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Background: Attitudes toward suicide are essential in suicide prevention, as suicide is socio-culturally nuanced. Although the relationship between individual attitudes and suicidal behavior has been extensively studied, the effect of community attitudes--aggregated by region--on suicide mortality remains ambiguous. This study explored the association between community attitudes and real-world suicide mortality. Methods: Data on attitudes toward suicide from the 2018 Korea National Suicide Survey (N = 1500) and individual mortality data from the MicroData Integrated System were obtained. Confirmatory factor analysis supported a factor structure with three factors: "Permissiveness," "Unjustified behavior," and "Readiness to help/Preventability." Thirty regional units in South Korea aggregated the data for ecological analysis. We used negative binomial models to examine the association at the regional level, and stratified analysis by gender and age group was conducted. Results: "Permissiveness" was associated with reduced suicide rates in a univariate model (P < 0.001). Adjusting for gender, age, and additional sociodemographics did not alter the association. Additionally, this relationship was observed in males and individuals under 60 years of age after stratification. However, "Unjustified Behavior" and "Readiness to help/Preventability" exhibited no significant association with suicide in any model or stratum. Conclusion: The observed inverse association between permissive community attitudes and suicide contradicts the findings of previous research that links permissive individual attitudes to increased suicidal behavior. Our findings suggest that attitudes may operate differently at the individual and group levels. Although the cross-sectional design and single-country focus of this study warrant further investigation, our findings indicate that attitudes are significant contextual factors in the process of suicide, which could lead to novel approaches in suicide prevention. [ABSTRACT FROM AUTHOR]

This article attempts to establish the causes, trace the dynamics, and assess the significance of suicides that occurred in the Siberian and West Siberian regions between 1925 and 1937. The research is based on a diverse array of sources, including statistical compilations, minutes from meetings, resolutions from party, Soviet, and Komsomol bodies, reports from special commissions, administrative correspondence, and materials from periodical publications. Through a comprehensive analysis of this heterogeneous information, the article demonstrates an increase in the number of suicides in Siberia, elucidates the demographic and social-professional composition of those who voluntarily ended their lives, and identifies the methods employed as well as the most common reasons for suicide. These parameters are analyzed in comparison with similar indicators across the RSFSR and the USSR, revealing the presence of regional specificity. The article challenges the prevailing historiographical view that placed sole responsibility for suicides on the individuals themselves. It presents evidence that one significant avenue for combating suicides involved holding accountable those whose actions or inactions contributed to these tragic events. The conclusion drawn is that, despite failing to achieve tangible success in preventing suicides, the higher political leadership at both regional and provincial levels managed to create an illusion that this phenomenon had been entirely eradicated.

Suicidal behavior and action, which occur due to negative experiences in individuals’ lives, occur as a result of them acting with this thought in their daily lives. The literal meaning of suicide is explained as the act of ending one’s life. Individuals who see suicide as the only way out resort to this action and end their lives. The fact that there are very few studies on suicide in the literature constitutes the motivation for this study. In this context, the study examined the economic factors affecting female and male suicide rates in OECD countries between 2000 and 2019, and the relationships between these factors and suicide rates were estimated by the panel regression method. Additionally, causality relationships between variables were tried to be determined with Dumitrescu & Hurlin (2012) Granger Causality test. As a result of the analysis, it was seen that the increase in the unemployment rate and inflation rate increased the suicide rates of women and men, and the increase in the labor force rate of women and men and in GDP decreased the suicide rates of women and men. According to the results obtained from the causality test, there is a bidirectional causality relationship between female suicide rates and unemployment and GDP, between male suicide rates and inflation, male labor force and GDP, while there is a unidirectional causality relationship from female suicide rates to female labor force and from unemployment rates to male suicide rates. It is expected that the study results will contribute to future studies on the subject and provide suggestions to policy makers. [ABSTRACT FROM AUTHOR]

Suicide is the ending of one's own life for economic, psychological, and social reasons. Suicide cases worldwide occur mostly in low- and middle-income countries. The aim of this study is to examine the effect of economic indicators of low and middle-income countries on suicide rates by panel data analysis method. The dependent variable is the (crude) suicide rate. The independent variables are gross domestic product, per capita income, general unemployment rate, poverty level, and Gini index value. In the study, two different econometric models were developed. In Model 1, it was predicted that a 1% increase in the poverty level of countries in the middle-income group could lead to an increase of 0.66% in the suicide rate. In Model-2, it was estimated that a 1% increase in the per capita income of low-income countries would cause a 0.52% decrease in the suicide rate. It was predicted that a possible increase of 1% in the Gini index value would cause an increase of 0.24% and 0.32% in the suicide rates of middle- and low-income countries, respectively. Although there are various factors affecting the suicide rate in society, there are often economic reasons at the root of the problem. The consequences of the unequal distribution of income in a poorer society can be more devastating. Although the results of the study are important in terms of revealing the effect of economic indicators on suicide rates more research is needed in this area. [ABSTRACT FROM AUTHOR]

Suicide is considered one of the leading causes of premature death worldwide, and it is still an understudied subject in Pakistan. There are no national statistics on suicide; however, local and regional studies showed a higher inclination in some areas of Sindh, KP, and Gilgit-Baltistan. The data was extracted from my PhD research work which aimed to cross-investigate the suicide statistics, and document the trends of suicide and its linkages with socio-demographic information of suicide victims to explore the influence of later on. Qualitative data were analyzed using SPSS; case studies were included to support the description. The result showed that the female suicide rate is higher than male; students and housewives categorically on the top. Gunshots, hanging, and jumping into rivers were the mostly used tools to commit suicide. A comprehensive, policy-based study is necessary to curb the issue. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that conditions with decreased morning and increased evening light exposure, including shift work, daylight-saving time, and eveningness, are associated with elevated mortality and suicide risk. Given that the alignment between the astronomical, biological, and social time varies across a time zone, with later-shifted daylight exposure in the western partition, we hypothesized that western time zone partitions would have higher suicide rates than eastern partitions. United States (U.S.) county-level suicide and demographic data, from 2010 to 2018, were obtained from a Centers for Disease Control database. Using longitude and latitude, counties were sorted into the western, middle, or eastern partition of their respective time zones, as well as the northern and southern halves of the U.S. Linear regressions were used to estimate the associations between suicide rates and time zone partitions, adjusting for gender, race, ethnicity, age group, and unemployment rates. Data were available for 2872 counties. Across the U.S., western partitions had statistically significantly higher rates of suicide compared to eastern partitions and averaged up to two additional yearly deaths per 100,000 people (p <.001). Ecological design and limited adjustment for socioeconomic factors. To our knowledge, this is the first study of the relationship between longitude-based time zone partitions and suicide. The results were consistent with the hypothesized elevated suicide rates in the western partitions, and concordant with previous reports on cancer mortality and transportation fatalities. The next step is to retest the hypothesis with individual-level data, accounting for latitude, photoperiodic changes, daylight-saving time, geoclimatic variables, physical and mental health indicators, as well as socioeconomic adversity and protection. • Social-solar time alignment varies within each time-zone, based on longitude. • Cancer mortality and fatal traffic accidents are higher in west vs. east time zone partitions. • We therefore set out to compare suicide mortality across time zone partitions. • In the U.S., suicide rates were higher in west vs. east time zone partitions. • Misalignments between circadian, light-dark, sleep-wake, and rest-activity rhythms are modifiable suicide risk factors. [ABSTRACT FROM AUTHOR]

