A study of attempted suicides in urban versus rural areas, with a follow-up

The group of subjects consisted of 44 patients (attempters) who were admitted to hospital for treatment because of attempted suicide during a 3-month period in Norther Savo (in Eastern Finland), another 44 patients (non-attempters) admitted to hospital in the same period for other reasons serving as controls. The number of women was the same in both groups, and so was, in consequence, the number of men. The study compared the attempters with the non-attempters and, in addition, the patients coming from urban areas with those coming from rural areas, the ratio of the urban to the rural patients being the same in both groups. The study was based on personal psychiatric interviews with the patients, which took place in each case both immediately following the patient's admission and precisely 3 months afterwards. The results showed that schizophrenia was significantly more frequent in the rural than in the urban attempter group. By contrast, alcoholism and alcohol abuse were more frequent in the urban than in the rural attempter group. Compared with the urban patients, the rural patients tended to be physically more seriously desordered. Poisoning by drugs was a significantly more frequent means of attempted suicide in the urban than in th rural group. The patients in the latter group, again, had resorted oftener to the so-called "active" methods of attempted suicide. Of the attempters, 25% attempted suicide anew during the 3-month follow-up period, the corresponding figure for the non-attempter group being only 6%. During the follow-up period, a greater number of suicidal attempts was made by the patients in the rural group than by those in the urban group, and, as regards the intent to succeed, the attempts of the former were more serious than those of the latter. The so-called "active" methods were used more often by rural than by urban patients also during the follow-up period. All in all, the self-destructive behaviour exhibited during the follow-up period was graver in the rural than in the urban group.