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Introduction In the U.S., state-level household firearm ownership is strongly associated with firearm suicide mortality rates. Whether the recent increases in firearm suicide are explained by state-level household firearm ownership rates and trends remains unknown. Methods Mortality data from the U.S. National Vital Statistics System and an estimate of state-level household firearm ownership rate were used to conduct hierarchical age–period–cohort (random-effects) modeling of firearm suicide mortality between 2001 and 2016. Models were adjusted for individual-level race and sex and for state-level poverty rate, unemployment rate, median household income in U.S. dollars, population density, and elevation. Results Between 2001 and 2016, the crude national firearm suicide mortality rate increased from 6.8 to 8.0 per 100,000, and household firearm ownership rate remained relatively stable, at around 40%. Both variables were markedly heterogeneous and correlated at the state level. Age–period–cohort models revealed period effects (affecting people across ages) and cohort effects (affecting specific birth cohorts) underlying the recent increases in firearm suicide. Individuals born after 2000 had higher firearm suicide rates than most cohorts born before. A 2001–2006 decreasing period effect was followed, after 2009, by an increasing period effect that peaked in 2015. State-level household firearm ownership rates and trends did not explain cohort effects and only minimally explained period effects. Conclusions State-level firearm ownership rates largely explain the state-level differences in firearm suicide but only marginally explain recent increases in firearm suicide. Although firearms in the home increase firearm suicide risk, the recent national rise in firearm suicide might be the result of broader, more distal causes of suicide risk.

BACKGROUND: Ongoing surveillance of the means of suicide is necessary for effective prevention. We examined how mortality rates owing to different means of suicide changed in Canada from 1981 to 2018. METHODS: We obtained data from 1981 to 2018 on suicide deaths of individuals aged 10 years and older, from the Canadian Vital Statistics Death Database. We used joinpoint regression analysis to examine changes over time in the suicide mortality rate for the 3 most common means of suicide. RESULTS: The age-standardized suicide mortality rate declined in earlier decades for both sexes, but did not significantly change in recent decades for either sex. The age-standardized rate of suicide by suffocation increased from 1993 for females (2.1% per year) and from 1996 for males (0.4% per year). The age-standardized rate of suicide by poisoning decreased for females (2.2% per year) and males (2.1% per year) from 1981 to 2018. The age-standardized rate of suicide by firearm decreased from 1981 to 2008 (7.4% per year) but did not significantly change there-after for females; for males, it decreased 2.1% per year from 1981 to 1993 and 5.7% per year from 1993 to 2007, but did not significantly change thereafter. INTERPRETATION: For both sexes, the rate of suicide by poisoning is decreasing, the rate of suicide by suffocation is increasing, and the rate of suicide by firearm has not significantly changed in the last decade. Given the high proportion of suicide deaths by suffocation, its increasing rate and the difficulty of restricting the means of suffocation, other approaches to suicide prevention are needed.

The number of suicides has increased in the last decades in several developed countries. For instance, Spain has experienced a gradual but steady increase in suicides since the 80’s and it is currently the leading external cause of death in the country. At the same time, the dualisation of the labor market, with a strong and persistent incidence of temporary contracts, has increased the instability of employment conditions. Both developments have a stronger incidence for individuals with lower levels of education. Therefore, in this paper we use rich administrative data in order to estimate the impact of the wide spread use of temporary contracts on suicides. In order to do that we exploit a reform that liberalised the use of fix-term contracts in Spain in 1984. Our results show strong long-term effects of the reform, which increased the suicide mortality rate of affected cohorts (those entering the labor market just after the liberalisation) by at least 25.3%. We believe that this result has important policy implications and should be taken into account in the design of the national suicide prevention plans.