The research is conducted to examine the relationship between suicide rate and the macroeconomic indicators of high-income countries according to the World Bank income classification. In the research, the independent variables comprise of the economic variables, and the dependent variable is the suicide rate seen in a country. An econometric model with a random effects approach is developed for the effect of the specified independent variables on suicide rate in the population. As a result of the analysis, a 1%increase in the Gini index value may cause an increase of 0.26% in the suicide rate; income distribution disorders directly affect the suicide rate and increase suicide; and a 1% increase in the unemployment level causes 0.02% increase in the suicide rate. In addition, it is stated that there is a negative correlation between income per capita and suicide rate, and a 1% increase in income per capita may cause a 0.10% decrease in the suicide rate. Within the scope of the research, suicide rate, which is an important indicator of society, can be examined in different income groups or in similar income groups within the scope of different variables. [ABSTRACT FROM AUTHOR]

Abstract Background Suicide among the elderly has become a global public health concern. This study was carried out to determine the trend of completed suicide rates according to age, sex, and ethnicity and the suicidal methods among the elderly in Malaysia. Methods All suicide-related deaths in elderly aged 60 years and above from the Year 1995 to 2020 reported to the National Registration Department (NRD) were analyzed. Causes of death for suicide were coded based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The completed suicide rate was calculated by dividing the completed suicide number by the total elderly population for the respective year. Results Overall, the analysis of 1,600 suicide-related deaths was investigated over 26 years. Male was seen to be correlated with higher suicidal risk, with a male–female relative risk (RR) = 1.89 (95%CI:1.46,2.45). The risk of suicide was also found to be significantly higher for those aged 60 to 74 years old and Chinese, with RR = 4.26 (95%CI:2.94, 6.18) and RR = 5.81 (95%CI: 3.70, 9.12), respectively. Hanging was found to be a statistically significant suicide method (IRR:4.76, 95%CI:2.34,9.65) as compared to pesticide poisoning. The completed suicide rate was fluctuating over the years. Conclusions In conclusion, it is believed that Malaysia's elderly suicide rate has reached an alarmingly high incidence. By identifying the crucial criteria of sociodemographic factors, the government and responsible agencies have the essential and additional information to put together a more effective strategy and approach to overcome the issue in the future.

Suicide is defined as the realization of death after the act of one's own will. The situation where the action does not result in death is expressed as a suicide attempt. Suicide can be considered as a complex phenomenon with many dimensions, so it is not possible to analyze or understand suicides that occur for only one reason. All changes and transformations in the social structure affect the phenomenon of suicide and cause differentiation in its speed. The aim of this research is to describe the dimensions of suicide in Turkey by explaining suicide as a sociological phenomenon. For this purpose, sociological theories of suicide are evaluated and suicides in Turkey are discussed and examined by years, taking into account age, gender, educational status, marital status, reason for suicide, region and provinces in each region. Research is a secondary data analysis study, which is one of the methods of obtaining quantitative data. In the study, suicide statistics obtained from the data on death and cause of death in the Population and Demographics Database of TUIK were used. From data on suicides published up to 2021, eleven years of data between 2011 and 2021 were analyzed to assess the change over time. According to the results of the research, Suicide increases in young adulthood and adulthood, It is seen more in men than in women, there is no difference when this situation is evaluated in terms of year or region. Suicide is more common in married people than in single, divorced and widowed people. Suicide rate is more common in socially and economically developed regions and cities. The prevalence and situation of suicides in the society should be investigated by taking into account their social and demographic characteristics, covering wider time periods and including variables such as economic status, occupation and residence conditions. It is important and necessary to reach data on the causes of suicides, to understand the phenomenon of suicide, to evaluate its sociological dimension, and to do what can be done to solve the problem. Investigating the social determinants that cause suicide will facilitate intervention in the structure in which suicide is produced and prevent suicides. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to evaluate the suicide rate in individuals with mental disorders in terms of gender and time. Design and Methods: In this study, a retrospective research design was used and secondary data were used. The sample of the study consisted of OECD countries. Findings: Although the suicide rate is higher in men than in women, there is no statistical difference (p>0.05). Suicide rate increases during hospitalization, 30 days after discharge, and in follow-ups within one year (p

There is limited quantitative evidence to investigate short-term suicide rates although the risk of suicide in psychiatric patients is exceptionally high in the early post-discharge period. This study aimed to explore the trends of the 30 days suicide rate after discharge using population-based data from Korea. This study was conducted on psychiatric patients aged 15 years or older discharged between 2010 and 2018. Patients were extracted from the National Health Insurance Claim Database (NHICD) and information on suicide was obtained from the National Statistical Office. Age-standardized suicide rate (ASR) and Standardized Mortality Ratio (SMR) within 30 days after discharge was estimated and tested using joinpoint regression. Of the 1,576,028 patients discharged from hospitals from 2010 to 2018, 53.9 % were male and 47.9 % were aged between 40 and 59 years. The 30 days ASRs for psychiatric patients after discharge varied from 174.9 to 218.0 per 100,000 patients with no clear trend excluding patients with schizophrenia and anxiety disorder. The SMR for suicide within 30 days after discharge was 66.8 in 2016–2018, and patients aged 20 to 39, female, and patients with depression had high SMRs compared to other groups. Factors that may impact the suicide were not considered in this study. Since the NHICD data is collected for payment of medical expenses, there may be scope for inaccuracies. The 30 days suicide rate after psychiatric discharge has failed to decrease between 2010 and 2018. This study recommends early interventions after discharge and intensive interventions for patient groups who may be vulnerable to suicide. • The annual age-standardized suicide rates varied from 174.9 to 218.0 per 100,000 patients and there were no significant decrease between 2010 and 2018 in Korea • The standardized mortality ratio for suicide indicated a steady decline over time. • Patients aged 20 to 59, female, and patients with depression had high standardized mortality ratios compared to other groups. [ABSTRACT FROM AUTHOR]

