Incidence Rate Of Suicide Research Articles

The incidence rates of suicide attempts and successful suicides in seven climatic conditions in Iran from 2001 to 2014: a systematic review and meta-analysis

Background And Aim: Suicide is a social problem which can be influenced by geographical, cultural, economic, social, and environmental factors. The aim of the present study was to perform a systematic review and meta-analysis in order to evaluate the relationship of rates of suicide attempts and successful suicides with seven climatic conditions in Iran. Materials and methods: The present study was a systematic review and meta-analysis on the incidence rates of suicide attempts and successful suicide in seven climatic areas of Iran which was carried out by reviewing the published papers between 2001 and 2014. Using the keywords suicide, attempted suicide, incidence, Iran and combined terms, two trained investigators searched SID, ISI, Pubmed, Google Scholar, Irandoc, Scopus, and Magiran databases and all the relevant articles were extracted independently by them. The results were analyzed by using weighted average and Poisson distribution. Results: Among 74 articles, 30 were eligible for our study. The highest level of suicide attempts belonged to the climate area 5 (Isfahan, Yazd, Semnan and Qom cities) with and incidence rate of 114. 7/100000 people and the least belonged to the climate area 6(Chaharmahal and Bakhtiaree, kohkiloyeh and BoyerAhmad, Khuzestan Province) with the incidence rate of 37/ 100000 people. The highest and lowest incidence rates of successful suicide belonged to climate area 1 (Ilam, Lorestan, Hamadan, Kurdistan and Kermanshah) and climate area 5 with incidence rates of 12. 9 and 2. 8/100000 people respectively. Climate zone 5 had the highest incidence rate of suicide attempts and lowest rate of successful suicide. Conclusion: According to the findings of this study, the incidence of suicide and successful suicide can be influenced by climatic factors. Based on the results of the studies conducted in different regions of the world, geographical and climatic factors can affect the incidence rates of suicide attempts and successful suicides. This was an ecological study. In order to find the association of climate factors with suicide attempts and successful suicides, further studies should be done on individual level. © 2017, Kurdistan University of Medical Sciences. All rights reserved.

Suicidal Deaths-A Study in Kalaburagi

Suicide is a global phenomenon in all regions of the world: in fact 75% of global suicide occurred in low and middle income countries in 2012. Suicide accounted for 1.4% of all deaths worldwide making it the 15th leading cause of death in 2012. Suicide committed by an individual will be burden on whole family. The present study is conducted to know the incidence of suicide in Kalabuargi, risked age group, sex and the different methods employed for committing suicide. Total of 659 medico legal post mortem cases conducted at District hospital, Kalaburagi between 1st January 2015 to 31st December 2015 were analysed. In this 220 cases were alleged suicidal deaths. Incidence rate of suicide is suicide is 33.38% in this region. Males outnumbered females (137 cases in males and 83 cases in females). Age group 21 to 30 is most commonly involved (77 cases 35%). Burning was the most common method of committing suicide (92 cases 41.8%), followed by poisoning (70 cases 31.8%). However in the males poisoning was the preferred method of committing suicide (54 cases 39.42% out of 137 suicides in males). Suicidal deaths are preventable by combined efforts of Government agencies, stringent law and by changing the mindset of the people to adopt to all difficult situations.

Epidemiological survey of intentional poisoning suicide during 1993-2013 in Ilam Province, Iran.

