Space–time self-harm and suicide clusters in two cities in Taiwan
Abstract Aims Suicidal acts may cluster in time and space and lead to community concerns about further imitative suicidal episodes. Although suicide clusters have been researched in previous studies, less is known about the clustering of non-fatal suicidal behaviour (self-harm). Furthermore, most pr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-01-01
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| Series: | Epidemiology and Psychiatric Sciences |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796023000513/type/journal_article |
| _version_ | 1797814475869388800 |
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| author | Fang-Wen Lu Erica Conway Ya-Lun Liang Ying-Yeh Chen David Gunnell Shu-Sen Chang |
| author_facet | Fang-Wen Lu Erica Conway Ya-Lun Liang Ying-Yeh Chen David Gunnell Shu-Sen Chang |
| author_sort | Fang-Wen Lu |
| collection | DOAJ |
| description | Abstract
Aims
Suicidal acts may cluster in time and space and lead to community concerns about further imitative suicidal episodes. Although suicide clusters have been researched in previous studies, less is known about the clustering of non-fatal suicidal behaviour (self-harm). Furthermore, most previous studies used crude temporal and spatial information, e.g., numbers aggregated by month and residence area, for cluster detection analysis. This study aimed to (i) identify space–time clusters of self-harm and suicide using daily incidence data and exact address and (ii) investigate the characteristics of cluster-related suicidal acts.
Methods
Data on emergency department presentations for self-harm and suicide deaths in Taipei City and New Taipei City, Taiwan, were used in this study. In all-age and age-specific analyses, self-harm and suicide clusters were identified using space–time permutation scan statistics. A cut-off of 0.10 for the p value was used to identify possible clusters. Logistic regression was used to investigate the characteristics associated with cluster-related episodes.
Results
A total of 5,291 self-harm episodes and 1,406 suicides in Taipei City (2004–2006) and 20,531 self-harm episodes and 2,329 suicides in New Taipei City (2012–2016) were included in the analysis. In the two cities, two self-harm clusters (n [number of self-harm episodes or suicide deaths in the cluster] = 4 and 8 in Taipei City), four suicide clusters (n = 3 in Taipei City and n = 4, 11 and 4 in New Taipei City) and two self-harm and suicide combined clusters (n = 4 in Taipei City and n = 8 in New Taipei City) were identified. Space–time clusters of self-harm, suicide, and self-harm and suicide combined accounted for 0.05%, 0.59%, and 0.08% of the respective groups of suicidal acts. Cluster-related episodes of self-harm and suicide were more likely to be male (adjusted odds ratio [aOR] = 2.22, 95% confidence interval [CI] 1.26, 3.89) and young people aged 10–29 years (aOR = 2.72, 95% CI 1.43, 5.21) than their cluster-unrelated counterparts.
Conclusions
Space–time clusters of self-harm, suicide, and self-harm and suicide combined accounted for a relatively small proportion of suicidal acts and were associated with some sex/age characteristics. Focusing on suicide deaths alone may underestimate the size of some clusters and/or lead to some clusters being overlooked. Future research could consider combining self-harm and suicide data and use social connection information to investigate possible clusters of suicidal acts.
