adult suicide in hong kong sar n.
Skip this Video
Loading SlideShow in 5 Seconds..
Adult Suicide in Hong Kong SAR 香港的成人自杀 PowerPoint Presentation
Download Presentation
Adult Suicide in Hong Kong SAR 香港的成人自杀

Loading in 2 Seconds...

play fullscreen
1 / 35

Adult Suicide in Hong Kong SAR 香港的成人自杀 - PowerPoint PPT Presentation

  • Uploaded on

Adult Suicide in Hong Kong SAR 香港的成人自杀. Sandra Chan Associate Professor Department of Psychiatry The Chinese University of Hong Kong 香港中文大学 精神科学系陈秀雯副教授. Completed suicide 自杀已遂. Sources of Mortality statistics in HK- A surveillance system enforced by Judicial System.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Adult Suicide in Hong Kong SAR 香港的成人自杀' - felicia

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
adult suicide in hong kong sar

Adult Suicide in Hong Kong SAR香港的成人自杀

Sandra Chan

Associate Professor

Department of PsychiatryThe Chinese University of Hong Kong



sources of mortality statistics in hk a surveillance system enforced by judicial system
Sources of Mortality statistics in HK-A surveillance system enforced by Judicial System

As part of the Judicial System of HK, there exists a long-standing mandatory death enquiry system (Coroner’s Inquest) to investigate :

  • “Dead-on-arrival” at the Emergency Room;
  • “Deaths occurring within 24 hours of admission to hospital”;
  • Suspected murder;
  • Suspected suicide;
  • Dead body found in public places or private premises;
  • Deaths occurring in hospital anytime after admission that cannot be satisfactorily explained by known medical conditions;

The Coroner’s court works closely with the Police Department, Forensic Pathologist and Clinical Pathologist who gather information related to the circumstances surrounding death.




II) 入院二十四小时内死亡;

III) 怀疑谋杀;

IV) 怀疑自杀;

V) 在公众或私人地方发现尸体;

VI) 住院期间任何死亡(不能用已知的医疗情况合理地解释 )


closer look at trend in suicide rates by age groups from 1990 2005
Closer look at trend in Suicide Rates (by Age Groups) from 1990-2005

Census and Statistics Dept of HKSAR

leading causes of death in hk
Leading causes of death in HK香港主要死亡原因
  • Malignant neoplasm 恶性肿瘤- 31.8%
  • Cardiac Diseases 心脏病- 15.7%
  • Cerebrovascular Diseases 脑血管疾病- 9.2%
  • Pneumonia 肺炎 - 9.9%
  • COPD慢性阻塞性肺病- 5.7%
  • Renal Diseases肾病- 3.2%
  • Suicide自杀- 2.8%
  • Others其它- 7.5%
who suicide statistics
WHO Suicide Statistics世卫自杀统计
  • According to the latest statistics from WHO, the average global suicide rate is 14/100,000.全球平均自杀率为14/100,000
  • HK ranks 24th while China (rates in selected areas) ranks 27th among 100 countries.在100个国家中,香港排行第二十四,而中国(选择地区)排行第二十七。
  • All top 8 ranking countries are from East Europee.g. Lithuania 38.6/100,000; Hungary 27.7/100,000; Latvia 24.3/100,000).首八位国家都在东欧(例如:立陶宛38.6/100,000;匈牙利27.7/100,000;拉脱维亚24.3/100,000)。
  • Japan ranks 8th (24/100,000), which is highest among Asian countries, followed by Sri Lanka (21.6/100,000) and Korea (17.9/100,000).日本排行第八,是亚洲区中最高,其后是斯里兰卡和韩国。
  • Finland ranks 12th, highest ranking among North European countries (20.6/100,000).


trend in suicide methods in hk
Trend in Suicide methods in HK香港自杀方法趋势
  • Jumping from height (40-60%) across all age groups ever since late 1970’s


  • Hanging- second commonest method in over 55 yrs old (30%)


  • Charcoal burning- second commonest method adopted by 15-55 yrs old (accounted for 1/3 suicide deaths since 2001)