BackgroundSuicide is an important social tragic phenomenon which occurs by different tools or methods in different communities. Considering deliberate poisoning as a common and important method in Ilam province for suicide, the present study was launched to epidemiologically assess committing suicide in Ilam province, Iran, based on intentional poisoning.MethodsBy a retrospective study, all the recorded data associated with intentional poisoning suicide in Ilam Province during 1993–2013 were analyzed. All the demographic variables and the suicides’ outcomes were analyzed using the Chi-Square test, and the univariate and multivariate logistic regression models.ResultsTotally, 6794 cases of suicide (annual incidence rate of 87.28/ 100, 000) associated with poisoning were evaluated. The incidence rate of suicide attempts was 84.63/ 100, 000 (94.51 in female and 74.98 in male) and the incidence rate of completed suicide was 2.17/ 100, 000 (1.94 in female and 2.40 in male). Also, the highest rates of attempted and completed suicide (annual incidence rate of 172.42 and 4.14, respectively) were attributed to the age group of 15–24 year.ConclusionFemales had a greater tendency to commit suicide by poisoning, and the lower level of education, the age group of 15–24 years and single individuals were more associated with suicide using poisonings. The incidence of attempted suicide in females and completed suicide in males was higher in this method. Considering the high rate of suicide by poisoning, further attention and supervision on the sale and reserve of drugs and poisons is necessary.Meanwhile, it seems that due to momentary emotions during the pubertal stage, the risk of committing suicide is increased especially among unemployed individuals; therefore, performing an extensive psychotherapy intervention is needed in the societies with younger populations.

An ecological study of social fragmentation, socioeconomic deprivation, and suicide in rural China: 2008–2010

China accounts for a large number of suicides worldwide, and most occur in rural areas. Suicide research in China has primarily focused on individual-level risk factors, few have studied the influence of neighborhood contexts. This ecological study examines the association of suicide rates with social fragmentation and socioeconomic deprivation in Chinese rural villages. Data from the community survey of the China Health and Retirement Longitudinal Study were analyzed using negative binomial regression. A total of 307 rural villages were included. The community survey collected data about the villages from local leaders. Suicide counts were measured by the leaders' report of the number of suicide deaths in the villages. Social fragmentation was indicated by out-migration, in-migration and ethnic diversity; socioeconomic deprivation was indicated by physical infrastructure, illiteracy rates and public transit accessibility. Results show that higher incidence rates of suicide occurred in villages with high proportions of out-migration (vs. low), inflow of migrants (vs. no migrants), mixes of Han and ethnic minority residents (vs. Han only), high degrees of infrastructure deficiency (vs. low) and poor access to public transportation (vs. excellent). Villages with higher percentages of older adults also had higher suicide rates. This is one of the first studies to examine the association between neighborhood contexts and suicide in China. The findings have implications for suicide prevention in rural China.

The Association between Inappropriate Weight Control Behaviors and Suicide Ideation and Attempt among Korean Adolescents.

Suicide is a leading cause of death among adolescents globally, and body weight is also a recognized reason for adolescent suicide. Therefore, we investigated the association between weight control behaviors (WCB) and suicide ideation and attempt, focusing on inappropriate weight control measures. We used data from the 2014 Korea Youth Risk Behavior Web-based Survey, representing a total of 35,224 boys and 34,361 girls aged 12 to 18 years. Adolescents were classified into groups based on WCB: appropriate WCB, inappropriate WCB, and no WCB. We performed logistic regression models to examine associations between WCB and suicide ideation and attempt, controlling for covariates. Both boys and girls with inappropriate WCB were more likely to report suicide ideation and attempt. Underweight and normal weight boys with inappropriate WCB were more likely to think or attempt suicide, and underweight girls with inappropriate WCB were also more likely to attempt suicide. Among five common WCB combinations, the combination of "regular exercise, fasting, eating less" was highly associated with suicide ideation and attempt. We confirmed that inappropriate WCB is associated with suicide ideation and attempt among Korean adolescents. Given the high incidence rate of suicide among adolescents and the adverse effect of inappropriate WCB, encouraging adolescents to control their weight in healthy ways is imperative.

A Nationwide Population-Based Study of Corrosive Ingestion in Taiwan: Incidence, Gender Differences, and Mortality.