Fundamentos: o suicídio em idosos é um dos grandes problemas de saúde pública, que vem expressando taxas cada vez mais alarmantes pelo mundo atualmente. Objetivo: analisar o índice e taxa de mortalidade por suicídio em idosos nas capitais brasileiras no período de 2001 a 2015. Métodos: Trata-se de um estudo ecológico misto, com dados secundários coletados no Sistema de Indicadores de Saúde e Acompanhamento de Políticas Públicas do Idoso (SISAP IDOSO) e no Sistema de Informação sobre Mortalidade (SIM). A coleta ocorreu no período de setembro a novembro de 2018. Os dados foram tabulados e analisados descritivamente, com apresentação de gráficos e tabelas e frequências simples absolutas e percentuais. Principais resultados: 74,9% que cometeram suicídio foram homens e 53,7% estavam entre 60 a 69 anos. A região sudeste apresentou maior índice de mortalidade, porém a maior taxa de mortalidade para cada 10.000 habitantes foi na região centro-oeste. Conclusão: há um crescente aumento nos índices e nas taxas de mortalidade de idosos, tornando-se uma preocupação para a saúde pública.

Studies on the Global Burden of Disease (GBD) and its risk factors have shown worldwide the preponderant role of accidents and violence in the burden of disease and the role of alcohol consumption as a main risk factor in the current epidemiological profile (GBD 2019 Risk Factors Collaborators, 2020; GBD 2019 Diseases and Injuries Collaborators, 2020). GBD studies in Mexico have not only confirmed this (Gomez-Dantes et al., 2016), but also shown the enormous human loss entailed by violence in Mexico and the preponderant role of alcohol consumption as a risk factor. To complicate things further, whereas the suicide mortality rate fell by 32.7% between 1990 and 2016 worldwide, Mexico is experiencing a constant increase in this cause of mortality (Naghavi et al., 2019). One step to enhance coping with this complicated panorama is to give mental and neurological disorders, substance use, and suicide the role that corresponds to them, programmatically and financially, due to their implication in the burden of disease in Mexico (PAHO, 2018). This number of Salud Mental touches several of these important issues and paves the way to advance our comprehension of violence, suicide, alcohol use, and stigma in Mexico

Media reports of a celebrity’s suicide may be followed by copycat suicides, and the impact may vary in different age and sex subgroups. We proposed a quantitative framework to assess the vulnerability of age and sex subgroups to copycat suicide and used this method to investigate copycat suicides in relation to the suicides of 10 celebrities in South Korea from 1993 to 2013. By applying a detrending model to control for annual and seasonal fluctuations, we estimated the expected number of suicides within a copycat suicide period. The copycat effect was assessed in two ways: the magnitude of copycat suicide by dividing the observed by the expected number of suicides, and the mortality rate by subtracting the expected from the observed number of suicides. Females aged 20–29 years were the most vulnerable subgroup according to both the magnitude of the copycat effect (2.31-fold increase over baseline) and the mortality rate from copycat suicide (22.7-increase). Males aged 50–59 years were the second most vulnerable subgroup according to the copycat suicide mortality rate (20.5- increase). We hope that the proposed quantitative framework will be used to identify vulnerable subgroups to copycat effect, thereby helping devise strategies for prevention.

This thesis studies two indicators of good health and well-being embedded in the United Nations 2030 Agenda for Sustainable Development; suicide mortality rate and harmful use of alcohol. Firstly, socio-economic determinants of suicide mortality rate and alcohol per capita consumption in countries of the European Union are analysed. As an econometric approach, panel data methods are utilized. Among selected economic and socio-demographic variables, suicide mortality rate is found sensitive to unemployment rate, whilst economic growth, fertility rate and female labour participation rate are concluded not have a significant impact. Model of alcohol consumption confirms relatively higher sensitivity to changing income than to alcohol price level. First differencing estimation produces income and price elasticity within range of prior estimates. Secondly, an ARIMA forecast is performed for the EU and its member states to assess current prospects of attaining targets corresponding to the two health quality indicators in question by year 2030. For the EU collectively, forecasts suggest rather favourable development, although considerable disparities are present among individual member states.

This study analyzed the suicide mortality rate in 12 municipalities in Fukushima Prefecture designated as evacuation areas following the 2011 nuclear disaster. Changes in suicide rates were examined using an exponential smoothing time series model. In the evacuation areas, the suicide rate of men increased immediately after the disaster and then decreased from 47.8 to 23.1 per 100,000 during about 1½ years after the disaster. However, with the lifting of the evacuation order, it again exceeded that of non-evacuation areas and continued to do so for the next 3 years. On the other hand, the suicide rate in women in the evacuation areas increased later than that in men. These results indicate the need for continuous support following the lifting of the evacuation order. In addition, it is necessary to enhance social networks, which continue to confer protection, because of the isolation of the elderly as highlighted in our previous study.