Risk factors for completed suicide in adult population in HK-evidence from a recent case-control psychological autopsy study
  • 150 suicide deceased ( death occurring in 2002-04) aged 15-59 were studied using psychological autopsy method (semi-structured diagnostic interview and psychosocial enquiry with proxy-informant); 150 living controls matched by age and gender were randomly selected from a representative pre-selected community sample involved in another epidemiologic survey.
  • Factors found to significantly and independently contribute to suicide were:

Unemployment, indebtedness, being single, psychiatric illness and history of past attempts

(Chen et al, 2006 in Psychological Medicine)

  • 用心理剖析法来研究150位年龄由15至59岁的自杀死者(用半结构诊断访问及心理社会查询来访问死者近亲)而另外150位对照人士亦与死者年龄及性别配合,从社区中随机抽样选出来。
  • 独立地引致自杀的重要因素包括:


(Chen et al, 2006 in Psychological Medicine)

adjusted parameter estimates of risk factors in a logistic regression model p 0 01 p 0 001
Adjusted parameter estimates of risk factors in a logistic regression model (** p<0.01; *** p,0.001)

Chen et al, 2006 in Psychological Medicine

Logistic regression showing the attributable risk for completed suicide by DSM IV Psychiatric Diagnoses

Chan et al, unpublished data



(明报) 2007年09月 21日星期五 05:10AM



charcoal burning suicide in hk
Charcoal burning suicide in HK香港烧炭自杀

First index case in Nov 1998. Largely publicized by media;

Review of Coroners’ record on charcoal burning deaths (Lee et al, 2000) showed that 60% were faced with financial debts and most victims had no prior history of psychiatric illness; this view is substantiated by an ethnographic study on a middle-aged suicide attempters who survived after charcoal burning (Chan et al 2005)


回顾死因裁判法庭关于烧炭死亡的纪录(Lee et al, 2000)显示60%面对债务,很多受害者之前没有精神病历,这种看法后来在中年企图烧炭自杀人士获救后的研究得以被证实(Chan et al, 2005)。

sociodemograhic profile of charcoal burning victims results from the recent pa study
Sociodemograhic profile of charcoal burning victims- results from the recent PA study

Chan et al, unpublished data

psychiatric profile of charcoal burning victims results from the recent pa study
Psychiatric profile of charcoal burning victims- results from the recent PA study

Chan et al, unpublished data

health care utilization pattern in the psychological autopsy cohort
Health care utilization pattern in the psychological autopsy cohort
  • Among the 121 suicide victims with Axis I diagnoses, 60% had attended clinicians and 43% had received treatment from psychiatrists in the six months before death.
  • The overall service contact rate is similar to other case-control PA studies (25-60%).
  • Among the 52 suicide decedents who had seen psychiatrists in their last 6 months, 33% had their last appointments within one week before death and 62% had their last appointment within one month.
  • 在121自杀死者有主轴I诊断中60%曾看医生及43%在死前六个月曾接受精神科医生诊治。
  • 整体使用率与其它心理剖析研究相近。
  • 在52位过去六个月曾看精神科医生的自杀死者中,有33%曾在死前一个星期覆诊,而62%曾在一个月内覆诊。80%自杀死者有精神分裂征状,死前六个月看过精神科医生。
Eighty percent of suicide decedents with schizophrenic spectrum disorder had seen psychiatrists in their last 6 months of life. In cases with Mood (Major Depressive Disorder, current episode or lifetime diagnosis, Bipolar Affective Disorder) and Neurotic Spectrum Disorder, less than 50% had consulted with psychiatrists from the public and private sector in their last 6 months of life.
  • Fewer suicide decedents Alcohol Misuse Disorder (20%) and Substance Misuse Disorder (33%) had consulted psychiatrists in the 6 months before death.

