Lower Suicide Rates Research Articles

Can real-time surveillance systems of suspected suicide accurately reflect national suicide rates? Age-specific and sex-specific findings from the first two years of the COVID-19 pandemic in England: an observational study

Introduction‘Real-time surveillance’ (RTS) systems of suspected suicide showed no overall rise in the early COVID-19 pandemic several months before official statistics reported the same. There has to date been no...

Global trends in youth suicide from 1990 to 2020: an analysis of data from the WHO mortality database

Suicide is a serious but preventable public health concern at the global level, showing relevant geographical differences. This study aims to monitor global temporal and geographical patterns in suicide mortality in pre-adolescents, adolescents, and young adults (i.e., aged 10-24 years), from 1990 to 2020 or the most recent available year. Using the World Health Organisation mortality database, we conducted an analysis on a subset of 52 countries with valid and high-quality data. We computed age-standardised suicide rates (ASR) by sex, country, and calendar year, and performed a joinpoint regression analysis to identify significant changes in the temporal suicide trends over the studied period. High variability in suicide rates and trends was observed, with a male-to-female ratio of two to five. Between 1990 and 2020, most European countries reported declining suicide trends, with some exceptions. In particular, alarming trends emerged in the United Kingdom, with annual rises of 2.5% (95% CI: 1.6-3.5) since 2005 among males and 8.5% (95% CI: 4.7-12.6) since 2012 among females. The most favorable trends and lowest suicide rates were in Southern Europe, with 3.1/100,000 persons in Italy (2020) and 3.5/100,000 persons in Spain (2021) among males, and 0.9/100,000 persons in Italy (2020) and 1.1/100,000 persons in Romania (2019) among females. Conversely, the highest rates were in Central-Eastern Europe, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Higher suicide rates and significant increases were reported in not European areas. The highest ASR was 15.5/100,000 males in the United States of America, with an annual increase of 3.8% (95% CI: 3.1-4.5) among males in 2009-2020 and 6.7% (95% CI: 5.6-7.8) among females in 2007-2017, followed by a levelling off. Temporal and geographical comparisons of suicide mortality should be interpreted with caution due to potential misclassification or under-reporting of suicide deaths in some countries. None.

Exploring Teen Suicide Rates through the Lens of Macro Risk Factors

ABSTRACT As the second leading cause of death in teenagers, suicide has been a consistent public health issue for the past decade. Our goal is to understand the relationship between increasing teen suicide rates by state policies. We explore links between macro-level risk factors and state suicide rates. Risk factors explored include state behavioral health spending, child access policies for firearms, insurance coverage, tax revenue from tobacco and alcohol, school spending per pupil, pupil support services funding, and teacher spending. This research shows a relationship between pupil support spending, any child access law, required legislation, and lower teen suicide rates. The results from this study can aid in the understanding of macro-level influences on teen suicide; empowering advocates, lawmakers, and researchers to develop informed interventions and policies. Increasing multi-level understanding around suicide can provide an opportunity to slow or stop suicide rates.

Suicide Rates and Prescription of Antidepressants.

Background: Previous ecological studies reported that increasing antidepressant prescriptions were associated with decreasing suicide rates. Aim: To determine whether antidepressant prescription prevalence is negatively associated with suicide rates (i.e., as antidepressant prescribing increases, suicide rates decrease) between 1999 and 2020. Method: The study protocol was pre-registered on the Open Science Framework (https://osf.io/978sk/). Publicly available data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) and Medical Expenditure Panel Survey (MEPS) were used. Results: Overall, both the antidepressant prescription prevalence and the suicide rate were increasing from 1990 to 2020 in the United States. Positive trends for both outcomes were also evident when analyses were stratified according to sex and/or race/ethnicity. Pearson's correlation analyses consistently found positive associations between antidepressant prescription prevalence and suicide rates. Limitations: Trends and their associations were examined at the population level. The results cannot clarify the causal nature of the association observed. Conclusion: The results of our analysis consistently demonstrated positive trends for both antidepressant prescription prevalence and suicide rates over time as well as positive associations between them. These findings update those from previous studies and are at odds with the notion that, at a population level, more antidepressant prescriptions would lead to lower suicide rates. However, it needs to be acknowledged that ecological studies provide insufficient evidence to infer causality.