The unprecedented impact of COVID-19 has raised concern for the potential of increased suicides due to a convergence of suicide risk factors. We obtained suicide mortality data to assess completed suicides during the period of strict stay-at-home quarantine measures in Connecticut and compared this data with previous years. While the total age-adjusted suicide mortality rate decreased by 13% during the lockdown period compared with the 5-year average, a significantly higher proportion of suicide decedents were from racial minority groups. This finding may provide early evidence of a disproportionate impact from the social and economic challenges of COVID-19 on minority populations.

Editorial - Drug misuse and suicidal behavior are among the most concerning and unclear issues in public health and psychiatry worldwide. Over the years, healthcare professionals have been facing much stigma to evaluate those who seek aid for these issues, but there is still a long way to go concerning prevention, accessibility, and treatment quality. The World Health Organization (WHO) has stated that reducing the suicide mortality rate is a global imperative, considering that it accounts for 800,000 annual deaths......

This paper examines the influence of economic upturns and downturns on suicide mortality rate of men in Russian regions in the period from 2006 to 2013. The author uses real GRP per head, Gini coefficient, alcohol sales, demographic burden (and squared), birth rate, unemployment rate, GRP growth rate (current and lagged), number of physicians and divorce rate as independent variables in fixed effects models. In result the hypothesis of the role of economic fluctuations confirms. In addition, demographic burden and birth rate are significant for suicide behavior. Moreover, this paper reflects the difference between urban and rural population in terms of significance of variables and shows the double effect that demographic burden cause to the suicide behavior.

Background: The effects of socio-economic factors on suicide were gender-dependent. Japanese suicide mortality gender ratio (male: female) had gradually increased during the twentieth century. Methods: With the data covering 1947-2010 collected from Japanese official websites, we conducted non-parametric rank test, curve estimations, spearman ranking correlation and quantile regression in succession with Stata version 12.0. Results: The suicide mortality rate in male with a "U" shape had been always higher than that in female with a "J" shape. The male suicide mortality peaked around in 1955 (38.5 per 100,000 populations), dropped quickly afterwards until the 19705; it increased in the 19805 with another peak in 2003 (33.2 per 100,000 populations). For female, an overall decreasing trend was seen with a peak during the 1950s (23.5 per 100,000 populations in 1958). It dropped gradually afterwards with small variations in 1970s and 80s, and was stabilized after 1995 (9.3 per 100,000 populations). The unemployment rate could be used as a single positive predictor of suicide mortality for men (p < 0.01), while the total fertility rate (TFR) (p < 0.01) and divorce rate (p < 0.01) were significantly associated positively and negatively with women's suicide, respectively. Limitations: The impact of mental disorders was not analyzed and age specific analysis was not conducted. Conclusion: The findings of these gender differences in, and the associated factors with, suicide in Japan, warranted further studies including delineation of the implications of differential economic pressure between genders, as well as child rearing pressure and marriage satisfaction. (C) 2013 Elsevier B.V. All rights reserved.

The aim of this study was to compare the regional difference of death from intentional self-harm. The analysis was based on data of intentional self-harm deaths (31,450) from the 2010-2011 vital statistics of Korea. The suicide rate (per 100,000 population) was 46.2 in male and 22.3 in female. Gender ratio (male / female) of suicide rate was 2.07, and Jeju province had the lowest gender ratio (1.82), and Chungbuk province had the highest gender ratio (2.42). In the age-gender standardized death rate (per 100,000) of self-harm by region, the highest suicide rate was observed in Gangwon province (44.8) and Chungnam province (44.3), and the lowest in Seoul metropolitan city (28.9) and Ulsan metropolitan city (29.2). There was a significant increase in the rate of suicide in city areas (odds ratio: 1.11, 95% CI: 1.08-1.13), county areas (1.62, 1.56-1.67) as compared with the rate of suicide in metropolitan areas. The commonest methods of suicide were hanging (53.7 percent), self-poisoning by pesticides (16.8 percent) and jumping from a height (14.3 percent). The methods used for suicide differed between rural (county) and urban areas (metropolitan city and city). In county areas, 43 percent of suicides used pesticides as compared to only 7-18 percent of those in urban areas. In urban areas, jumping was more common (13-17 percent vs. 6 percent). There were no difference in hanging between urban and rural areas. The odds ratio of death by pesticides was 9.86 in rural areas compared with death rate of metropolitan areas. The odds ratio of death by jumping was 0.59 in rural compared with death rate of metropolitan areas.

