This application from the University of Hong Kong's Hong Kong Jockey Club Centre for Suicide Research and Prevention proposes to clarify the risk and protective factors of suicidal behavior (suicide and suicide attempts) in a long-term follow-up study in a Chinese rural community-based sample of 510 individuals with schizophrenia. Major collaborative colleagues are from University of Rochester and Sichuan University (China). Suicide research and prevention for persons with schizophrenia are international public health priorities. The limited knowledge base poses a significant obstacle to the development of prevention programs. Few prospective long-term studies of persons with schizophrenia in a rural community have been conducted to determine risk and protective factors of suicidal behavior, especially in China. Given the unique characteristics of suicide and the lack of systematic psychiatric registration which allows us to study the mortality and suicide of psychiatric patients in China, this special research project should be important to explore the risk and protective factors of suicide among persons with schizophrenia. The long-term goal of this research program is to decrease suicide rates in people with schizophrenia through developing and implementing prevention strategies that target the identified risk and protective factors.
The aims of this study are, first, to examine risk and protective factors (demographic, symptoms, treatment, social support) of suicide attempts, second, to explore risk and protective factors (demographic, symptoms, treatment, social support) of suicide, thus, this study aims also to identify the difference between suicide and suicide attempts. An 11-year prospective cohort study will be conducted. This study is a combination of both a prospective and a retrospective study, and a combination of cohort and nested case control designs. The subjects of this study will include all people with schizophrenia (N=510), who live in 6 townships of Xinjin County as identified in our previous study in 1994. All subjects were over 15 years of age and met the ICD-10 diagnosis of schizophrenia. All the subjects and/or next-of-kin will be traced and interviewed in community. Information of demographic, clinical symptoms, treatment, and social support will be collected. Univariate/descriptive, bivariate comparison, and regression analysis will be used to analyze the data. Odds ratios will also be calculated for predictor variables. The major advantage of the study is reduction of the methodological problems most often encountered in the previous studies. The results of this study will be crucial for further mental health intervention and prevention of suicide among persons with schizophrenia. ? ?