An Exploratory Qualitative Analysis of the Stanford-Templeton Convenings on Islam and Suicide.

For over 70years, studies have reported lower rates of completed suicide in Muslim-majority countries and individuals who identify as Muslim. To this point, the mechanisms underlying the relationship between Islam and lower risk of suicide remain understudied. In an effort to advance our understanding, we convened a bilingual international interdisciplinary panel of experts for a discussion of the current state and future directions of the field. In this paper, we present an exploratory qualitative analysis of the core themes that emerged from the group interviews. We also derive a general theoretical model of the association between Islam and suicide risk.

The effects of physical exercise, parent-child interaction and peer relationship on adolescent depression: An empirical analysis based on CEPS data.

Currently, depression is the predominant mental illness impacting adolescents, causing severe damage to their overall health. Engaging in physical exercise can not only aid in restoring adolescent physical well-being but also function as a strategy to prevent depression and lower suicide rates. Drawing upon data from the China Education Panel Survey (CEPS) conducted between 2014 and 2015, this study delves into the effects of physical exercise on alleviating depressive symptoms among adolescent students and explores the underlying mechanisms through the lens of parent-child interactions and peer relationships. The mediation effect tests indicate that physical exercise can mitigate adolescent depression by reinforcing parent-child bonds and improving peer connections. Parents and educational institutions should judiciously plan the time for adolescents to engage in both academic pursuits and physical activities, and they should encourage greater participation in sports among adolescents through various means, thereby maximizing the beneficial role of physical exercise in ameliorating adolescent depression.

Negative interaction between emotional vulnerability and depressive symptoms may heighten suicidal ideation among Japanese university students: a cross-sectional study.

Studies examining the relationships among suicidal ideation, emotional vulnerability, and depressive symptoms are scarce. This study examined the effects of emotional vulnerability and depressive symptoms on suicidal ideation among Japanese university students. A questionnaire survey was conducted with 370 Japanese university students. Data were analyzed using descriptive statistics and multiple regression analysis. In the multiple regression analysis, depressive symptoms were significant (β = .46, p <.001) but emotional vulnerability was not (β = .05, p = .318). A significant interaction emerged between emotional vulnerability and depressive symptoms (β = .22, p <.001). The model's R 2 value was.31 (p <.001). Simple slopes tests revealed the impact of depressive symptoms on suicidal ideation, even with low emotional vulnerability (b = .06, β = .27, p <.001), and a higher impact with high emotional vulnerability (b = .15, β = .65, p <.001). The negative interaction between emotional vulnerability and depressive symptoms may heighten suicidal ideation among Japanese university students. Interventions targeting emotional vulnerability may help reduce suicidal ideation and achieve lower suicide rates.

Socioeconomic Factors and their Influence on Suicide Rate: A Multiple Regression Case Study in Washington

Washington State’s suicide rate is 11% higher than the national average, making it one of the top 10 states with the highest suicide rates in the U.S.. Although efforts have been made to address behavioral factors that contribute to suicide risk, little attention has been given to the impact of socioeconomic factors on the mental health of Washington residents. The purpose of the research is to investigate the relationship between socioeconomic status and suicide rates in Washington State. The results of the study can help guide policymakers and healthcare professionals in developing intervention strategies to reduce suicide risk. The suicide rate among Washington residents from 2011-2020 was provided by the 57 vital statistics jurisdictions participating in the Vital Statistics Cooperative Program. Three indicators, including poverty rate, lower than high school graduate rate, and unemployment rate, were chosen to explore the relationship between socioeconomic factors and suicide rate. The data from 57 jurisdictions were analyzed using R, with F tests and multiple linear regressions employed. The multiple R-squared value was 0.7648, indicating that 76.48% of the variation can be explained by the independent variables. These results suggest that poverty and employment rates have a significant positive relationship with suicide rate. However, the relationship between lower educational attainment and suicide rate was not statistically significant. Addressing the issue of rising suicide rates requires a collaborative effort between healthcare officials and policymakers. Policymakers should prioritize promoting job opportunities and providing educational resources to alleviate financial stress and increase access to mental healthcare.