Background: Suicide among the elderly has become a global public health concern. This study was carried out to determine the trend of completed suicide rates according to age, sex, and ethnicity and the suicidal methods among the elderly in Malaysia. Methods: All suicide-related deaths in elderly aged 60 years and above from the Year 1995 to 2020 reported to the National Registration Department (NRD) were analyzed. Causes of death for suicide were coded based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The completed suicide rate was calculated by dividing the completed suicide number by the total elderly population for the respective year. Results: Overall, the analysis of 1,600 suicide-related deaths was investigated over 26 years. Male was seen to be correlated with higher suicidal risk, with a male–female relative risk (RR) = 1.89 (95%CI:1.46,2.45). The risk of suicide was also found to be significantly higher for those aged 60 to 74 years old and Chinese, with RR = 4.26 (95%CI:2.94, 6.18) and RR = 5.81 (95%CI: 3.70, 9.12), respectively. Hanging was found to be a statistically significant suicide method (IRR:4.76, 95%CI:2.34,9.65) as compared to pesticide poisoning. The completed suicide rate was fluctuating over the years. Conclusions: In conclusion, it is believed that Malaysia's elderly suicide rate has reached an alarmingly high incidence. By identifying the crucial criteria of sociodemographic factors, the government and responsible agencies have the essential and additional information to put together a more effective strategy and approach to overcome the issue in the future. [ABSTRACT FROM AUTHOR]

Positive and negative economic growth is closely related to the suicide rate. To answer the question whether economic development has a dynamic impact on this rate, we used a panel smooth transition autoregressive model to evaluate the threshold effect of economic growth rate on the persistence of suicide. The research period was from 1994 to 2020, and the results show that the suicide rate had a persistent effect, which varied over time depending on the transition variable within different threshold intervals. However, the persistent effect was manifested in different degrees with the change in the economic growth rate and as the lag period of the suicide rate increased, the effect of the influence gradually decreased. We investigated different lag periods and noted that the impact on the suicide rate was the strongest in the first year after an economic change and then reduced to be only marginal after three years. This means that the growth momentum of the suicide rate within the first two years after a change in the economic growth rate, should be included in policy considerations of how to prevent suicides.

Abstract Background This study examines the 20-year trend of suicide in 46 Muslim-majority countries throughout the world and compares their suicide rates and trends with the global average. Ecological-level associations between the proportion of the Muslim population, the age-standardized suicide rates, male-to-female suicide rate ratio, and the Human Development Index (HDI) in 2019 were examined. Methods Age-standardized suicide rates were extracted from the WHO Global Health Estimates database for the period between 2000 and 2019. The rates in each country were compared with the age-standardized global average during the past 20 years. The countries were further grouped according to their regions/sub-regions to calculate the regional and sub-regional weighted age-standardized suicide rates involving Muslim-majority countries. Correlation analyses were conducted between the proportion of Muslims, age-standardized suicide rate, male: female suicide rate ratio, and the HDI in all countries. Joinpoint regression was used to analyze the age-standardized suicide rates in 2000-2019. Results The 46 countries retained for analysis included an estimated 1.39 billion Muslims from a total worldwide Muslim population of 1.57 billion. Of these countries, eleven (23.9%) had an age-standardized suicide rate above the global average in 2019. In terms of regional/sub-regional suicide rates, Muslim-majority countries in the Sub-Saharan region recorded the highest weighted average age-standardized suicide rate of 10.02/100,000 population, and Southeastern Asia recorded the lowest rate (2.58/100,000 population). There were significant correlations between the Muslim population proportion and male-to-female rate ratios (r=-0.324, p=0.028), HDI index and age-standardized suicide rates (r=-0.506, p

Background: Patients with oral cancer usually experience disfigurement and dysfunction which are shared risk factors of suicide. The aim of the study was to comprehensively assess the characteristics of suicide and risk factors for suicide in patients with oral cancer., Methods: Surveillance, Epidemiology, and End Results database was used to acquire information of patients with common malignant tumors including oral cancer from 1975 to 2020. The aim was to explore the incidence of suicide, and timing of suicide among patients with oral cancer. A Fine-Gray competing risks regression model was employed to analyze risk factors associated with suicide among patients with various demographic and tumor characteristics., Results: Totally, 7685 patients with different malignant tumors committed suicide. Among them, 203 patients with oral cancer died due to suicide, presenting a suicide rate of 54.5/100,000 person-years, which was almost 3.5 times that of the US general population and 1.5 times that of the overall US patients with cancer in our study. Approximately 18 %, 40 %, and 55 % of suicides occurred in first year, first 3 years, and first 5 years after diagnosis. Being male, White race, and having a single primary tumor might be regarded as the risk factors for suicide., Conclusion: As oral cavity is closely associated with appearance, pronunciation and ingestion, patients with oral cancer have a significant high risk of suicide. Tremendous attention needs to be paid to patients with oral cancer particularly those exhibiting characteristics associated with a high risk of suicide., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Attitudes toward suicide are essential in suicide prevention, as suicide is socio-culturally nuanced. Although the relationship between individual attitudes and suicidal behavior has been extensively studied, the effect of community attitudes-aggregated by region-on suicide mortality remains ambiguous. This study explored the association between community attitudes and real-world suicide mortality., Methods: Data on attitudes toward suicide from the 2018 Korea National Suicide Survey (N = 1500) and individual mortality data from the MicroData Integrated System were obtained. Confirmatory factor analysis supported a factor structure with three factors: "Permissiveness," "Unjustified behavior," and "Readiness to help/Preventability." Thirty regional units in South Korea aggregated the data for ecological analysis. We used negative binomial models to examine the association at the regional level, and stratified analysis by gender and age group was conducted., Results: "Permissiveness" was associated with reduced suicide rates in a univariate model (P < 0.001). Adjusting for gender, age, and additional sociodemographics did not alter the association. Additionally, this relationship was observed in males and individuals under 60 years of age after stratification. However, "Unjustified Behavior" and "Readiness to help/Preventability" exhibited no significant association with suicide in any model or stratum., Conclusion: The observed inverse association between permissive community attitudes and suicide contradicts the findings of previous research that links permissive individual attitudes to increased suicidal behavior. Our findings suggest that attitudes may operate differently at the individual and group levels. Although the cross-sectional design and single-country focus of this study warrant further investigation, our findings indicate that attitudes are significant contextual factors in the process of suicide, which could lead to novel approaches in suicide prevention., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hong, Kim, Park, Lee, Rhee, Min, Kim, Yang, Song, Son and Ahn.)

