A Study of the Characteristics of Suicide Notes in China

Abstract

Background: Suicide notes in China are rarely studied and seldom available. Aims: This study examines the characteristics of suicide note leavers and analyzes the contents of their suicide notes for the period of 2004–2016 in Pudong, Shanghai, which has more than 5.5 million inhabitants. Method: The characteristics of the note leavers (n = 458) and those who left no notes (n = 1949) were compared. Four major groupings of the suicide note content were identified, namely, addressees, mandates/requests, expressions, and difficulties. Results: Only 19.0% of the deceased left suicide notes and they were characterized by having no diagnosed psychiatric illnesses, being in debt, having a high education level, having made no previous suicide attempts, and having used suicide methods that required preparation. Wanting to hide their suicide information was not uncommon for these individuals (9.7%). Adolescents were likely to mention a negative interpersonal relationship with someone (27.4%). Illnesses/pain was frequently mentioned by adults (33.4%) and older people (61.5%). Limitations: Many features of suicide notes, e.g., interpersonal features of suicides, were not examined. Conclusion: Education level might be a key factor influencing the likelihood of leaving suicide notes. Most people who left suicide notes showed a negative attitude toward suicidal behavior. The myth of an afterlife should also be addressed.