SKIN TONE AND GENDER INFLUENCE SUICIDAL BEHAVIOR OF BRAZILIANS: A CORRESPONDENCE ANALYSIS USING THE CAINTERTOOLS PACKAGE

Suicide is a multidetermined biopsychosocial phenomenon that involves the subjectivity and the environment experienced by individuals. The study aimed to analyze the correspondence between gender and race in the Brazilian regions in 2020 about suicide. A descriptive, quantitative study was carried out, based on the collection of the DATASUS database, in October 2022. Multivariate dimension reduction techniques were used, together with correspondence analysis and cluster analysis, in the rows representing the 27 states of the federation and the types of races as column variables. In the Southeast, the highest suicide rate is for the brown and black races, especially SP, RJ, and PR. We observed the association of indigenous suicide in the state of AM. In CO, there was also variability in the yellow race. The lowest rates were in AP, ES, and RR. The Northeast region had the lowest suicide rates by race. The indigenous race has a weak correlation with the other races. In the states of SC, RS, SP, and PR, suicides by race are associated with the white race. Thus, the number of suicides in Brazilian states is associated with race, color, and gender.

Colleges and Crime—Comparing Homicide and Suicide Rates Among College Towns and Their Counterparts

IntroductionTo investigate differences in homicide and suicide rates across college town status and determine whether college towns were predisposed to changes in rates over time. MethodsWe analyzed county-level homicide and suicide rates (total and by firearm) across college town status using 2015-2019 CDC death certificate data and data from the American Communities Project. ResultsPopulation-level homicide rates were similar across college town status, but younger age groups were at increased risk for firearm homicide and total homicide in college towns. College town status was associated with lower population-level firearm suicide rates, but individuals aged less than 18 y were at increased risk for total and firearm suicide. Finally, college towns were not classified as outliers for changes in either firearm homicide or suicide rates over time. ConclusionsCollege towns had similar homicide rates and significantly lower firearm suicide rates than other counties; however, individuals aged less than 18 y were at increased risk for both outcomes. The distinctive demographic, social, economic, and cultural features of college towns may contribute to differing risk profiles among certain age groups, thus may also be amenable to focused prevention efforts.

Urbanisation and Declining Suicide Rates in China Between 2005 and 2017.

Worldwide suicide rates have declined since 2000s, with China being the primary contributor. This study aimed to investigate whether urbanisation is associated with decreasing suicide rates in China. Suicide rates and economic indicators of 31 provinces, municipalities, and autonomous regions of China between 2005 and 2017 were analysed. Poisson random intercept models were used to determine associations between suicide rates, urbanicity, sexes, and gross regional product (GRP). Between 2005 and 2017, suicide rates in 31 provinces, municipalities, and autonomous regions of China continued to decrease. Urbanicity and GRP were associated with decreased suicide rates among Chinese males and females. An increase in urbanicity by 1% was associated with a 2.2% decrease in suicide rates (p < 0.001). The most urbanised and populous cities (Beijing, Shanghai, Tianjin) had the lowest suicide rates. Urbanicity was associated with a greater decline in suicide rates among females, compared with males. Association between increased urbanicity and reduced suicide rates was independent of GRP. Urbanisation was associated with declining suicide rates in China; this association was stronger among females than males.

Why is Korean girls' suicidal ideation rate higher than boys' rate? The role of gender heterogeneity in peer groups.