Introduction: Social capital is a complex and multifaceted structure or concept. Although it has become a pervasive subject in sociological texts; however, few studies have been conducted on its validity and explanatory value in the field of suicide. In the present study, the author tries to critically review the available resources, while presenting the results of researchers’ finding and their critique and to show the relationship between social capital and suicide in the provinces of Iran. In most studies, researchers have hypothesized that the relationship between social capital and suicide is positive, and in practice, they have found that with increasing and decreasing social capital, the rate of suicide fluctuates. However, there is no consensus on the impact of social capital on suicide in Iran. Some researchers have used suicide as an indicator to measure social capital and define the relationship between suicide and social capital (regardless of the causal relationship) to establish a structural relationship between these two concepts (Bastani et al., 2014; Mohammadian et al., 2016). The structural relationship between suicide and social capital emphasizes that the two concepts are strongly interdependent at the theoretical level, and the researcher does not need to distinguish between the two. Despite such a hypothetical link between the two concepts, some argue that social capital has conflicting effects on suicide. Given the above explanations, the lack of consensus on the type of the relationship between suicide and social capital, and the reverse effect of social capital on suicide, the following research question was posed in this study: What are the effects of social capital on the rate of suicide in Iranian provinces? Materials and Methods: The present study tries to explain the rate of suicide based on social capital from the perspective of relational, interpretive, and causal explanations. This comparative research compares the social units (the provinces) of the research. The statistical population includes all documentary data in at least 28 provinces of Iran. It is worth mentioning that there is no specific method for measuring the reliability and validity of social capital; however, the findings extracted and derived from statistical data are more dependable than the data gathered through the surveys and attitudes. Discussion of Results and Conclusions: The results of the study showed that social capital had no effect on the suicide rate and its components had different relationships with the suicide rate. Social participation based on family outcomes affected and reduced the suicide rate. However, at the survey level, severing ties with relatives reduced the suicide rate (a finding different from the statistical data). The political or civic participation presented in this study in the form of electoral participation also had a reducing effect on the suicide rate. But, at the level of triangulation, this effect was different and increased suicide. Security as another component of suicide had a reducing effect on suicide and decreased with increasing the security of suicide. The extent of the conflict, which was measured statistically, had an inverse relationship with the rate of suicide and with increasing the level of conflict in the provinces of Iran. Some components of social capital collected at the survey and attitude levels had an unreasonable relationship with the suicide rate. The components include: 1) desire to live abroad, 2) obtaining citizenship of other countries, 3) the degree of honor of Iran's foreign policy, 4) national identity (the composite structure), and 5) the extent of participation in the war by oneself and other people. If we want to draw the personality of the suicidal person based on the achievements of this research considering the independent variables, we can consider the suicidal person as a person who: Has little social participation. He may have limited contact with relatives; Cannot divorce or divorce his partner and cannot run away from his family; Participates less in the elections. If he/she participates in elections, he/she casts a blank ballot; Has self-doubt; Trusts individuals and the system; Is honest or at least is not a liar; Does not feel safe; Does not have enough energy for conflict; Does not want to live abroad.

Purpose: The aim of the study is to evaluate the suicide rate in individuals with mental disorders in terms of gender and time. Design and Methods: In this study, a retrospective research design was used and secondary data were used. The sample of the study consisted of OECD countries. Findings: Although the suicide rate is higher in men than in women, there is no statistical difference (p>0.05). Suicide rate increases during hospitalization, 30 days after discharge, and in follow-ups within one year (p<0.001). Conclusion: It is believed that the results will guide healthcare professionals in diagnosing suicide risk and planning related actions (policy and interventions). [ABSTRACT FROM AUTHOR]

Objective: To quantify the contributions of epidemiological changes (age‐ and gender‐specific suicide rates) and demographic forces (population growth and aging) to global changes in years of life lost (YLLs) from suicide over the last 30 years. Method: A decomposition analysis was used to assess the impacts of population growth, population aging, and suicide prevalence on global changes in YLLs from suicide between 1990 and 2019. Results: From 1990 to 2019, global YLLs from suicide reduced by 2,073,714 years (5.9%), from 35,246,316 years to 33,172,602 years. This was mainly due to the decline in age‐specific suicide rates, which reduced the overall YLLs from suicide by 20,185,691 years (973.4%). However, this decline was offset by the impacts of population growth and population aging, which increased global YLLs from suicide by 14,949,110 years (−720.9%) and 3,442,074 years (−166.0%), respectively. The combined effects of epidemiological and demographic drivers were also reflected in different trends in YLLs from suicide across genders and World Bank income level regions, with particularly notable increases in low‐ income and lower‐middle income countries and the aging population. Conclusions: With the significant effects of epidemiological and demographic drivers, global and regional YLLs from suicide may be expected to change greatly in the future. Efforts to reduce the burden of suicide require appropriate allocation of resources for suicide‐prevention strategies and further consideration of demographic factors. [ABSTRACT FROM AUTHOR]