Corrosive injury results from the intake of corrosive-acid-based chemicals. However, this phenomenon is limited to a small number of cases and cannot be extrapolated to the epidemiology of corrosive injuries in actual situations. This study focuses on the annual incidence of corrosive injury and its connection to gender, risk factors, and in-hospital mortality. All patients with corrosive injury (ICD-9 947.0–947.3) were identified using a nationwide inpatient sample from 1996 until 2010. Chi-squared tests and multivariate logistic regression were used to examine risk factors of gender differences and in-hospital mortality of corrosive injury. Young adults comprised the majority of patients (71.2%), and mean age was 44.6 ± 20.9 years. Women showed a higher incidence rate of corrosive injuries, age, suicide, psychiatric disorder, and systemic complications compared with men (p < 0.001). The present study demonstrated that age (OR = 10.93; 95% CI 5.37–22.27), systemic complications (OR = 5.43; 95% CI 4.61–6.41), malignant neoplasms (OR = 2.23; 95% CI 1.37–3.62), gastrointestinal complications (OR = 2.02; 95% CI 1.63–2.51), chronic disease (OR = 1.30; 95% CI 1.08–1.56), and suicide (OR = 1.23; 95% CI 1.05–1.44) were strongly associated with in-hospital mortality. Educational programs may be helpful for reducing the incidence of ingestion of corrosive chemicals.

Incidence of Suicide in Patients With Head and Neck Cancer.

Suicide rates among patients with cancer in the US are significantly higher than those of the general population. To our knowledge, large cohort studies examining suicide rates among patients with head and neck cancer have not been performed. To identify incidence rate, trends, and risk factors of suicide in patients with cancer of the head and neck. This was a retrospective cohort study of geographic areas served by the Surveillance, Epidemiology, and End Results (SEER) program. In total, 350,413 cases of patients with head and neck cancer were recorded within the SEER registry between 1973 and 2011. Data analyses were performed in 2014. Incidence data were calculated from the subset of that population that had the cause of death category coded as "suicide and self-inflicted injury." Patients diagnosed as having a primary cancer of the head and neck region. Influence of demographic factors, anatomic site of tumor, disease stage, and time since diagnosis on risk for suicide. Among 350,413 SEER registry patients with head and neck cancer, observed for 2,263,376 person-years, 857 suicides were identified with an age-, sex-, and race-adjusted suicide rate of 37.9/100,000 person-years. In contrast, the US general population suicide rate was 11.8 per 100,000 person-years. Suicide rates were higher in those treated with radiation alone (standardized mortality ratio [SMR], 5.12; 95% CI, 3.83-6.41) compared with those treated with surgery alone (SMR, 2.57; 95% CI, 1.66-3.49). The highest suicide risk was seen in patients with cancers of the hypopharynx (SMR, 13.91; 95% CI, 11.78-16.03) and larynx (SMR, 5.48; 95% CI, 4.14-6.81). Patients with head and neck cancer have more than 3 times the incidence of suicide compared with the general US population. Furthermore, suicide rates were highest among those with cancers of the larynx and hypopharynx.

Completed suicide and associated risk factors: a six-year population based survey.

The investigations on suicide conducted within low- and middle-income countries are limited. This study evaluated the trend of suicide and its associated risk factors in the west of Iran. This six-year population-based survey was conducted in Kermanshah Province, in 2012. The data on suicide was extracted from the suicide database of the Provincial Health Center, which was collected for six successive years. Multivariate logistic regression analysis was performed and odds ratio (OR) as well as its 95% confidence intervals (CI) was reported. During the study period, 13,810 attempted suicides occurred of which 1,564 (11.33%) were completed. The incidence rate of suicide has increased in recent years. Based on logistic regression analysis, OR estimate of completed suicide increased 1.46 (95% CI: 1.36, 1.56) fold for every 10-year increase in age. Moreover, OR estimate of completed suicide was 2.53 (95% CI: 1.94, 3.31) in men compared to women. Compared to married people, the OR estimate of completed suicide was 1.41 (95% CI: 1.15, 1.72) in single people, 1.92 (95% CI: 1.15, 3.23) in widowed people, and 1.97 (1.32, 2.95) in divorced people. The lower the educational level, the higher the risk of completed suicide. Compared to school/college students, the risk of completed suicide was higher among housewives, employed people or employees, and retirees. A majority of the suicides (90.05%) occurred at home. Taking medications was the most common way (69.13%) of a suicide attempt. We indicated that associated factors with completed suicide vary in Iran compared to other developed and developing countries and that factors associated with attempted suicide are different from that of completed suicide.