Girls typically show much lower suicide rates than boys in most OECD countries. However, in South Korea, the suicide rate of girls almost reaches that of boys. Moreover, Korean girls' suicide rate is remarkable even among other advanced countries. One potential approach to explaining Korean girls' relatively high suicide rate is to investigate how their peer groups affect suicidal ideation, but this approach has rarely been explored in Korean adolescents. We tested how the gender heterogeneity of peer groups is associated with suicidal ideation by analyzing 2,990 adolescents from the 2018 Korean Children and Youth Well-Being Index Survey. For the analysis, logistic regression models with survey weights were used. The analysis revealed that adolescents with different-gender friends were associated with a higher likelihood of suicidal ideation than those with exclusively same-gender friends when adjusting for covariates. In addition, an analysis stratified by gender found that this association was significant only among girls. Furthermore, the protective power of having a mentor against suicidal ideation was significantly lower in girls with male and female friends than in girls with only female friends. The findings suggest a less protective role of different-gender peer groups for suicidal ideation among girls. During adolescent suicidality consultations, school counselors and practitioners should pay attention to the characteristics of adolescents' peers, particularly their gender.

Association between mental health workforce supply and clusters of high and low rates of youth suicide: An Australian study using suicide mortality data from 2016 to 2020.

To examine the association between mental health workforce supply and spatial clusters of high versus low incidence of youth suicide. A cross-sectional analysis of spatial suicide clusters in young Australians (aged 10-25) from 2016 to 2020 was conducted using the scan statistic and suicide data from the National Coronial Information System. Mental health workforce was extracted from the 2020 National Health Workforce Dataset by local government areas. The Geographic Index of Relative Supply was used to estimate low and moderate-to-high mental health workforce supply for clusters characterised by a high and low incidence of suicide (termed suicide hotspots and coldspots, respectively). Univariate and multivariate logistic regression was used to determine the association between suicide clusters and a range of sociodemographic characteristics including mental health workforce supply. Eight suicide hotspots and two suicide coldspots were identified. The multivariate analysis showed low mental health workforce supply was associated with increased odds of being involved in a suicide hotspot (adjusted odds ratio = 8.29; 95% confidence interval = 5.20-13.60), followed by residential remoteness (adjusted odds ratio = 2.85; 95% confidence interval = 1.68-4.89), and illicit drug consumption (adjusted odds ratio = 1.97; 1.24-3.11). Both coldspot clusters occurred in areas with moderate-to-high mental health workforce supply. Findings highlight the potential risk and protective roles that mental health workforce supply may play in the spatial distributions of youth suicide clusters. These findings have important implications for the provision of postvention and the prevention of suicide clusters.

Risk of suicide among stroke survivors in the United States

BackgroundStroke is the largest cause of disability and the 5th leading cause of death in the United States. Suicide is the 12th leading cause of death in the United States. However, little is known about the risk of suicide among people with a prior stroke. ObjectivesUsing Multiple Cause of Death data (1999-2020) from the Centers for Disease Control and Prevention WONDER database, we examined via cross-sectional analysis the risk of suicide among survivors of stroke as compared to the general U.S. population and among subgroups within the United States. MethodsWe assessed disparities in suicide rate among patients with stroke stratified by sex, race, urbanization levels, and census regions using the CDC WONDER multiple cause of death database. Standardized mortality rates were calculated to compare the suicide rate of stroke patients with the rates among demographic-matched cohorts and the general United States population. ResultsAs compared to the general population, stroke survivors had an elevated risk of suicide. Black stroke survivors had a lower rate of suicide as compared to the general population, while White stroke survivors and those in nonmetropolitan areas had an elevated risk compared to the general population. ConclusionThere was a slightly elevated risk of suicide among people with a prior stroke in the United States. This risk may be elevated among White people and among people living in nonmetropolitan areas.

