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Psychiatric history modifies the gender ratio of suicide: an East and West comparison

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Abstract

Objective

Gender ratios of suicide rates differ greatly across countries. Victoria has a high male:female ratio in suicide that is typical in English-speaking and European countries, while in Hong Kong the low ratio is similar to other SouthEast Asian countries. This study investigates the effect of gender in the psychiatric and non-psychiatric populations to examine how psychiatric history may modulate the effect of gender in these two different communities.

Method

Review of coronial documentation of all suicide cases in 2000 in Hong Kong and Victoria, Australia. Log-linear model was used to test the gender-psychiatric history-location interaction.

Results

Gender difference in suicide was narrower in victims with psychiatric history than those without in both communities, albeit gender remained to have an effect even among those with a psychiatric history in Victoria. The impact of cultural- and gender-specific factors is most apparent in suicide cases with no prior psychiatric history in Victoria: the male:female ratio was as high as 8:1 in this group of victims. Log-linear model results show that the gender-psychiatric history-location interaction was statistically significant.

Conclusions

The gender differentials in suicide rates in these two communities are mainly driven by gender’s effect in the population with no psychiatric history. Severe clinical conditions can override some, but not all, of gender’s effects in Victoria. Suicide prevention effort should target gender-specific factors to prevent suicides in men without history of psychiatric disorders.

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Acknowledgments

The authors would like to thank the Coroner’s courts in Hong Kong and Victoria for approving and assisting the data collection. We thank Will Lee, Michael Wong, Rhoda Cheung, Jade Au Brian Ip and Annette Graham for their assistance in data collection. We would also like to thank the Hong Kong Department of Health, HP Yuen from the University of Melbourne, Phil Barelli from the Information Development and Analysis Service Monitoring and Review Unit and Mr. Bill MacDonald from the Manager CAMHS and Youth Mental Health, Mental Health Branch of the Australian Government for their assistance in retrieving patient statistics in Hong Kong and Victoria.

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Authors and Affiliations

  1. Institute of Social and Economic Research and Policy, Columbia University, New York, NY, USA

    Ka Y. Liu

  2. Dept. of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong

    Eric Y. H. Chen

  3. Austin Health, Heidelberg, VIC, Australia

    Ada S. Z. Cheung

  4. HKJC Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong

    Paul S. F. Yip

  5. Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong

    Paul S. F. Yip

Authors
  1. Ka Y. Liu
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  2. Eric Y. H. Chen
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  3. Ada S. Z. Cheung
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  4. Paul S. F. Yip
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Corresponding author

Correspondence to Paul S. F. Yip.

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Liu, K.Y., Chen, E.Y.H., Cheung, A.S.Z. et al. Psychiatric history modifies the gender ratio of suicide: an East and West comparison. Soc Psychiat Epidemiol 44, 130–134 (2009). https://doi.org/10.1007/s00127-008-0413-2

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  • DOI: https://doi.org/10.1007/s00127-008-0413-2

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