Suicide rates raise with age has remained consistent for more than 150 years but over the last 50 years major changes occurred. We examined Age-Period-Cohort (APC) effects on suicide mortality rate by gender in Canada and in Quebec from 1926 to 2008. Durkheim theoretical framework is used to interpret our findings. Descriptive analysis and APC models relating to the Intrinsic Estimator (IE) were used to assess these effects. IE model shows suicide net age effect for men in Canada and Quebec as death rate increased until 25 years old before reaching a plateau. For women it’s an inverted "U" shape peaking at mid-adulthood. While period effect differs, a net cohort effect is found for men born in 1941, and women in 1981 until most recent cohorts.

Suicide, a deliberate self-inflicted death, is a significant public health issue worldwide. The World Health Organization (WHO) estimates that about one million suicide deaths occur annually, which gives a suicide mortality rate of 16 per 100,000 population. The most common causes underlying suicide are psychiatric conditions, especially depression and substance abuse.

Lithium has been used as a mood-stabilizing drug in people with mood disorders. Previous studies have shown that natural levels of lithium in drinking water may protect against suicide. This study evaluated the association between lithium levels in tap water and the suicide standardized mortality ratio (SMR) in 40 municipalities of Aomori prefecture, which has the highest levels of suicide mortality rate in Japan. Lithium levels in the tap water supplies of each municipality were measured using inductively coupled plasma-mass spectrometry. After adjusting for confounders, a statistical trend toward significance was found for the relationship between lithium levels and the average SMR among females. These findings indicate that natural levels of lithium in drinking water might have a protective effect on the risk of suicide among females. Future research is warranted to confirm this association.

Because suicide is increasingly becoming a public health threat in Japan, it is necessary to identify high-risk groups to develop effective preventive measures. The suicide mortality trends from 1985 to 2006 for Japanese aged between 15 and 79 years were analyzed by a Bayesian age–period–cohort analysis to evaluate the independent effects of age, period, and birth cohort. Age-specific effect showed an overall increase with age in both genders, but a distinct increase was noted only among men aged between 50 and 64 years. The period effect exhibited a sudden rise in 1998; this effect was more apparent in men than in women. The cohort-specific effect increased in male birth cohorts born after 1926 and in female birth cohorts born after 1956. In conclusion, a gender difference was detected in the effects of age, period, and cohort on suicide risk among Japanese.

Introduction Suicide is one of the main causes of premature mortality in Russia. There is strong evidence of a crucial role of harmful drinking pattern (binge drinking) in explanation a high suicide rate in this country. Objectives This paper was design to estimate the aggregate level effect of binge drinking on suicide mortality rate in Russia. Method Trends in age-adjusted, sex-specific suicide mortality and fatal alcohol poisoning rate (as a proxy for binge drinking) from 1980 to 2005 were analyzed employing a distributed lags analysis in order to asses bivariate relationship between the two time series. Results The results of the time series analysis indicate the presence of a statistically significant association between the two time series at zero lag for male (R = 0.44; P Conclusions This study indicates that substantial proportion of suicide deaths in Russia is due to acute effect of binge drinking. The findings from the present study also suggest that a restrictive alcohol policy can be considered as an effective measure of suicide prevention in countries where higher rate of alcohol consumption and binge drinking pattern.