Background: This study examines the 20-year trend of suicide in 46 Muslim-majority countries throughout the world and compares their suicide rates and trends with the global average. Ecological-level associations between the proportion of the Muslim population, the age-standardized suicide rates, male-to-female suicide rate ratio, and the Human Development Index (HDI) in 2019 were examined.Methods: Age-standardized suicide rates were extracted from the WHO Global Health Estimates database for the period between 2000 and 2019. The rates in each country were compared with the age-standardized global average during the past 20 years. The countries were further grouped according to their regions/sub-regions to calculate the regional and sub-regional weighted age-standardized suicide rates involving Muslim-majority countries. Correlation analyses were conducted between the proportion of Muslims, age-standardized suicide rate, male: female suicide rate ratio, and the HDI in all countries. Joinpoint regression was used to analyze the age-standardized suicide rates in 2000-2019.Results: The 46 countries retained for analysis included an estimated 1.39 billion Muslims from a total worldwide Muslim population of 1.57 billion. Of these countries, eleven (23.9%) had an age-standardized suicide rate above the global average in 2019. In terms of regional/sub-regional suicide rates, Muslim-majority countries in the Sub-Saharan region recorded the highest weighted average age-standardized suicide rate of 10.02/100,000 population, and Southeastern Asia recorded the lowest rate (2.58/100,000 population). There were significant correlations between the Muslim population proportion and male-to-female rate ratios (r=-0.324, p=0.028), HDI index and age-standardized suicide rates (r=-0.506, p<0.001), and HDI index and male-to-female rate ratios (r=0.503, p<0.001) in 2019. Joinpoint analysis revealed that seven Muslim-majority countries (15.2%) recorded an increase in the average annual percentage change regarding age-standardized suicide rates during 2000-2019.Conclusions: Most Muslim-majority countries had lower age-standardized suicide rates than the global average, which might reflect religious belief and practice or due to Muslim laws in their judicial and social structure which may lead to underreporting. This finding needs further in-depth country and region-specific study with regard to its implication for public policy. [ABSTRACT FROM AUTHOR]

ObjectivesThe provide a descriptive analysis of the available population-level aggregated data on committed suicides in the Republic of Croatia, in the 2004–2018 period, showing emerging trends in suicide incidence focusing on sex/age/geographical distribution of suicides and the primary and secondary causes of suicide mortality, as well as making comparisons with similar neighboring neighboring countries.MethodsThe aggregated suicide data were obtained from the Croatian Committed Suicides Registry, a national registry maintained by the public health authority. The raw data extract was organized into tables according to several variables (age, sex, place of birth, place of residence, and cause of death). Simple descriptive statistics were performed on the structured data.ResultsDespite being among the highest in the world and EU, the number of committed suicides in Croatia is in decline since 2004. A higher number of suicides by males was observed when compared to females. Most of the suicides occur during spring and summer. The wealthier, northern continental region of the country had the highest average rate of committed suicides per 1,00,000 population, contrary to some of the findings in the published literature associating economic instability with suicide. The most common way to commit suicide for both sexes in all age groups is self-harm by hanging, strangulation and suffocation. Suicide by firearm and explosive devices discharge remains higher than the global average.ConclusionsDespite its steadily declining incidence rates in the past 20 years, suicides remain a major public health challenge in Croatia. Results may bolster the Ugro-Finnish suicide hypothesis, linking higher suicide rates to regions with populations of Hungarian descent.

Multilayered approaches to suicide prevention combine universal, selective, and indicated prevention interventions. These approaches may be more successful in reducing suicide rates among older adults if they link these layers more systematically: that is, if the programs are designed so that interventions at a lower level facilitate involvement at a higher level when appropriate. This study aimed to examine the effect on suicide rates of the structure of multilayered approaches, and in particular the types of interventions and the connections or linkages between them. We also wished to consider any different effects by sex. A literature search used PubMed and PsycINFO to identify systematic reviews of interventions in this age group. From the reference lists of these articles, we identified controlled studies assessing the impact of a multilayered program on suicide incidence among older adults. We were particularly interested in initiatives linking different kinds of prevention interventions. We found three relevant systematic reviews, and from these, we identified nine eligible studies. These included seven non-randomized controlled studies from rural areas in Japan (average eligible population: 3,087, 59% women, average duration: 8 years). We also found two cohort studies. The first was from a semi-urban area in Padua, Italy (18,600 service users, 84% women, duration: 11 years). The second was from urban Hong Kong, with 351 participants (57% women) over a 2-year follow-up period. We used a narrative synthesis of these studies to identify five different multilayered programs with different forms of connections or linkages between layers. Two studies/programs (Italy and Hong Kong) involved selective and indicated prevention interventions. One study/program (Yuri, Japan) included universal and selective prevention interventions, and the final six studies (two programs in northern Japan) involved linkages between all three layers. We also found that these linkages could be either formal or informal. Formal linkages were professional referrals between levels. Informal linkages included advice from professionals and self-referrals. Several of the studies noted that during the program, the service users developed relationships with services or providers, which may have facilitated movements between levels. All five programs were associated with reduced suicide incidence among women in the target groups or communities. Two programs were also associated with a reduction among men. The study authors speculated that women were more likely to accept services than men, and that the care provided in some studies did less to address issues that are more likely to affect men, such as suicidal impulsivity. We therefore suggest that it is important to build relationships between levels, especially between selective and indicated prevention interventions, but that these can be both formal and informal. Additionally, to reach older men, it may be important to create systematic methods to involve mental health professionals in the indicated prevention intervention. Universal interventions, especially in conjunction with systematically linked indicated and selective interventions, can help to disseminate the benefits across the community.

The article examines the impact of daily activities on the suicide rate on the basis of data from the European Detailed Mortality Database of the World Health Organization and the Harmonized European Time Use Survey.Purpose. To evaluate the relation between the suicide rate and duration of the main daily activities of employees in the spheres of work, household and leisure activities in terms of the multifactor models. Materials and methods. Daily activities are understood as time spent on work, household and leisure activities. In order to analyze the relation between the variables an end-to-end linear regression model arranged by all years and countries is used; the panel data structures are not taken into account in the model (as we have to deal with pseudo panel data). In addition, in order to weaken prerequisites of parametric models, a non-parametric estimate is used. The calculations are made in the econometric package STATA IC 16. The source of the data on the suicide rate (total, men, women) at the ages of 15-74 is the European Detailed Mortality Database of the World Health Organization; the source of the data on time spent on the main daily activities of employees in the spheres of work, household and leisure activities and the level of employees’ occupation is Eurostat.Results. The analysis revealed that with the increase in time spent on TV and video the suicide rate increases for the employed men; and with the increase in time spent on housekeeping the suicide rate increases for the employed women. In addition, during working days employed men are expected to be at risk of suicide due to the time spent on work, related activities and travel to and from work; employed women remain at risk due to the time spent on housekeeping. The duration of TV and video watching and housekeeping is a referent of suicide risk factors – loneliness and retreat from the society. It has been established that a possible shift to a four-day working week with an increase in the working hours while maintaining weekly hours leads to the suicide rate increase. Conclusion. In order to reduce the suicide rate in European countries, it is necessary to have such an organization of labour, daily routine and leisure activities, which will allow male employees to reduce their working hours to a minimum of 7.4 hours and to displace watching TV and video on the periphery of the hierarchy of occupations, primarily on weekends, as well as to eradicate "kitchen slavery" among female employees. While evaluating the possible shift to a four-day working week, it is necessary to conduct more research on the impact of the number (ratio) of working days and full days off on the suicide rate.