Spatial regularity in suicides and alcohol psychoses in Belarus

Objective. Epidemiological evidence suggests that rates of suicide mortality vary noticeably between the regions in Belarus with the regular spatial pattern in suicide distribution. The present study considers the effect of regional alcohol consumption as a factor responsible for regional variations in suicide rates. Methods. The cross-sectional time series analysis of suicide and alcohol psychoses (as a proxy for alcohol consumption) rates by the regions of Belarus between 1990 and 2010 was made. Results. In general, the regional variations of suicide and alcohol psychoses incidence rates have a similar spatial regularity, meaning that the regions with a high suicide rate also have a high alcohol psychoses incidence rate. Conclusions. The findings on spatial relationship between suicide and alcohol psychoses incidence rates seem to support the hypothesis that considers the regional pattern of alcohol consumption as a factor responsible for suicide rate regional variations.

Suicide in first episode psychosis: A nationwide cohort study

BackgroundRelatively little is known about suicide in diagnostic subtypes of first episode psychosis (FEP). Our aim was to assess suicide rates and potential risk factors for suicide in FEP. MethodsThis is a national register-based cohort study of patients born in 1973–1978 in Sweden and who were hospitalized with a FEP between ages 15 and 30years (n=2819). The patients were followed from date of discharge until death, emigration, or 31st of December 2008. The suicide rates for six diagnostic subtypes of FEP were calculated. Suicide incidence rate ratios (IRRs) were calculated to evaluate the association between suicide and psychiatric, familial, social, and demographic factors. ResultsIn total 121 patients died by suicide. The overall suicide rate was 4.3 (95% confidence interval [CI] 3.5–5.0) per 1000person-years. The highest suicide rates were found in depressive disorder with psychotic symptoms and in delusional disorder. In an adjusted model, the strongest risk factors for suicide were self-harm (IRR 2.7, CI 1.7–4.4) or a conviction for violent crime (IRR 2.0, CI 1.3–3.2). Also having a first-degree relative with a schizophrenia/bipolar diagnosis (IRR 2.1, CI 1.2–3.6) or substance use disorder (IRR 2.0, CI 1.2–3.2) were significant risk factors for suicide. ConclusionsImpulsive behavior such as self-harm as well as having a family history of severe mental disorder or substance use are important risk factors for suicide in FEP.

A survey of characteristics of self-immolation in the northern iran.

Background:Suicide is an action deliberately initiated and performed by a person with complete awareness of its fatal outcome, prevalence of which is very rare in developed countries, but it is reported with more frequency in Middle East including Iran.Aim:This study was carried out to analyze the characteristics, mortality, and related factors of burned patients who attempted to suicide by self-immolation in Northern Iran.Materials and Methods:In this retrospective study, the archived files of 101 cases that referred to the main burn care center located in northern Iran (Included: Mazadaran, Golestan cities) - cause of suicide attempting by self-immolation during 2 years 2010-2011, analyzed. A record sheet designed to extract data such as: Age, education, occupation, gender, residence, marital status, drug abuse, and extent of the burn injuries as a percent of burned total body surface area (TBSA).Results:The incidence rate of suicide attempted cases were 1.98/100,000 person-years. The mean ages for cases were 31.8 (13.6). The mean age for males and females were 36.1 (14.8) and 30.1 (12.9) years, respectively. In, about 84% (84/101) of the patient's burned TBSA was more than 40% (41/101). Burn injuries were more frequent, larger, and included higher mortality in females than males. Kerosene was the most common used material to self-burning. The mortality rate was about 74% (74/101), which showed a high mortality rate in this study. Other social factors such as marital status, employment, and education level have a role as individually protective or risk factors for self-burning.Conclusion:Finding of the current study manifested high rate of suicide by self-immolation among young, married, and low educated women in Northern Iran. It implies a social problem, and need to an arrangement of a cultural program aimed to improving health, psychological habits and educational level.