Purpose The annual global suicide mortality rate is 16 per 100,000 and suicide attempts are 20 times more frequent. We aimed at comparing patients referring to the emergency room (ER) for self-inflicted injury vs those needing psychiatric consultation for other reasons, in order to assess possible predictors of self-injury. Methods Determinants of ER psychiatric consultations were studied prospectively during the period 2008–2011 at the ‘Maggiore’ Hospital in Novara. A multivariate analysis was performed using a logistic regression in order to assess the potential predictors of self-injury behaviors. Results are expressed as Odds Ratio (OR) with 95% Confidence Intervals (95%CI). Statistical significance was set at p≤0.05. Results In a sample of 1888 psychiatric consultations, 280 (14.8%) were due to self-inflicted injuries . Female gender (OR: 1.51; p=0.005) was found to positively correlate with attempted suicides, whereas unemployment (OR: 0.68; p=0.013) and being in the colder months of the year (OR: 0.75; p=0.043) were found to be negative correlated. A positive trend without statistical significance was observed for foreign nationality, being not married and living with parents/own family vs a negative trend was found for history of psychiatric disorders. Conclusions In accordance with other studies, we observed the female gender positively correlates with attempted suicides and sunlight may act as a trigger. In contrast with literature, individuals with a permanent job would be at higher risk of self-injury behaviours, whereas having a history of psychiatric disorders and being under the care of a psychiatrist might be a protective predictor.

Background Suicide is one of the main causes of premature mortality in Belarus, brining considerable losses of human lives. There is strong evidence of a crucial role of alcohol in explanation of high suicide rate and its profound fluctuations over the past decades in this country. The aim of this study was to examine the relation between the overall alcohol consumption and suicide mortality rates in Belarus. Method Trends in alcohol consumption per capita and age-standardized male and female suicide rates from 1980 to 2005 were analyzed employing ARIMA time series analysis. Results Alcohol consumption is significantly associated with both male and female suicide rates. The results suggest that 1 litre increase in overall alcohol consumption would result in a 7.4% increase in the male suicide rates and 3.2% increase in female suicide rates. The estimated effects of alcohol consumption on the age-specific suicide rates for men ranging from 0.024 (15–29 age group) to 0.082 (30–44 and 45–59 age groups). The estimated effects of alcohol consumption on age specific rates for women were positive for age groups 15–29 (0.017), 30–44 (0.047), 45–59 (0.039) and 60–74 (0.017). The estimated alcohol attributable fraction (AAF) for men ranging from 28% (15–29 age group) to 67% (30–44/45–59 age groups) and for women raging from 21% (15–29 age group) to 47% (30–34 age group). Conclusions The outcome of this study provides indirect support for the hypothesis that alcohol played a crucial role in the fluctuation in suicide mortality rate in Belarus during recent decades.

Jarvholm and Stenberg1 evaluated suicide mortality rates among electricians (“exposed to electromagnetic fields (EMFs)”) and glass and wood workers (“unexposed to EMFs”) in the Swedish construction industry. Standard mortality rates were lower for the two job groups compared to the Swedish general population. This is likely to be due to the healthy worker effect. The internal cohort analysis showed that electricians had a lower suicide mortality rate than glass and wood workers. As the authors rightfully point out, these results should not be seen as evidence against the association between exposure to EMFs and suicide, in particular because no quantitative estimates of exposure were obtained to directly evaluate this association. …

In the article "Cancer Mortality Rate" published in the May, 1962, issue ofArchives of General Psychiatry, Lawrence LeShan advanced statistical evidence on the effect of psychological factors on the cancer mortality rate. The following comments on that article indicate that the statistical evidence presented does not constitute a satisfactory argument. LeShan attempted to demonstrate the psychological factors of the cancer mortality rates by correlating the cancer mortality rates with the suicide mortality rates from 1914 to 1953. (The data used were from the Vital Statistics, Special Reports , vol 43, No. 11, June 27, 1956, and vol 43, No. 30, Aug 22, 1956, National Office of Vital Statistics, US Public Health Service, US Department of Health, Education, and Welfare.) Many of the correlations he computed were large in absolute value. From this, the conclusion was drawn that both the cancer mortality rate and the suicide mortality rate shared, at