Background: Suicide is a preventable cause of death. Examining suicide rates and trends are important in shaping national suicide prevention strategies. Therefore, the objectives of this study were to analyze age-standardized suicide trends of Malaysia between 2000 and 2019 using the WHO Global Health Estimates data, and to compare the 2019 rate with countries from the Association of South-East Asian Nations (ASEAN), Muslim majority countries, and the Group of Seven (G7). Methods: The age-standardized suicide rates data were extracted from the WHO Global Health Estimates. We calculated the average age-standardized suicide rates of the last 3 years from 2017 to 2019. Joinpoint regression analysis was conducted to calculate the average annual percentage change (APC) of the age-standardized suicide rates in Malaysia from 2000 to 2019. Results: Between 2000 and 2019, the minimum and maximum suicide rates for both sexes in Malaysia were 4.9 and 6.1 per 100,000 population respectively, whilst the past 3-year (2017–2019) average rates were 5.6, 8.8, and 2.4 for both sexes, males, and females, respectively. The suicide rates decreased significantly for both sexes between 2000 and 2013. Between 2014 and 2019, the suicide rates increased significantly for males. In 2019, Malaysia recorded the rate of 5.8 per 100,000 population, with an estimated 1,841 suicide deaths, i.e., ~5 deaths per day. The Malaysian suicide rate was the second highest amongst selected Muslim majority countries, in the middle range amongst ASEAN countries, and lower than all G7 countries except Italy. Conclusions: There is a need to further explore factors contributing to the higher suicide rates among Malaysian males. In light of the rising suicide rates in Malaysia, national mental health and suicide prevention initiatives are discussed and the importance of high-quality suicide surveillance data is emphasized. [ABSTRACT FROM AUTHOR]

Aim. The paper examines the impact of education on the rate of suicides in India and takes a global outlook on how prevalent is suicide among countries with high education indicators. Methodology. The paper is based on secondary research with data collected from National Databases like NCRB and International databases of WHO and OECD. Data analysis has been performed in MS Excel using statistical techniques such as correlation. Results. The study reveals that in India, the increase in the education levels of people has had a negligible impact on the number of suicides in the country. Across states, the suicide rates and literacy rates have a positive correlation of .35; while correlation does not mean causation and the two are mildly correlated, it does establish the fact that education does not have a direct impact on the suicide rate. The analysis indicates that even though the education levels in the country have risen, subsequently, the educational level among people who committed suicide also increased. Also, it is found that the countries that are ranked higher on PISA ranking and tertiary education attainment have mostly higher rates of suicide. Conclusion. As shown throughout the study, education has not been an effective instrument in equipping people with survival skills. It is as if education is happening in vacuum with no impact on the people committing suicides. Thus, it is important that we question our educational practices, and re-align our goals of education so that they lead to the overall development of an individual. [ABSTRACT FROM AUTHOR]

Genomic testing for early-onset dementia is becoming more accessible, along with predictive testing for at-risk relatives; however, complex counselling issues are important to address. The topic of suicide often has stigma associated, and thoughts or experiences may not be volunteered without prompting. Little has been published with consideration to suicide rates in the context of family experiences and their significance in genetic counselling for relatives of people with Huntington disease and frontotemporal dementia. This study included pedigree information for 267 symptomatic individuals with frontotemporal dementia or Huntington disease, provided via genetic counselling clinics. Descriptive statistics and suicide rate calculations based on family reported pedigree data. The suicide rate was 2996 per 100,000 compared with the population rate of 10 per 100,000. Approximately one in 15 families reported suicide of an affected family member, and file notes indicated that one in five families had experienced suicide, suicidal thoughts or suicide attempts in one or more affected, unaffected or pre-symptomatic relative. Health professional awareness of family experiences, including suicide of a relative, is vital in facilitating client decisions about genetic testing, and in providing adequate psychosocial support during the process of genetic testing and adaption to results. [ABSTRACT FROM AUTHOR]

Abstract Background Most studies have reported that suicide mortality rates are negatively associated with lithium levels in tap water; however, a few studies showed either no association or a positive association. Thus, the association between suicide mortality and lithium levels in tap water remains controversial. To clarify the association, our study evaluated the association between lithium levels in tap water and suicide mortality rates in Miyazaki Prefecture of Japan, after adjusting for confounding factors. Methods We measured lithium levels in tap water across the 26 municipalities of Miyazaki Prefecture in Japan. We examined the standardized mortality ratio (SMR) for suicide in each municipality and used the data as the average suicide SMRs over 5 years (2009–2013). Weighted least-squares regression analysis, adjusted for the size of each municipality’s population, was used to investigate the association between lithium levels in tap water and suicide SMRs. In addition to a crude model, in an adjusted model, potential confounding factors (proportion of elderly people, proportion of one-person households, annual marriage rate, annual mean income, unemployment rate, the density of medical doctors per 100,000 people, annual total rainfall, and proportion of people with a college education or higher) were added as covariates. Results We showed that male and female suicide SMRs were not associated with lithium levels in tap water in Miyazaki Prefecture. After adjusting for confounders, male suicide SMRs were significantly and positively associated with the proportion of elderly people in the population and annual total rainfall, and female suicide SMRs were associated with the proportion of elderly people in the population. Conclusions No association between lithium levels in tap water and suicide mortality rates was found in Miyazaki Prefecture.