Efficacy of a digitally supported regional systems intervention for suicide prevention (SUPREMOCOL) in Noord-Brabant, the Netherlands

ObjectiveWe evaluated the effect of a digitally supported systems intervention for suicide prevention (SUPREMOCOL) in Noord-Brabant, the Netherlands. MethodNon-randomized stepped wedge trial design (SWTD). Stepwise implementation in the five subregions of the systems intervention. Pre-post analysis for the whole province (Exact Rate Ratio Test, Poisson count). SWTD Hazard Ratios of suicides per person-years for subregional analysis of control versus intervention conditions over five times three months. Sensitivity analysis. ResultsSuicide rates dropped 17.8% (p = .013) from 14.4 suicides per 100,000 before the start of implementation of the systems intervention (2017), to 11.9 (2018) and 11.8 (2019) per 100, during implementation; a significant reduction (p = .043) compared to no changes in the rest of the Netherlands. Suicide rates dropped further by 21.5% (p = .002) to 11.3 suicides per 100,000 during sustained implementation in 2021. Sensitivity analysis confirmed the reduction (p = .02). The SWTD analysis over 15 months in 2018–2019 did not show a significant association of this reduction with implementation per subregional level, probably due to insufficient power given the short SWTD timeframe for implementation and low suicide rates per subregion. ConclusionsDuring the SUPREMOCOL systems intervention, over four years, there was a sustained and significant reduction of suicides in Noord-Brabant.

Suicide and Self-Harm Among Immigrant Youth to Ontario, Canada From Muslim Majority Countries: A Population-Based Study.

To examine the association between Muslim religious affiliation and suicide and self-harm presentations among first- and second-generation immigrant youth. We performed a population-based cohort study involving individuals aged 12 to 24 years, living in Ontario, who immigrated to Canada between 1 January 2003 and 31 May 2017 (first generation) and those born to immigrant mothers (second generation). Health administrative and demographic data were used to analyze suicide and self-harm presentations. Sex-stratified logistic regression models generated odds ratios (OR) for suicide and negative binomial regression models generated rate ratios (aRR) for self-harm presentations, adjusting for refugee status and time since migration. Of 1,070,248 immigrant youth (50.1% female), there were 129,919 (23.8%) females and 129,446 (24.2%) males from Muslim-majority countries. Males from Muslim-majority countries had lower suicide rates (3.8/100,000 person years [PY]) compared to males from Muslim-minority countries (5.9/100,000 PY) (OR: 0.62, 95% CI, 0.42-0.92). Rates of suicide between female Muslim-majority and Muslim-minority groups were not different (Muslim-majority 1.8/100,000 PY; Muslim-minority 2.2/100,000 PY) (OR: 0.82, 95% CI, 0.46-1.47). Males from Muslim-majority countries had lower rates of self-harm presentations than males from Muslim-minority (<10%) countries (Muslim majority: 12.2/10,000 PY, Muslim-minority: 14.1/10,000 PY) (aRR: 0.82, 95% CI, 0.75, 0.90). Among female immigrants, rates of self-harm presentations were not different among Muslim-majority (30.1/10,000 PY) compared to Muslim-minority (<10%) (32.9/10,000 PY) (aRR: 0.93, 95% CI, 0.87-1.00) countries. For females, older age at immigration conferred a lower risk of self-harm presentations. Being a male from a Muslim-majority country may confer protection from suicide and self-harm presentations but the same was not observed for females. Approaches to understanding the observed sex-based differences are warranted.

Post-discharge suicide among high-risk psychiatric inpatients: Risk factors and warnings signs

The present study explored the predictive value of a novel suicide risk assessment with regard to suicide deaths within three years of discharge from an acute inpatient unit. The contributions of the different components of the assessment to overall determination of suicide risk were also explored. A total of 380 acute psychiatric inpatients were analysed in a 3- year prospective study. At admission, the physician on duty performed a suicide risk assessment based on national guidelines and clinical state variables. A dichotomous variable reflecting high/low suicide risk level was determined by the clinician and recorded in the chart. Information on the number and causes of deaths was obtained from the Norwegian Cause of Death Registry. Eleven (2.9%) patients died by suicide within three years after discharge, eight high-risk patients and three low risk patients (OR = 8.7, 95% CI: 2.2–33, p = 0.002). In multivariable analysis, recent suicidal ideation (SI) (OR = 3.6, 95% CI: 1.5–8.7, p = 0.004), and affective disturbance (OR = 4.3, 95% CI: 1.5–12.6, p = 0.008) were significantly associated with rating of high suicide risk. The sample size was rather small, which in conjunction with the low base rate of suicide, reduces power and limits generalizability of the findings. We found that a novel suicide risk assessment at admission to an acute psychiatric service was a powerful predictor of suicide post-discharge. The components of the risk assessment that were statistically significant with high suicide risk were affective disturbance and recent SI.

