk of suicide. For non-suicide mortality the SMRs were 6.7 (95% CI 5.7-7.8) in the first year and 4.4 (95% CI 3.9-4.9) during the whole follow-up period., Conclusions: Patterns of increased all-cause and suicide mortality following an episode of self-harm are similar in Taipei City to those seen in Western countries. Designing better aftercare following non-fatal self-harm, particularly for those with underlying physical disorders or who have used lethal self-harm methods, should be a priority for suicide prevention programmes in Asia.

Background: Extensive media reporting of suicide events has been indicated as a contributing factor to the upsurge in suicide rates in Taiwan in the past decade., Aims: The study compares gender differences in sociodemographic profiles and method of suicide selectively reported in the newspapers and all suicide cases registered in official death records. It also identifies gender differences in media reports of suicides., Methods: Articles reporting suicide news from four major newspapers in Taiwan (China Times, United Daily, Liberty Times, and Apple Daily) in 2009 were retrieved and analyzed. Gender differences in sociodemographic profiles of suicides reported in the newspapers and official records of all suicide deaths were compared. Any gender differences in newspaper depictions of contributing factors of suicide and situations surrounding the suicidal acts were compared., Results: Newspapers in Taiwan tended to overreport unusual methods of suicide among men and extended suicide among women. The reasons for suicide in men were more frequently portrayed as work-related or after legal problems, whereas in women suicide was more frequently framed as due to mental illness or relationship problems. The news media tended to underreport mental illness as a reason for suicide in men., Limitation: The analysis was based solely on news reporting in the four major newspapers during the year 2009., Conclusions: Media representation of suicide generally follow societal-gendered assumptions of acceptable/unacceptable behaviors. Media professionals should be more careful and responsible in reporting suicide news and avoid any gender bias in their framing of suicide stories. Sensitive rather than sensational reporting should be promoted in order not to reinforce the myths of suicides in the community.

Objectives: To assess changes in the intensity of suicide news reporting in Taiwan's local newspapers after the arrival of a daily tabloid-type newspaper, Apple Daily (AD), and evaluate the impact of suicide news reporting on actual suicides and possible mutual causation., Methods: A counting process was used to estimate the intensity of daily suicide news items reported in the China Times (CT) and United Daily (UD) before and after the arrival of AD (2002-05). Poisson regression models were used to assess the impact of the intensity of suicide news reporting on the actual number of next day suicides. Granger's causation model was used to assess mutual causation between suicide news reporting and actual suicides., Results: There was a significant increase in reporting intensity of suicide news in the UD soon after the entry of the AD into Taiwan's media market, while a delayed increase of approximately 1 year was observed in the CT. After the arrival of the AD, the reporting intensity in the UD was significantly related to the occurrence of actual suicides (p<0.05), even after controlling for social variables, whereas no significant correlation was previously observed. Mutual causation between suicide news reporting and actual suicides was also observed., Conclusions: The presence of the AD in Taiwan has fuelled competitive reporting of suicide news among traditional newspapers. This increase in the intensity of suicide news reporting has consequently had an impact on the actual number of suicides. This provides further empirical support for improving media reporting as a key element in suicide prevention.

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles., Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places., Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4-14% provided sources for help-seeking and 27-90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers., Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups.

Background: Taiwan has experienced a marked increase in the suicide rate in the last decade. However, the socioeconomic burden and impact to the community has not been adequately assessed., Aims: This study aimed to estimate the social and economic burden of premature mortality from suicide in Taiwan in 1997-2007., Methods: The suicide rate, potential years of life lost (PYLL), and present value of lifetime earnings (PVLE) by sex and age groups in 1997-2007 were calculated. The contribution of each suicide method to PYLL for each age group was also assessed., Results: Using the PYLL calculations, suicide had become the third leading cause of death in Taiwan in 2007, compared to its ninth position in terms of absolute numbers. Furthermore, the PYLL was associated with an estimated NTD (New Taiwan Dollars) 32.5 billion of lost earnings in 2007. The increase in PYLL and PVLE from suicide was highest in middle-aged men (aged 25-59 years). Charcoal burning suicide accounted for most of the increase in PYLL in the middle-aged group in the past decade., Conclusions: The loss of life in middle-aged males contributes disproportionately to the social and economic burden of suicide in Taiwan. Suicide intervention effort should target this high-risk population.