Background: Suicide is a preventable cause of death. Examining suicide rates and trends are important in shaping national suicide prevention strategies. Therefore, the objectives of this study were to analyze age-standardized suicide trends of Malaysia between 2000 and 2019 using the WHO Global Health Estimates data, and to compare the 2019 rate with countries from the Association of South-East Asian Nations (ASEAN), Muslim majority countries, and the Group of Seven (G7).Methods: The age-standardized suicide rates data were extracted from the WHO Global Health Estimates. We calculated the average age-standardized suicide rates of the last 3 years from 2017 to 2019. Joinpoint regression analysis was conducted to calculate the average annual percentage change (APC) of the age-standardized suicide rates in Malaysia from 2000 to 2019.Results: Between 2000 and 2019, the minimum and maximum suicide rates for both sexes in Malaysia were 4.9 and 6.1 per 100,000 population respectively, whilst the past 3-year (2017–2019) average rates were 5.6, 8.8, and 2.4 for both sexes, males, and females, respectively. The suicide rates decreased significantly for both sexes between 2000 and 2013. Between 2014 and 2019, the suicide rates increased significantly for males. In 2019, Malaysia recorded the rate of 5.8 per 100,000 population, with an estimated 1,841 suicide deaths, i.e., ~5 deaths per day. The Malaysian suicide rate was the second highest amongst selected Muslim majority countries, in the middle range amongst ASEAN countries, and lower than all G7 countries except Italy.Conclusions: There is a need to further explore factors contributing to the higher suicide rates among Malaysian males. In light of the rising suicide rates in Malaysia, national mental health and suicide prevention initiatives are discussed and the importance of high-quality suicide surveillance data is emphasized.

Purpose. To develop criteria for screening express diagnostics of suicide risk. Material and methods. The statistical data on the number of suicides in the Republic of Belarus and the Grodno region for the period 1995-2018 as well as the data on the medical and social characteristics of suicides in the Grodno region (n = 746) were analyzed. To process the data, we used the statistical application package “Microsoft Office Excel” (Analysis ToolРак), namely the methods of parametric and nonparametric statistics (Pearson’s r-test, correlation and approximation methods), and the analytical method. Results. Medical and social portrait of the average suicide of the Grodno region is the following: a man aged 31- 60 years, married; lives in his own family or with relatives; has his own accommodation; has secondary or secondary professional education; his financial situation is average, satisfactory or good; is satisfactorily or positively characterized in his community; rarely visits medical facilities; is not under the supervision of a psychiatristnarcologist; has not committed any suicide attempts before. Significant circumstances preceding suicide are: alcohol abuse, the presence of a chronic disease, domestic conflict, a difficult life situation and a conflict of inter-sexual relationships. Conclusion. Suicide risk factors, which are individually significant for each suicide, are mainly social in nature and can be generalized at the population (territorial) level in the form of criteria for screening express diagnostics of suicide risk. The relevance of these criteria is determined by their compliance with the medical and social portrait of the average suicide.

Background: South Korea’s suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. Methods: the statistics on causes of death and resident registration central population (RRCP) provided by the National Statistical Office were used to calculate the suicide rate among older adults in Korea. We examined gender (male, female), age (young–old, old–old), and region (urban, rural) by conducting latent growth modeling to estimate changes in the overall older adult suicide rate and verify its relationship. Results: over a period of 8 years, the older adult suicide rate was 104.232 on average in 2010 and it decreased by approximately 10.317 every year, and the rate of decrease gradually slowed down. The initial value of the older adult suicide rate was found to be higher among males, the old–old group, and those living in rural regions. In the quadratic function change rate, only males and the old–old group were statistically significant. Conclusion: in this study, the direction of and the rate of change in the older adult suicide rates and the relationship between gender, age, and region were examined. It is expected that this study will provide basic data to assist in establishing older adult suicide prevention policies, considering the gender, age, and region of the aging population.

Introduction: Social capital is a complex and multifaceted structure or concept. Although it has become a pervasive subject in sociological texts; however, few studies have been conducted on its validity and explanatory value in the field of suicide. In the present study, the author tries to critically review the available resources, while presenting the results of researchers' finding and their critique and to show the relationship between social capital and suicide in the provinces of Iran. In most studies, researchers have hypothesized that the relationship between social capital and suicide is positive, and in practice, they have found that with increasing and decreasing social capital, the rate of suicide fluctuates. However, there is no consensus on the impact of social capital on suicide in Iran. Some researchers have used suicide as an indicator to measure social capital and define the relationship between suicide and social capital (regardless of the causal relationship) to establish a structural relationship between these two concepts (Bastani et al., 2014; Mohammadian et al., 2016). The structural relationship between suicide and social capital emphasizes that the two concepts are strongly interdependent at the theoretical level, and the researcher does not need to distinguish between the two. Despite such a hypothetical link between the two concepts, some argue that social capital has conflicting effects on suicide. Given the above explanations, the lack of consensus on the type of the relationship between suicide and social capital, and the reverse effect of social capital on suicide, the following research question was posed in this study: What are the effects of social capital on the rate of suicide in Iranian provinces? Materials and Methods: The present study tries to explain the rate of suicide based on social capital from the perspective of relational, interpretive, and causal explanations. This comparative research compares the social units (the provinces) of the research. The statistical population includes all documentary data in at least 28 provinces of Iran. It is worth mentioning that there is no specific method for measuring the reliability and validity of social capital; however, the findings extracted and derived from statistical data are more dependable than the data gathered through the surveys and attitudes. Discussion of Results and Conclusions: The results of the study showed that social capital had no effect on the suicide rate and its components had different relationships with the suicide rate. Social participation based on family outcomes affected and reduced the suicide rate. However, at the survey level, severing ties with relatives reduced the suicide rate (a finding different from the statistical data). The political or civic participation presented in this study in the form of electoral participation also had a reducing effect on the suicide rate. But, at the level of triangulation, this effect was different and increased suicide. Security as another component of suicide had a reducing effect on suicide and decreased with increasing the security of suicide. The extent of the conflict, which was measured statistically, had an inverse relationship with the rate of suicide and with increasing the level of conflict in the provinces of Iran. Some components of social capital collected at the survey and attitude levels had an unreasonable relationship with the suicide rate. The components include: 1) desire to live abroad, 2) obtaining citizenship of other countries, 3) the degree of honor of Iran's foreign policy, 4) national identity (the composite structure), and 5) the extent of participation in the war by oneself and other people. If we want to draw the personality of the suicidal person based on the achievements of this research considering the independent variables, we can consider the suicidal person as a person who: 1. Has little social participation. He may have limited contact with relatives; 2. Cannot divorce or divorce his partner and cannot run away from his family; 3. Participates less in the elections. If he/she participates in elections, he/she casts a blank ballot; 4. Has self-doubt; 5. Trusts individuals and the system; 6. Is honest or at least is not a liar; 7. Does not feel safe; 8. Does not have enough energy for conflict; 9. Does not want to live abroad. [ABSTRACT FROM AUTHOR]