Genetic and familial environmental effects on suicide--an adoption study of siblings.

BackgroundWhile there is clear evidence of familial influences on suicide, the origin of these is less certain. We have investigated genetic and familial environmental factors by studying the occurrence of suicide in biological and adoptive siblings of adoptees who died by suicide compared to siblings of surviving adoptees.MethodWe used the Danish Adoption Register and Danish population registers to compare 221 siblings of adoptees who died by suicide with the siblings of 1,903 adoptees who did not die by suicide. All adoptions in the Danish Adoption Register are non-familial, i.e. the adoptive parents are biologically unrelated to the adoptee. Analyses were conducted on incidence rates of suicide in biological and adoptive siblings given occurrence of suicide in the adoptees while also taking into account psychiatric disorders.ResultsThe risk of suicide in full siblings of adoptees who died by suicide before age 60 years was significantly higher than in full siblings of adoptees who had not died by suicide (incidence rate ratios (IRR) = 5.01; 95% confidence interval [CI] = 1.28 - 19.6). This increase persisted after adjustment for history of psychiatric admission of siblings (IRR = 4.19; 95% CI = 1.00 - 17.5).ConclusionsGenetic factors influence risk of suicide, probably independently of psychiatric disorder. This is relevant in provision of advice to families, including possible prevention of suicide.

Validation of suicide and self‐harm records in the Clinical Practice Research Datalink

AimsThe UK Clinical Practice Research Datalink (CPRD) is increasingly being used to investigate suicide-related adverse drug reactions. No studies have comprehensively validated the recording of suicide and nonfatal self-harm in the CPRD. We validated general practitioners' recording of these outcomes using linked Office for National Statistics (ONS) mortality and Hospital Episode Statistics (HES) admission data.MethodsWe identified cases of suicide and self-harm recorded using appropriate Read codes in the CPRD between 1998 and 2010 in patients aged ≥15 years. Suicides were defined as patients with Read codes for suicide recorded within 95 days of their death. International Classification of Diseases codes were used to identify suicides/hospital admissions for self-harm in the linked ONS and HES data sets. We compared CPRD-derived cases/incidence of suicide and self-harm with those identified from linked ONS mortality and HES data, national suicide incidence rates and published self-harm incidence data.ResultsOnly 26.1% (n = 590) of the ‘true’ (ONS-confirmed) suicides were identified using Read codes. Furthermore, only 55.5% of Read code-identified suicides were confirmed as suicide by the ONS data. Of the HES-identified cases of self-harm, 68.4% were identified in the CPRD using Read codes. The CPRD self-harm rates based on Read codes had similar age and sex distributions to rates observed in self-harm hospital registers, although rates were underestimated in all age groups.ConclusionsThe CPRD recording of suicide using Read codes is unreliable, with significant inaccuracy (over- and under-reporting). Future CPRD suicide studies should use linked ONS mortality data. The under-reporting of self-harm appears to be less marked.

Spatial distribution of suicide incidence rates in municipalities in the state of Espírito Santo (Brazil), 2003-2007: spatial analysis to identify risk areas

To analyze the spatial distribution of suicide incidence rate in a residential municipality of the state of Espírito Santo (ES), Brazil, from 2003 to 2007. Ecologic study of the exploratory kind, based on secondary data. Deaths per suicide, which took place in each municipality of ES, were included in the data according to information provided by the Mortality Information System. For the spatial data analysis, a Bayesian approach was used (Global empirical and Local Bayesian ones) to correct epidemiological rates. Moran's I index was calculated to a worldwide spatial level dependence, and Local Moran (LISA) to a local spatial correlation. The following software applications were used: Excel; R 2.6.2; SPSS 11.5 and TerraView 3.3.1. The geographical localization of the municipalities that showed an incidence rate characterized as the average for suicide after adjustment (EBest Global) forms a corridor in the countryside. Some common characteristics among these municipalities are: a) immigration (Italians, Pomeranians/ Germans); b) rural population (average of 53%); c) supporting economy (agriculture, husbandry and livestock). A global and local spatial correlation was found among the municipalities (p < 0.05). The study identified the spatial context where the greatest death incidence rate per suicide occurred in the state of ES, during the mentioned period.

