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Objective: This present study aims to estimate the structural validity, internal consistency reliability of the LSNS-6 and examine the associations between the LSNS-6 and suicidal outcomes among mainland Chinese older adults., Methods: This validation study used a big representative sample (N = 2819) of older adults in Beijing from the Sample Survey on Aged Population in Urban/Rural China. Confirmatory factor analyses (CFA) were applied to examine the factor structures of the Chinese version of LSNS-6. Internal consistency reliability of the LSNS-6 was examined by Cronbach's alpha coefficient and the corrected item-total correlation. Logistic regression analyses were used to explore the associations between the LSNS-6 and late-life death wishes, suicidal ideation in mainland Chinese., Findings: This present study showed good internal consistency and consistent factor structure of the LSNS-6 as well as its subscales. The present data demonstrated the LSNS-6 could be a useful tool for assessing social networks among older mainland Chinese. Interestingly, among the mainland Chinese, late-life suicidality was highly associated with the LSNS-6 family subscale, rather than the friends subscale., Conclusion: The LSNS-6 could be a useful tool for assessing social networks among older mainland Chinese. In addition, suggestion is made to improve social networks, especially in family bonds and support, as a promising strategy in reducing late-life suicide risks in mainland China., Competing Interests: The authors have declared that no competing interests exist.

Objectives: Studies have highlighted the association between the degree of urbanicity and spatial disparities in suicide, but few have evaluated its changes across time. We explored the geospatial trends of suicide in South Korea from 1992 to 2012, and their relationship to the nation's evolving urbanicity., Setting: South Korea., Primary Outcome Measures: Age-sex-specific suicide rate., Results: Suicide rates increased in all regions of South Korea during the study period. Controlling the effects of age and sex, there was an overall inverse relationship between the degree of urbanicity and regional suicide rates. These associations were, however, attenuated across the periods, as there were smaller increases in suicide rates in mid-sized urban regions as compared to larger cities and to rural areas. Increases over time in the suicide rates among youth and working-age adults were greater in large urban centres and in rural regions. For elders, the increase was far greater in rural regions., Conclusions: The association of urbanicity and the geospatial pattern of suicide in South Korea was a dynamic process and varied by age groups across the course of two decades. Internal migration and related social processes most likely contributed to these changes., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Introduction: The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death., Method: We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated., Results: We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes., Conclusion: Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.

With some exceptions, literature has consistently shown that divorced populations are at higher risk for suicide than married ones. Here we make use of coefficients of aggravation (COAs), suicide rate ratios of the divorcees over the married, to study patterns of COAs and test the contribution of international sociocultural factors and gender to the relationship between divorce and suicide. We conducted a systematic search of electronic databases to identify ecological studies reporting suicide rates and ratios of those rates within different marital statuses between Jan 1, 2000 and Dec 31, 2013. In total, ten studies consisting in suicide statistics of eleven countries/areas were selected. Using random-effect modeling, we noted that the pooled COA for men and women were 3.49 (95% CI 2.43-4.56) and 3.15 (95% CI 1.74-4.56), suggesting both divorced men and women exhibited a greater risk of suicide than their married counterparts. Subgroup analyses revealed that COAs in Asian countries are significantly higher than those in non-Asian ones. Among the sociocultural measures retrieved from the HOFSTEDE index and the World Values Surveys, we noted significant associations between COA and four measures, including the individualism-collectivism score, the long-term orientation scores, the survival/self-expression score, and the gender inequality indices. The magnitudes and the directions of the associations however differ by sex. The results confirm that overall divorced people have an aggregate higher suicide risk than married ones. The method used in our research could reveal what cultural indicators are exerting effect on the relationship between divorce and suicide risk, which might change with sociocultural transition. More investigation into the relationships and then the construction of culturally appropriate suicide prevention policy is recommended., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Multiple studies have shown that macroeconomic factors are associated with changes in suicide rates. We investigated how changes in economic conditions associated with the recent economic crisis in South Korea influenced suicide rates among working-age adults., Methods: Time-series analyses were performed to examine the temporal associations of national unemployment rates and sex-employment-specific suicide rates in South Korea from 2003 to 2011, with particular attention to the increases of suicides that occurred during the recessionary period that began in 2008. We also compared the relative risk of suicide among different occupations., Results: National unemployment rates were positively associated with suicide rates among employed and unemployed men and women, with a 2-month to 3 month lagged period. Significant increases of suicide rates among working-age adults during the recession were detected in most of the subgroups stratified by age, sex and employment status. Forty-three per cent of the increase of suicides was derived from the employed population. Compared with workers in elementary occupations, the relative risk of suicide for mangers increased by threefold during the recessionary period. Among those who were employed, half of the increases in suicides occurred among clerks and workers involved in sales and services., Conclusions: Changes in macroeconomic conditions are tied to population-level suicide risks for employed and unemployed persons. However, these associations vary depending on sex, employment status and occupational roles. In advance of future economic crises, it is important to develop prevention initiatives intended to reach the diverse populations potentially exposed to the adverse effects of sudden economic disruptions.

Unlike other East Asian countries, South Korea has until recently experienced relatively few charcoal burning suicides. We investigated trends in charcoal burning suicide immediately following the suicide by charcoal burning of the South Korean celebrity-Ahn Jae-Hwan-in September 2008. In the study, we compared the weekly number charcoal burning suicides 1 year before and after the celebrity's death. Before Ahn Jae-Hwan's suicide, charcoal burning accounted for <1% of suicides; his death was followed by an immediate and sustained increase in the use of this method-it accounted for nearly 5% of suicides (n = 772 suicides) in the subsequent 12 months. The demographic patterning (young male predominance) and location (inside cars) of the charcoal burning suicides further supported a copy-cat effect. Ahn Jae-Hwan's death appears to have triggered a rapid and sustained adoption of charcoal burning as a method of suicide in South Korea.