{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:44:24Z","timestamp":1791909864078,"version":"4.3.4"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:00:00Z","timestamp":1587686400000},"content-version":"unspecified","delay-in-days":114,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796020000335_sec_a1\" sec-type=\"other\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Loneliness is increasingly recognised as a serious public health issue worldwide. However, there is scarce research addressing the association between loneliness and suicide in older adults in rural China. We set out to examine loneliness and other psychosocial factors in elderly suicide cases and explore their interaction effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796020000335_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a 1 : 1 matched case\u2013control design, data were collected from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including demographic characteristics, loneliness, depression, hopelessness and social support. The chi-square automatic interaction detection (CHAID) tree model and multivariable logistic regression analysis were used to explore the relationships of these factors and suicide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796020000335_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The CHAID tree model showed that loneliness, hopelessness and depressive symptoms were closely associated with completed suicide and that loneliness and hopelessness interacted with each other. The result of multivariable logistic regression showed that individuals who were unemployed [odds ratio (OR) = 2.344; 95% confidence interval (CI): 1.233\u20134.457], living alone (OR = 2.176; 95% CI: 1.113\u20134.254), had lower levels of subjective social support (OR = 2.185; 95% CI: 1.243\u20133.843), experienced depressive symptoms (OR = 6.700; 95% CI: 3.405\u201313.182), showed higher levels of hopelessness (OR = 7.253; 95% CI: 3.764\u201313.974) and felt higher levels of hopelessness \u00d7 higher levels of loneliness (OR = 2.446; 95% CI: 1.089\u20135.492) were significantly associated with an elevated suicide risk in older people in rural China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796020000335_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Regular evaluation of loneliness, hopelessness and depression can help detect older adults who are at risk of committing suicide. Interventions should target social support systems, particularly among people living alone, to alleviate feelings of loneliness and hopelessness. Treating depression is also key to preventing suicide among elderly people in rural China.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796020000335","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T03:59:29Z","timestamp":1587700769000},"source":"Crossref","is-referenced-by-count":71,"title":["Loneliness, hopelessness and suicide in later life: a case\u2013control psychological autopsy study in rural China"],"prefix":"10.1017","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6945-4412","authenticated-orcid":false,"given":"Lu","family":"Niu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cunxian","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dexing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3207-7419","authenticated-orcid":false,"given":"Liang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,4,24]]},"reference":[{"key":"S2045796020000335_ref49","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171800106X"},{"key":"S2045796020000335_ref48","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.12325"},{"key":"S2045796020000335_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(93)71928-3"},{"key":"S2045796020000335_ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0882-4"},{"key":"S2045796020000335_ref41","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010914"},{"key":"S2045796020000335_ref9","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1176\/ajp.153.8.1001","article-title":"Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study","volume":"153","author":"Conwell","year":"1996","journal-title":"American Journal of Psychiatry"},{"key":"S2045796020000335_ref37","doi-asserted-by":"publisher","DOI":"10.1037\/a0018697"},{"key":"S2045796020000335_ref44","doi-asserted-by":"publisher","DOI":"10.1097\/01.NMD.0000081613.03157.D9"},{"key":"S2045796020000335_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.07.043"},{"key":"S2045796020000335_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/1099-1166(200102)16:2<155::AID-GPS289>3.0.CO;2-0"},{"key":"S2045796020000335_ref35","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12398"},{"key":"S2045796020000335_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1943-278X.2011.00073.x"},{"key":"S2045796020000335_ref3","doi-asserted-by":"publisher","DOI":"10.1080\/13811110802572221"},{"key":"S2045796020000335_ref38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016091"},{"key":"S2045796020000335_ref2","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2017.1392981"},{"key":"S2045796020000335_ref13","first-page":"352","article-title":"Lonely sunsets: impacts of rural\u2013urban migration on the left-behind elderly in rural China","volume":"20","author":"He","year":"2014","journal-title":"International Journal of Population Geography"},{"key":"S2045796020000335_ref32","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2018.27"},{"key":"S2045796020000335_ref18","first-page":"119","article-title":"An exploratory technique for investigating large quantities of categorical data","volume":"29","author":"Kass","year":"1980","journal-title":"Journal of the Royal Statistical Society, Series C: Applied Statistics"},{"key":"S2045796020000335_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11681-3"},{"key":"S2045796020000335_ref15","unstructured":"Hu, C (2016) Ideation Detection Rate Risk Factors for Suicide Ideation Among Elderly People Living Alone of the Rural Area of Anhui Province (Master's thesis). 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