Aim: Compare the prevalence and associated factors of lifetime suicidal ideation, plans and attempts in the Hui and Han ethnic groups in the Ningxia Hui Autonomous Region of China.

Methods: Using a probability proportionate to size sampling method and villages (in rural areas) or neighborhoods (in urban areas) as primary sampling units, 5880 residents aged 18 and over were sampled. Face-to-face interviews were conducted using a computer-administered Chinese version of the World Health Organization's Composite International Diagnostic Interview. Factors associated with self-reported lifetime suicidal ideation were identified using logistic regression models.

Results: Of the 4789 (81.4%) persons who completed the survey, the lifetime prevalence of suicidal ideation, suicidal plans and suicide attempts were 5.30% (95% confidence interval [CI]=4.66-5.93%), 1.52% (CI=1.17-1.86%), and 0.77% (CI=0.52-1.02%), respectively. The age standardized rate of lifetime suicidal ideation and lifetime suicidal planning were significantly higher in the largely Muslim Hui ethnic group (n=1955) than in the largely atheist Han ethnic group (n=2834); the lifetime prevalence of suicide attempt was also higher in the Hui group, but only at the trend level (p=0.20). Factors independently associated with lifetime suicidal ideation were female gender (odds ratio [OR]=2.07), being divorced or widowed (OR=2.02), rural residence (OR=1.95), mood disorder in the prior year (OR=1.96), other mental disorder in the prior year (OR=2.99), and self-reported poor physical health in the prior year (OR=2.21). After adjustment for these factors, ethnicity was not independently associated with lifetime suicidal ideation, but stratified analyses by ethnic group found some differences in the factors associated with lifetime suicidal ideation between Hui and Han respondents.

Conclusions: Contrary to previous studies, we found that lifetime suicidal ideation was more common in a Muslim ethnic group than in a non-Muslim ethnic group of Ningxia, but this difference did not persist in the multivariate analysis after adjusting for gender, mental disorders and other factors.