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

Alpha-2-Macroglobulin (A2M) and Dopamine Receptor D2 (DRD2) expression analysis and Influence of Separation from Parents in Childhood on the Suicide and Self-injury Behavior and Psychological Adjustment in Adolescence.

To explore the influence of separation from parents in childhood on suicide and self-injury behavior and psychological adjustment in adolescence. A total of 880 subjects were selected, including 197 students who were separated from their parents in childhood and 683 students who were not separated from their parents in childhood. The scores of psychological resilience, self-compassion, forgiveness and suicide and self-injury were investigated and analyzed. Logistic regression analysis was made on the relationship between suicide and self-injury behavior and psychological adjustment in adolescence. The scores of psychological resilience, self-compassion, forgiveness and suicide and self-injury were statistically significant between children who were separated from their parents and those who were not separated. The students who were not separated had better psychological adjustment abilities and a lower rate of suicide and self-injury (P<0.05). There was a positive correlation between separation from parents in childhood and suicide and self-injury behavior and psychological adjustment in adolescence (P<0.05). The separation from parents in childhood is closely related to psychological resilience, forgiveness, self-compassion, and suicide-related psychological behavior and self-injury behavior in adolescence. Suicide and self-injury behavior can be reduced by reducing separation from parents in childhood and improving self-psychological adjustment ability in adolescence. During the past years, genetics, heritability, and genes' contribution to depression disorders have been well established. Alpha-2-Macroglobulin (A2M) and Dopamine Receptor D2 (DRD2) genes are very effective in behavioral and mood disorders. The results of this study showed the expression of these genes in different organs, especially in connection with the cerebrospinal system, so investigating the mechanism of their effect is very effective and promising, and it is hoped that they will be used in other research.

Athletes are not at greater risk for death by suicide: A review.

Suicide represents a major mental and public health issue. Elite athletes share certain individual and environmental characteristics that may increase their risk for mental illnesses, ultimately leading to suicide. This notion conflicts with the general perception of athletes, being the healthiest representatives of society. A comprehensive literature search was carried out through PubMed and Embase databases for relevant publications. Recent calls for investigating suicidality among athletes resulted in a considerable amount of literature providing some evidence regarding lower rates of suicide among professional and high-performance athletes as well as similar incidence and prevalence of mental conditions, which are known as risk factors for suicide. Nevertheless, special attention is required in this population as predisposing and precipitating factors might differ from classical features of suicidality in the general population. Sports physicians, sports psychiatrists, and other mental health professionals in elite sports should be aware of early signs of affective disorders, risk of recreational drug abuse, misuse of performance-enhancing medications, sport-specific environmental stressors, serious physical injuries, and presence of physical or mental illness, all of which may increase suicidality. Traumatic brain injury (TBI) is with suicide with higher severity correlated with increased risk. Compared to active athletes, former athletes may have higher rates of suicide due to common life stressors occurring after sports retirement. The findings suggest a multidisciplinary approach to suicidality in elite athletes, the main goal of which should be the reduction of suicide-related morbidity and mortality. Further research is required to clarify the existing gaps in the current knowledge of the issue. While having lower rates of suicide, athletes share some similar (affective disorders, drug abuse, mental and physical illness) and unique factors (misuse of performance-enhancing substances, sports-related stressors, sports injuries, TBI) putting them at risk of suicide during active career and retirement.