Association between adverse childhood experiences and suicide and attempted suicide among rural residents

Objective: To explore the association between adverse experiences in childhood and suicide and at-tempted suicide in adulthood among rural residents.Methods: Cases of suicide death, accidental injury death and attempted suicide were collected from the cause of death reporting system and general hospital suicidal behavior registry system in four agricultural counties.Healthy residents were randomly selected from three agricultural counties as the control group.Two proxy informants of each recruited participant were interviewed using a Child-hood Trauma Questionnaire (CTQ), and a self-compiled Family Maltreatment Questionnaire to gather informa-tion about the participants’adverse experiences before 16 years old and related details.Results: A total of 151 suicides, 118 suicide attempts, 157 accidental injury death, and 140 healthy controls were selected to complete the research interviews.The proportion of poor family environment before 16 years old in the suicide group(22.0%) was higher than that in the other three groups (12.7%, 8.9%, 14.4%), and the difference was statistically significant (χ²=11.03, P=0.012).The proportion of experiencing adverse events in the suicide group (34.4%) was also higher than that in the other three groups (22.9%, 19.7%, 22.7%) and the difference was statistically signifi-cant(χ²=10.40, P=0.015).After demographic variables such as gender and age were adjusted, adverse family envi-ronment before 16 years old was a risk factor for sui-cide (compared with accidental death, AOR=3.59, P=0.001; compared with attempted suicide, AOR=2.13, P=0.045), but there was no significant difference in the association with attempted suicide (AOR=0.89, P=0.768).Conclusion: Adverse family environment before16 years old increases the risk of suicide in adulthood.Improvement home environment for children and adolescents should be taken into consideration in suicide prevention strategies in rural areas.