This study investigates social and economic factors influencing suicide rates in 231 South Korean cities, counties, and districts from 2010 to 2015. The results of a panel data analysis indicate that the number of social organizations did not have a significant effect on suicide rates; however, among six types of social organizations, social/recreational organizations showed a strong negative impact on suicide rates, suggesting that not all social organizations equally created social capital that addresses community health problems. Moreover, poverty and income are two strong predictors of municipal-level suicide rates, but municipal governments' welfare spending was only effective in rural areas. [ABSTRACT FROM AUTHOR]

This study attempts to investigate if suicide is interlinked with unemployment in Mexico by making use of a recently developed Bootstrap ARDL bound test over the years of 1981–2016. To avoid omitting variable bias, we use economic growth rate as a control variable. The empirical results indicate that no co-integration among these three variables and there is a positively bidirectional causality between suicide rate and the unemployment rate. This study will showcase that the economic growth rate negatively affects unemployment rate and unidirectional Granger causality running from economic growth rate to the unemployment rate in Mexico. The findings presented in this study could provide with valuable information for society and health policy makers to formulate the policies on suicide prevention in Mexico.

Introduction: Military suicide is an important issue; however, no previous studies have examined the prevalence of military suicide in Taiwan. Methods: We performed a retrospective analysis of the suicide data from the Military of National Defense and compared the results year-by-year with the suicide rate given in the national data provided by the Ministry of Health and Welfare during 2003–2015 in Taiwan. We also compared the results with the United States army and the Japan Self-Defense Force during 2008–2014. Results: The results showed that military suicide rate among Taiwanese soldiers was significantly lower than the general population (t = 10.89, P < 0.001) and the average suicide rate of the military and the general population was 16.5 ± 1.5 and 8.2 ± 2.2 per 100,000 people, respectively. The results also showed a lower suicide rate among the Taiwanese military personnel (7.2 ± 1.8) compared with the military of America (18.8 ± 2.5) and Japan (36.2 ± 2.6) during 2008–2014. Discussion: Taiwanese soldiers have relatively lower suicide rate compared to the general population in Taiwan. However, military suicide prevention program has to adjust the strategy, which is different from country and culture. We should focus on this issue and build on factors that can help avoid suicide incidents by promoting positive mental health and help-seeking.

The purpose of this study is to analyze the difference in suicide rates between regions and to determine the effect of social workers on the regional suicide rate. The main analysis results are as follows. First, the suicide rates in metropolitan cities were lower than was lower than in other regions, and cities and districts were lower than those in the county area. Second, suicide rates were high in areas with many cultural and social welfare facilities per population. Suicide rates were high in low mental health facilities and low social welfare budgets. The suicide rate in rural areas was high. Third, suicide rates were high in areas with low economic requirements, areas with a high proportion of the elderly, divorce rates, and areas with a small number of social security recipients and living alone. In other words, the suicide rate in rural areas was high. Finally, social workers did not affect the difference in local suicide rates. Local social services and budgets have no real impact on suicide rates. In the future, it is necessary to improve the quality and quantity of community welfare practices that can lower community suicide rates. [ABSTRACT FROM AUTHOR]

Background: Most studies have reported that suicide mortality rates are negatively associated with lithium levels in tap water; however, a few studies showed either no association or a positive association. Thus, the association between suicide mortality and lithium levels in tap water remains controversial. To clarify the association, our study evaluated the association between lithium levels in tap water and suicide mortality rates in Miyazaki Prefecture of Japan, after adjusting for confounding factors. Methods: We measured lithium levels in tap water across the 26 municipalities of Miyazaki Prefecture in Japan. We examined the standardized mortality ratio (SMR) for suicide in each municipality and used the data as the average suicide SMRs over 5 years (2009–2013). Weighted least-squares regression analysis, adjusted for the size of each municipality's population, was used to investigate the association between lithium levels in tap water and suicide SMRs. In addition to a crude model, in an adjusted model, potential confounding factors (proportion of elderly people, proportion of one-person households, annual marriage rate, annual mean income, unemployment rate, the density of medical doctors per 100,000 people, annual total rainfall, and proportion of people with a college education or higher) were added as covariates. Results: We showed that male and female suicide SMRs were not associated with lithium levels in tap water in Miyazaki Prefecture. After adjusting for confounders, male suicide SMRs were significantly and positively associated with the proportion of elderly people in the population and annual total rainfall, and female suicide SMRs were associated with the proportion of elderly people in the population. Conclusions: No association between lithium levels in tap water and suicide mortality rates was found in Miyazaki Prefecture. [ABSTRACT FROM AUTHOR]

Objectives: To identify the distribution of suicide rates in Turkey between 2007 and 2016 by gender, age, marital status, and geographical region. Methods: Suicide statistics obtained from the Turkish Statistical Institute and population data were used to calculate suicide rates by gender, age, marital status, and geographical region. An independent two-sample t-test and one-way analysis of variance (ANOVA) were used to analyze the data. Results: In Turkey, suicide rates are low, but they have slowly risen recently. The suicide rate of men was higher than that of women (p<0.001). The highest suicide rate by age group was among people 75 years and older and the second highest was among people 15 to 24 years old (p<0.001). The suicide rate of divorced people was higher than that of other marital status groups (p<0.001). Average suicide rates in the seven geographical regions of Turkey differed from each other, and suicide rates among men and women in each region varied (p<0.001). Conclusion: The suicide rate between 2007 and 2016 was higher in men, particularly for older ages, the divorced, and those living in both socio-economically developed and underdeveloped regions in Turkey. Socio-demographic characteristics must be taken into consideration in studies focusing on the prevalence and prevention of suicide. [ABSTRACT FROM AUTHOR]