The reversing trend in suicide rates in Shanghai, China, from 2002 to 2020

To explore changing patterns in suicides and provide suggestions for suicide prevention by reviewing all suicide deaths from 2002 to 2020 in Shanghai, China.

Suicide-death data were obtained from the Shanghai Death Surveillance System and analyzed in terms of year, sex, age group, area, suicide method, and depression diagnosis. Joinpoint regression analyses were conducted to examine time trends in suicide rates.

The age-adjusted suicide rate was 6.15/100,000 in 2002 and 5.10/100,000 in 2020. The change in this rate was U-shaped, with a downward trend before 2009 followed by an upward trend. The rate initially decreased by 6.33% annually (95% confidence interval [95%CI]: 4.25-8.37%) but, after 2009, increased by 2.60% annually (95%CI: 1.49-3.71%). Similar trends were found for men and women, the 0-29y and 30-49y age groups, and residents of central and suburban areas, respectively. In 2020, jumping from a high place was the leading suicide method (39.54%), and 22.54% of suicide victims had a diagnosis of depression.

Suicides may be misclassified in coding (however, provided misclassification rates remain stable, this should not influence overall trends). Suicides among temporary residents were not included because of inadequate stratified population data. The finding of a higher prevalence of depression may have been impacted by a higher detection rate.

The post-2002 decline in Shanghai suicide rates reversed in 2009, and the suicide pattern changed greatly from 2002 to 2020. With the current increasing trend in suicide rates, targeted suicide-prevention strategies featuring multi-departmental cooperation are necessary.