This study examines the impact of unemployment on suicide rates in Taiwan and Hong Kong during the period of rising unemployment (1997-2003) and its subsequent decline (2003-2007), with 2003 as the turning point. During these initial years of high unemployment, suicide rates increased markedly in Hong Kong and Taiwan; however, as employment conditions improved, suicide rates fell in Hong Kong but continued to increase in Taiwan. ARMAX time-series models with appropriate time lags were used to assess the impact of unemployment on suicide rates for both periods. It was found that for Taiwan, the unemployment rate was positively related with the suicide rate for both males and females during the period of high unemployment, whereas a negative relationship was observed as the rate of unemployment decreased. On the other hand, the reduction in suicide rates since 2003 was not statistically significantly related to the improvement of employment conditions for Hong Kong; whereas the suicide rate in Taiwan still remained at a high level due to the increasing number of charcoal burning suicide deaths despite improvements in employment conditions. In conclusion, lower unemployment was not necessarily associated with lower suicide rates. Exogenous factors other than economic ones have been suggested to be important for understanding differences in suicide patterns in Hong Kong and Taiwan. The impact of employment conditions on suicide across different countries deserves further investigation., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Objective: Evidence suggests that there is an increase in the suicide rate following incidents of celebrity suicide in different countries, but there are no data on the overall suicide risk across countries. The duration of increased suicide rates is usually assumed to be on a monthly basis, but the weekly increase remains uncertain. This study aims at estimating the risk for suicide after the suicide deaths of entertainment celebrities in Asia during the first 4 weeks after the celebrity suicides and on a weekly basis., Method: An ecological, retrospective time-series analysis and a meta-analysis of the suicide deaths in 3 Asian regions: Hong Kong (from 2001 to 2003), Taiwan, and South Korea (both from 2003 to 2005)., Results: The combined risks for suicide were found to be 1.43 (95% CI = 1.23 to 1.66), 1.29 (95% CI = 1.12 to 1.50), and 1.25 (95% CI = 1.08 to 1.45) in the first, second, and third week, respectively, after suicides of entertainment celebrities, while adjusting for secular trends, seasonality, economic situation, and temporal autocorrelation. The same-gender and same-method specific increases suggest that as people identify more with the celebrity, their risk for suicide rises. A medium-term rise in suicides up to 24 weeks after the incidents of celebrity suicide is also evident., Conclusion: This study is the first to estimate risk for suicides following celebrity suicides across 3 Asian regions. The results provide important information for public health policy makers in assessing the elevated risk associated with excessive media coverage of celebrity suicide and developing timely evidence-based interventions., (Copyright 2009 Physicians Postgraduate Press, Inc.)

The Asian economic crises of 1997 and the 2008 Global Financial Crisis (GFC) had far-reaching impacts on Asian and other global economies. Turmoil in the banking and finance sectors led to downturns in stock markets, resulting in bankruptcies, house repossessions and high unemployment. These crises have been shown to be correlated with a deterioration in mental health and an increase in suicides, and it is important to understand the implication of these impacts and how such recessions affect the health of affected populations. With the benefit of hindsight, did lessons learned from the negative effects of the 1997 Asian economic recession impact the aftermath of the 2008 GFC in Asian countries? Utilising a framework based on a simple strata-bootstrap algorithm using daily data – where available – we investigate the trend in suicide rates over time in three different populations (Hong Kong, Taiwan and South Korea), and examine whether there were any changes in the pattern of suicide rates in each country subsequent to both the 1997 Asian and 2008. We find that each country responded differently to each of the crises and the suicide rates for certain age-gender specific groups in each country were more affected. [ABSTRACT FROM AUTHOR]

Purpose: Some East/Southeast Asian countries have experienced a rapid increase in suicide by charcoal burning over the past decade. Media reporting and Internet use were thought to contribute to the epidemic. We investigated the association between method-specific suicide incidence and both Internet search volume and newspaper reporting in Taiwan.Method: Weekly data for suicide, suicide-related Google search volume, and the number of articles reporting suicide in four major newspapers in Taiwan during 2008-2011 were obtained. Poisson autoregressive regression models were used to examine the associations between these variables.Results: In the fully adjusted models, every 10 % increase in Google searches was associated with a 4.3 % [95 % confidence interval (CI) 1.1-7.6 %] increase in charcoal-burning suicide incidence in the same week, and a 3.8 % (95 % CI 0.4-7.2 %) increase in the following week. A one-article increase in the United Daily was associated with a 3.6 % (95 % CI 1.5-5.8 %) increase in charcoal-burning suicide in the same week. By contrast, non-charcoal-burning suicide was not associated with Google search volume, but was associated with the Apple Daily's reporting in the preceding week.Conclusions: We found that increased Internet searches for charcoal-burning suicide appeared to be associated with a subsequent increase in suicide by this method. The prevention of suicide using emerging methods may include monitoring and regulating online information that provides details of these methods as well as encouraging Internet service providers to provide help-seeking information. [ABSTRACT FROM AUTHOR]