Does place of residence affect risk of suicide? a spatial epidemiologic investigation in Kentucky from 1999 to 2008

BackgroundApproximately 32,000 people take their own lives every year in the United States. In Kentucky, suicide mortality rates have been steadily increasing since 1999. Few studies in the United States have assessed spatial clustering of suicides. The purpose of this study was to identify high-risk clusters of suicide at the county level in Kentucky and assess the characteristics of those suicide cases within the clusters.MethodsA spatial epidemiological study was undertaken using suicide data for the period January 1, 1999 to December 31, 2008, obtained from the Kentucky Office of Vital Statistics. Descriptive analyses using Pearson's chi-square test and t-test were performed to determine whether differences existed in age, marital status, year, season, and suicide method between males and females, and between cases inside and outside high-risk spatial clusters. Annual age-adjusted cumulative incidence rates were also calculated. Suicide incidence rates were spatially smoothed using the Spatial Empirical Bayesian technique. Kulldorff's spatial scan statistic was applied on all suicide cases at the county level to identify counties with the highest risks of suicide. Temporal cluster analysis was also performed.ResultsThere were a total of 5,551 suicide cases in Kentucky from 1999 to 2008, of which 5,237 (94%) were included in our analyses. The majority of suicide cases were males (82%). The average age of suicide victims was 45.4 years. Two statistically significant (p < 0.05) high-risk spatial clusters, involving 15 counties, were detected. The county level cumulative incidence rate in the most likely high-risk cluster ranged from 12.4 to 21.6 suicides per 100,000 persons. The counties inside both high-risk clusters had relative risks ranging from 1.24 to 1.38.ConclusionsStatistically significant high-risk spatial clusters of suicide were detected at the county level. This study may be useful for guiding future research and intervention efforts. Future studies will need to focus on these high-risk clusters to investigate reasons for these occurrences.

The impact of psychiatric illness on suicide: Differences by diagnosis of disorders and by sex and age of subjects

People with a psychiatric illness are at high risk for suicide; however, variation of the risk by patients’ sex and age and by specific diagnosis needs to be explored in a more detail. This large population study systematically assesses suicide incidence rate ratio (IRR) and population attributable risk (PAR) associated with various psychiatric disorders by comparing 21,169 suicides in Denmark over a 17-year period with sex-age-time-matched population controls. The study shows that suicide risk is significantly increased for persons with a hospitalized psychiatric disorder and the associated risk varies significantly by diagnosis and by sex and age of subjects. Further adjustment for personal socioeconomic differences eliminates the IRRs associated with various disorders only to a limited extend. Recurrent depression and borderline personality disorder increase suicide risk the strongest while dementia increases the risk the least for both males and females. The influence of various disorders generally weakens with increasing age; however, there are important exceptions. Schizophrenia affects people aged ≤35 years the strongest in terms of both IRR and PAR. Recurrent depression increases suicide risk particularly strong in all age groups and the associated PAR increases steadily with age. Borderline personality disorder has a strong effect in young people, especially those ≤35 years. Alcohol use disorder accounts the highest PAR of suicides in males of 36–60 years old. For the elderly above 60 years old, reaction to stress and adjustment disorder increases the risk for suicide the most in both sexes. These findings suggest that approaches to psychiatric suicide prevention should be varied according to diagnosis and sex and age of subjects.

