Stressful life events, self-esteem, and suicidal ideation among three comparative samples of Chinese population

Background: China accounts for nearly a half of the suicides in the world, but little is known about the risk factors of suicidal ideation among general Chinese population. This study examines the association between stressful life events, self-esteem and suicidal ideation among three community-based samples in China: rural residents, rural-to-urban migrants and urban residents.

Methods: Representative samples of rural-to-urban migrants (n=1006) and urban residents (n=1000) were recruited in Beijing. The sample of rural residents (n=1020) was recruited from 8 provinces from where 75% of migrant sample originated. All participants completed a cross-sectional survey. Multivariate logistic regressions were employed for data analyses.

Results: Approximately 9.2% of total participants had suicidal ideation in the past 6 months, and the rate was slightly higher among urban residents and females. A significant dose-response relationship was observed between the number of stressful life events and suicidal ideation. In multivariate regression model, both stressful life events and self-esteem were significantly associated with elevated risk of suicidal ideation among three groups of participants. No moderating effect of self-esteem was observed in the relationship between stressful life events and suicidal ideation.

Conclusion: Stressful life events and self-esteem were two significant risk factors for suicidal ideation among Chinese population. Appropriate intervention and education programs that aim at reducing suicide risks need to consider these two important factors.