(Chan et al, unpublished data)

  • 很少自杀死者是酗酒(20%)或滥用药物(33%)曾经在死前六个月看过精神科医生。

(Chan et al, unpublished data)

epidemiology of attempted suicide in hk
Epidemiology of attempted suicide in HK香港企图自杀的流行情况
  • No accurate statistics on prevalence of attempted suicide;
  • Estimates from HA figures - 10 times the number of completed suicide occurring in the territory
  • 没有准确统计香港企图自杀的流行状况;
  • 根据医院管理局的估计数字,数目大约是自杀已遂的10倍。
access to professional help in hk
Access to professional help in HK香港寻求专业协助的方法

Hospital-based mental/general medical health service

Primary care in private sector

Psychiatric specialists’ care in private setting

NGO hotlines

Social welfare department- family services centre






Clinical correlates of suicide attempters (observations from a suicide attempters’ cohort presented to a regional service in 2004; N=71)
  • Female= 63%; Male= 37%
  • Mean age= 35 yrs +/- 12
  • Method: DO (59%); Wrist laceration (20%); Jumping from height (20%); charcoal burning (11%)
  • DSM-IV Psych Dx- Adjustment disorder (35.2%); MDD/Dysthymia (47.8%); Bipolar Affective Disorder (1.4%); SA/Alcohol Misuese disorder (11%); Schizophrenic spectrum disorder (15.5%); Anxiety disorder (2.8%)

(Chan & Pang, 2006 in HK J of Psychiatry)

2004 n 71
  • 女=63%;男=37%
  • 平均年龄=35岁+/-12
  • 方法:服食药物(59%);割腕(20%);高处堕下(20%);烧炭(11%)
  • 精神科诊断:适应失调(35.2%);抑郁症(47.8%);躁郁症(1.4%);滥用药物/酗酒(11%);精神分裂症(15.5%)焦虑症(2.8%)

(Chan & Pang, 2006 in HK J of Psychiatry)


Macro-economic correlates of ups and downs in suicide rates

*Global financial crisis and blow to the local stock/property market in 1998;

*2003 SARS Epidemic (relatively well-defined natural disaster with territory-wide effect due to the community quarantine happening at that time, the persistence of economic downturn as well as disruptions in other social infrastructure such as health care services)

*from 1970s’ onwards, there have been rapid expansions of social welfare sector and govt-funded health care services ( including mental health service)

Any speculations in such direction is prone to ecological fallacy.







Two Poisson Regression Models of non-elder suicide rates from 1986-2003 using 1986 and 2003 as years of reference respectively
Gross inspection shows that the suicide rate of the population under age 65 has remained between 8 and 10 per100,000 from 1986 to 1999. There was a steady rise in suicide rate from 2000 onwards, reaching 15.26 per 100,000 in 2003.
  • Poisson regression of annual suicide rates in the population under 65 years of age using 1986 as the reference year shows that suicide rates in 1986-1997 do not differ significantly from the reference year, while rates in 1998-2003 are on the rise, with an IRR of 1.15-1.62 relative to the reference year, reaching statistically significant levels.
  • Despite the rising trend in 1998-2003, the difference in suicide rate in the non-elder population in 2002 and 2003 does not reach statistical significance when Poisson Regression is run using 2003 as the reference.

(Chan et al, 2006. In International J of Geriatric Psychiatry)

  • 以1986年作为参考年份,65岁以下全年整体自杀率的Poisson regression,1986-1999年自杀率并非有重大不同于参考年份,当自杀率在1998-2003上升,IRR1.15-1.62相对参考年份,达到统计学上有效程度。
  • 虽然上升趋势在1998-2003,当用2003年作Poisson Regression,2002年非长者人口的自杀率与2003年相比不能得出统计有效。

(Chan et al, 2006. In International J of Geriatric Psychiatry)




societal forces






Attempted suicide


Individual factors

e.g. psychiatric disorders,

drug abuse



cognitive style






Local factors

e.g. social support,

family psychopathology,

local and family resources,

local cultural norms







Coroner’s Office, Government of HKSAR

Forensic Pathology Service, Dept of Health

Centre for Suicide Research and Prevention, University of Hong Kong

Professor Helen Chiu, Suicide Research Unit, The Chinese University of Hong Kong