Background: Taipei has seen a substantial increase in suicide rates during the past decade, with a significant rise between 2004 and 2006, the time of this study period. Methods: A decompositional analytic method was used to quantify the relative contributions of age, sex and case fatality of methods to attempts and suicides. Results: From 2004 to 2006, the rate of fatal and non-fatal suicide attempts combined for population aged 15 years or above in Taipei increased by 37.3%, while the suicide rate increased by 29.2%. Three factors in these analyses contributed to the increase in suicide rates: (1) an increase in number of attempts, (2) a greater proportion of men among fatal and non-fatal attempts and (3) an increase in the use of a lethal method--burning of charcoal to produce carbon monoxide. The authors estimated that 74.5% and 25.6% among men and women, respectively, of the overall increased suicide mortality were attributable to increased 'charcoal burning suicides.' Conclusions: The rise in suicide rate reflected an increase in attempts and an influx of working-age men joining the pool of people attempting suicide. The much larger size of the attempter pool had the effect of reducing the case fatality even as the suicide rate climbed. The increase in the number of suicide attempts and the rise in the suicide rate were age-, sex-, and method-specific. These results strongly support the concept that reducing the total number of attempts is a central element to curbing suicides. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles. Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places. Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4--14% provided sources for help-seeking and 27--90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers. Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups. [ABSTRACT FROM AUTHOR]

Objectives: To assess changes in the intensity of suicide news reporting in Taiwan's local newspapers after the arrival of a daily tabloid-type newspaper, Apple Daily (AD), and evaluate the impact of suicide news reporting on actual suicides and possible mutual causation. Methods: A counting process was used to estimate the intensity of daily suicide news items reported in the China Times (CT) and United Daily (UD) before and after the arrival of AD (2002--05). Poisson regression models were used to assess the impact of the intensity of suicide news reporting on the actual number of next day suicides. Granger's causation model was used to assess mutual causation between suicide news reporting and actual suicides. Results: There was a significant increase in reporting intensity of suicide news in the UD soon after the entry of the AD into Taiwan's media market, while a delayed increase of approximately 1 year was observed in the CT. After the arrival of the AD, the reporting intensity in the UD was significantly related to the occurrence of actual suicides (p<0.05), even after controlling for social variables, whereas no significant correlation was previously observed. Mutual causation between suicide news reporting and actual suicides was also observed. Conclusions: The presence of the AD in Taiwan has fuelled competitive reporting of suicide news among traditional newspapers. This increase in the intensity of suicide news reporting has consequently had an impact on the actual number of suicides. This provides further empirical support for improving media reporting as a key element in suicide prevention. [ABSTRACT FROM AUTHOR]

Background: Differences and similarities were examined of suicide in Hong Kong, Beijing and Taiwan, the populations of which are all ethnically Chinese and share some characteristics of culture but which have very different social and political environments.Methods: The official death statistics were used for the periods 1981-94 (Hong Kong and Taiwan) and 1987-94 (Beijing).Results: Hong Kong has experienced a slight increase in suicide rate, whereas a significant decline was observed in Taiwan and Beijing. The suicide rates in all three increased with age, the rate among the elderly being four to five times the average. A relatively low male: female ratio (1.0-1.9) was also observed. Jumping and hanging were the most common methods of suicide in Hong Kong and Taiwan, respectively. Hong Kong had the most years of potential life lost.Conclusions: Despite the remarkable economic growth in all three places during the study period, the differences in suicide trends suggest that the social and political environments may be more important than the economic environment in suicide. In Hong Kong the suicide rate is likely to remain high or even to increase. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about a study which examined the impact of charcoal-burning suicide on suicide sex ratios in Taiwan and Hong Kong.

Background: Older adults worldwide are at a greater risk of suicide than other age groups. There is a scarcity of prospective studies exploring risk factors for suicide in older people and their discriminative ability to identify future suicide.Methods: We examined a prospective cohort of senior Taipei City residents between 2005 and 2009 (N=101,764). Cox proportional hazards regression analysis was used to determine significant risk factors and to construct a predictive score. The accuracy of the derived score in the prediction was tested by Receiver Operating Characteristic analysis.Results: Male sex (Hazard Ratio [HR]=3.41, p<0.001), lower education (HR=3.31, p<0.001) and lower income (HR=2.52, p=0.01) were associated with an increased risk of suicide, as well as depressed mood (HR=1.44, p=0.02; per unit increase in a 4-point scale) and insomnia (HR=1.30, p=0.03; per unit increase in a 4-point scale). The derived prediction score yielded a sensitivity of 0.63 a specificity of 0.73 and an area under curve of 0.73. Removing depressed mood from the prediction model did not significantly alter suicide predictability (P=0.11).Limitations: The dataset examined did not contain information regarding to important risk factors such as substance misuse and prescribed medications and the measures of mental health were relatively limited.Conclusion: Prediction of suicide based on factors recorded in a routine health screen of elderly people was unsatisfactory; the strongest predictors were factors that cannot be easily altered. Further understanding of how the socioeconomic condition of seniors contributes to suicide may provide valuable insights for intervention targeting this growing population-at-risk. [ABSTRACT FROM AUTHOR]