Ten years of follow-up study on committed suicide and attempted suicide in Jinuo nationality

Objective To investigate the recent decade (1999 to 2009) incidence of committed suicide and attempted suicide of the Jinuo nationality in Jinuo Mountain and study the clinical characteristics of it. Methods 10 610 subjects at 44 Jinuo villagers committees were investigated by the method of door-to-door inquiry under the help of clues and collected the data of larithmics and medical history. Results 32 committed suicide patients were found in total, and the average incidence rate per year in the recent decade was 30. 16/100 000. 5 attempted suicide patients were found and the average incidence rate per year in the recent decade was 4.71/100 000. Conclusion The Jinuo committed suicide incidence rate is higher than nationwide level. The attempted suicide incidence rate is lower than nationwide level. Key words: Jinuo nationality; Suicide; Attempted suicide

Declining Rates of Suicidal Behavior among General Practice Patients in Belgium: Results from Sentinel Surveillance between 1993 and 2008

The aim of this study was (1) to estimate the incidence of suicidal behavior, i.e., suicide and suicide attempts, among Belgian general practice patients in 2007–2008 and to estimate trends since previous surveillance periods, i.e., 1991–1993 and 2000–2001; and (2) to investigate characteristics of actors, acts, and first care delivery. Data were collected by the national network of sentinel general practitioners, recording all suicidal behavior they were confronted with in their daily practice in the three periods. In 2007–2008 incidence rates of both suicide and suicide attempts had declined compared to the previous periods while the use of violent versus non-violent suicidal methods remained unchanged. GP involvement in first care after suicidal behavior declined over time from 71% to 39% in the largest part of the population, i.e., younger and adult persons. The last surveillance of suicidal behavior by the Belgian sentinel network of GPs most likely resulted in an underestimation, probably as a result of a declining role of GPs in delivery of first care to patients following suicidal behavior.

Hospital‐treated psychosis and suicide in a rural community (1877–2005). Part 1: Incidence rates

To calculate the incidence rates of hospital-treated psychosis and suicide in historical cohorts of a small rural community in southeast Norway, and to compare the local findings with the national ones. We have carried out a longitudinal epidemiological study, reviewing the patient records at the mental hospitals of people born in the rural community after 1845. Based on these records, we have constructed a local register of psychosis and suicide in this population. The local incidence rates of psychosis and suicide have been compared with the national ones. The overall local incidence rates of psychosis and suicide were similar to the national ones. The local rates of schizophrenia dropped considerably after World War II. The overall local incidence rates of psychosis and suicide seem to be representative for the country at large despite frequent endogamy. The recent drop in the incidence rate of schizophrenia seems to be in agreement with several international studies.

State firearm laws and rates of suicide in men and women

Background To evaluate the associations of state laws restricting firearms and incidence rates of suicide in men and women using a cross-sectional design. Methods States were divided into three categories based on the restrictiveness of their firearm laws: restrictive ( n =8); modest ( n =22); and unrestrictive ( n =20). State suicide incidence rates stratified by gender were compared using Poisson regression analyses that controlled for measures of race/ethnicity, income, and urbanization. Analyses were based on 2000 census data and state suicide data from 1999 and 2000. Results In the analysis of women, compared to states with restrictive firearm laws, there were higher suicide incidence rate ratios (IRR) in states with modest (IRR=1.64; 95% confidence interval [CI], 1.34–2.01) and unrestrictive laws (IRR=1.55; 95% CI, 1.23–1.95). The analysis of men showed comparable results: modest firearm laws (IRR=1.51; 95% CI, 1.27–1.79); unrestrictive firearm laws (IRR=1.49; 95% CI, 1.23–1.82). Conclusions Results support the hypothesis that state restrictions on firearms have the potential to reduce the suicide rate. Findings do not support a hypothesis that greater firearm restrictions are associated with the substitution of alternative methods of suicide. Firearms appear to be a comparable exposure for suicide in men and women. Although men are more likely to use firearms in suicide than women, this difference may merely reflect more frequent gun ownership among men.