Abstract
BackgroundWhereas German suicide rates had a clear decreasing tendency between 1991 and 2006, they increased from 2007 to 2010. Deeper analyses of suicide data might help to understand better this change. The aim of this study was to analyze 1) whether recent trends can be related to changes in specific suicide methods and diverge by gender and age; 2) whether the decrease of suicide rates before 2007 as well as the increase from 2007 to 2010 are driven by the same suicide method.MethodsAnalyses were based on suicide data from the Federal Statistical Office of Germany. For 1998–2010, 136.583 suicide cases of men and women with known age and suicide method could be identified. These data were analyzed by joinpoint regression analysis, allowing identification of the best fitting point in time (“joinpoint”) at which the suicide rate significantly changes in magnitude or direction.ResultsThe national downward trend between 1998 and 2007 was mainly due to corresponding changes in self-poisoning by other means than drugs (e.g., pesticides) (annual percentage change (APC) ≤ −4.33), drowning (APC ≤ −2.73), hanging (APC ≤ −2.69) and suicides by firearms (APC ≤ −1.46) in both genders. Regarding the overall increase of age-adjusted suicide rates in Germany 2007–2010, mainly the increase of self-poisoning (e.g., by drugs) and “being overrun” (APC ≥ 1.50) contributed to this trend.LimitationsThe true suicide rates might have been underestimated because of errors in the official death certificates.ConclusionsIncrease in suicide rates in Germany since 2007 went along with corresponding changes for “being overrun” and “self-poisoning”. Copycat suicides following the railway suicide of the goalkeeper Robert Enke partly contributed to the results. Thus, prevention of Werther effects and limitation of the availability of high pack sizes for drugs are of special relevance for the reversal of this trend.
Highlights
Regarding the last two decades of the 20th century, there was a rather consistent decline of suicide rates in Europe, with the former states of the Soviet Union being a remarkable exception [1]
Copycat suicides following the railway suicide of the goalkeeper Robert Enke partly contributed to the results
We identified joinpoints for the ageadjusted German annual suicide rates from 1998 to 2010, for men and women separately
Summary
Regarding the last two decades of the 20th century, there was a rather consistent decline of suicide rates in Europe, with the former states of the Soviet Union being a remarkable exception [1]. German suicide rates further decreased between 2002 and 2006; from 2007 to 2010 a continuous increase of the German suicide rates was recorded Several reasons such as the economic crisis, changes in the prevalence of depression and other psychiatric disorders or demographic changes are discussed in this context. The intense media coverage concerning the suicide of the German national football goal keeper Robert Enke on Nov. 10, 2009 is of interest This media coverage has triggered short increases of railway suicides [6], but might have contributed to long-term increases in suicide rates. Deeper analyses of suicide data might help to better understand this change in suicide trends and sharpen suicide preventive strategies. The aim of this study was to analyze 1) whether recent trends can be related to changes in specific suicide methods and diverge by gender and age; 2) whether the decrease of suicide rates before 2007 as well as the increase from 2007 to 2010 are driven by the same suicide method
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