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| first_indexed | 2024-03-13T08:08:17Z |
| format | Article |
| id | doaj.art-5a16fb3e82584b0da8a1d93ebacded69 |
| institution | Directory Open Access Journal |
| issn | 2045-7960 2045-7979 |
| language | English |
| last_indexed | 2024-03-13T08:08:17Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj.art-5a16fb3e82584b0da8a1d93ebacded692023-06-01T02:26:31ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792023-01-013210.1017/S2045796023000513Space–time self-harm and suicide clusters in two cities in TaiwanFang-Wen Lu0https://orcid.org/0000-0002-0229-9240Erica Conway1Ya-Lun Liang2Ying-Yeh Chen3David Gunnell4https://orcid.org/0000-0002-0829-6470Shu-Sen Chang5https://orcid.org/0000-0001-5012-1132Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, TaiwanInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan Global Health Program, College of Public Health, National Taiwan University, Taipei, TaiwanInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, TaiwanTaipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan Institute of Public Health and Department of Public Health, National Yang-Ming Chiao Tung University, Taipei, TaiwanCentre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, UKInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanAbstract Aims Suicidal acts may cluster in time and space and lead to community concerns about further imitative suicidal episodes. Although suicide clusters have been researched in previous studies, less is known about the clustering of non-fatal suicidal behaviour (self-harm). Furthermore, most previous studies used crude temporal and spatial information, e.g., numbers aggregated by month and residence area, for cluster detection analysis. This study aimed to (i) identify space–time clusters of self-harm and suicide using daily incidence data and exact address and (ii) investigate the characteristics of cluster-related suicidal acts. Methods Data on emergency department presentations for self-harm and suicide deaths in Taipei City and New Taipei City, Taiwan, were used in this study. In all-age and age-specific analyses, self-harm and suicide clusters were identified using space–time permutation scan statistics. A cut-off of 0.10 for the p value was used to identify possible clusters. Logistic regression was used to investigate the characteristics associated with cluster-related episodes. Results A total of 5,291 self-harm episodes and 1,406 suicides in Taipei City (2004–2006) and 20,531 self-harm episodes and 2,329 suicides in New Taipei City (2012–2016) were included in the analysis. In the two cities, two self-harm clusters (n [number of self-harm episodes or suicide deaths in the cluster] = 4 and 8 in Taipei City), four suicide clusters (n = 3 in Taipei City and n = 4, 11 and 4 in New Taipei City) and two self-harm and suicide combined clusters (n = 4 in Taipei City and n = 8 in New Taipei City) were identified. Space–time clusters of self-harm, suicide, and self-harm and suicide combined accounted for 0.05%, 0.59%, and 0.08% of the respective groups of suicidal acts. Cluster-related episodes of self-harm and suicide were more likely to be male (adjusted odds ratio [aOR] = 2.22, 95% confidence interval [CI] 1.26, 3.89) and young people aged 10–29 years (aOR = 2.72, 95% CI 1.43, 5.21) than their cluster-unrelated counterparts. Conclusions Space–time clusters of self-harm, suicide, and self-harm and suicide combined accounted for a relatively small proportion of suicidal acts and were associated with some sex/age characteristics. Focusing on suicide deaths alone may underestimate the size of some clusters and/or lead to some clusters being overlooked. Future research could consider combining self-harm and suicide data and use social connection information to investigate possible clusters of suicidal acts. https://www.cambridge.org/core/product/identifier/S2045796023000513/type/journal_articleepidemiologymental healthrisk factorsscan statisticsself-harmsuicidesuicide clusterTaiwan |
| spellingShingle | Fang-Wen Lu Erica Conway Ya-Lun Liang Ying-Yeh Chen David Gunnell Shu-Sen Chang Space–time self-harm and suicide clusters in two cities in Taiwan Epidemiology and Psychiatric Sciences epidemiology mental health risk factors scan statistics self-harm suicide suicide cluster Taiwan |
| title | Space–time self-harm and suicide clusters in two cities in Taiwan |
| title_full | Space–time self-harm and suicide clusters in two cities in Taiwan |
| title_fullStr | Space–time self-harm and suicide clusters in two cities in Taiwan |
| title_full_unstemmed | Space–time self-harm and suicide clusters in two cities in Taiwan |
| title_short | Space–time self-harm and suicide clusters in two cities in Taiwan |
| title_sort | space time self harm and suicide clusters in two cities in taiwan |
| topic | epidemiology mental health risk factors scan statistics self-harm suicide suicide cluster Taiwan |
| url | https://www.cambridge.org/core/product/identifier/S2045796023000513/type/journal_article |
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