Relative Risk Of Suicide Research Articles

Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability.

New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs), were introduced in the late 1980s; however, few comprehensive studies have compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in young patients. A comprehensive literature search of PubMed, Cochrane, Embase, Web of Science, and PsycINFO databases was conducted from 1970 to January 2015. Only clinical trials that randomly assigned one SNRI or placebo to patients aged 7 to 18 years who met the diagnostic criteria for major depressive disorder were included. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Primary efficacy was determined by pooling the risk ratios (RRs) of treatment response and remission. Acceptability was determined by pooling the RRs of dropouts for all reasons and for adverse effects as well as suicide-risk outcomes. Five trials with a total of 973 patients were included. SNRIs were not significantly more effective than placebo for treatment response but were for remission. The comparison of patients taking SNRIs that dropped out for all reasons and those taking placebo did not reach statistical significance. Significantly more patients taking SNRIs dropped out for adverse effects than those taking placebo. No significant difference was found in suicide-related risk outcomes. SNRI therapy does not display a superior efficacy and is not better tolerated compared to placebo in these young patients. However, duloxetine has a potential beneficial effect for depression in young populations, showing a need for further research.

The Impact of a Suicide Prevention Strategy on Reducing the Economic Cost of Suicide in the New South Wales Construction Industry.

. Background: Little research has been conducted into the cost and prevention of self-harm in the workplace. Aims: To quantify the economic cost of self-harm and suicide among New South Wales (NSW) construction industry (CI) workers and to examine the potential economic impact of implementing Mates in Construction (MIC). Method: Direct and indirect costs were estimated. Effectiveness was measured using the relative risk ratio (RRR). In Queensland (QLD), relative suicide risks were estimated for 5-year periods before and after the commencement of MIC. For NSW, the difference between the expected (i.e., using NSW pre-MIC [2008–2012] suicide risk) and counterfactual suicide cases (i.e., applying QLD RRR) provided an estimate of potential suicide cases averted in the post-MIC period (2013–2017). Results were adjusted using the average uptake (i.e., 9.4%) of MIC activities in QLD. Economic savings from averted cases were compared with the cost of implementing MIC. Results: The cost of self-harm and suicide in the NSW CI was AU $527 million in 2010. MIC could potentially avert 0.4 suicides, 1.01 full incapacity cases, and 4.92 short absences, generating annual savings of AU $3.66 million. For every AU $1 invested, the economic return is approximately AU $4.6. Conclusion: MIC represents a positive economic investment in workplace safety.

Inequalities in suicide mortality rates and the economic recession in the municipalities of Catalonia, Spain.

IntroductionWhile previous research already exists on the impact of the current economic crisis and whether it leads to an increase in mortality by suicide, our objective in this paper is to determine if the increase in the suicide rate in Catalonia, Spain from 2010 onwards has been statistically significant and whether it is associated with rising unemployment.MethodsWe used hierarchical mixed models, separately considering the crude death rate of suicides for municipalities with more than and less than 10,000 inhabitants as dependent variables both unstratified and stratified according to gender and/or age group.ResultsIn municipalities with 10,000 or more inhabitants there was an increase in the relative risk of suicide from 2009 onwards. This increase was only statistically significant for working-aged women (16–64 years). In municipalities with less than 10,000 inhabitants the relative risk showed a decreasing trend even after 2009. In no case did we find the unemployment rate to be associated (statistically significant) with the suicide rate.ConclusionsThe increase in the suicide rate from 2010 in Catalonia was not statistically significant as a whole, with the exception of working-aged women (16–64 years) living in municipalities with 10,000 or more inhabitants. We have not found this increase to be associated with rising unemployment in any of the cases. Future research into the effects of economic recessions on suicide mortality should take into account inequalities by age, sex and size of municipalities.

Prevalence of non-suicidal self-injury and distinct groups of self-injurers in a community sample of adolescents.

Adolescence is an important developmental period for the first onset of non-suicidal self-injury (NSSI), a behavior known to be associated with elevated suicide risk. Little is currently known, however, about NSSI among adolescents. The primary objectives of this research were to establish the prevalence of non-suicidal self-injury (NSSI) in a representative sample of Turkish high school students and to identify and describe distinct subgroups of self-injurers. A total of 1656 of 1676 eligible students (98.8% participation rate) from 18 schools were surveyed during the 2010-2011 academic year. Questionnaires were administered that assessed prior engagement in a variety of self-injurious behaviors, current psychiatric symptoms, suicide-related risk factors, and participation in health-risk behaviors. Latent class analysis (LCA) methods were used to identify distinct groups of self-injurers. Almost one-third of the sample (N=519) endorsed some previous engagement in NSSI behaviors. In LCA analyses restricted to youth with prior histories of NSSI, four distinct classes were identified characterized by: (1) low rates of NSSI behaviors (29%); (2) high rates of self-battery (32%); (3) high rates of self-cutting (19%); and (4) high rates of multiple NSSI behaviors (19%). These classes were further distinguished by current psychiatric symptoms, suicide risk factors, and other health-risk behaviors. Findings from the present study indicate that NSSI is a common form of behavior among adolescent youth. There is, however, considerable heterogeneity among those with NSSI histories, with about 40% at particularly high risk for ongoing distress, future acts of intentional self-harm, and suicidal behavior.

Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000–11

As with previous economic downturns, there has been debate about an association between the 2008 economic crisis, rising unemployment, and suicide. Unemployment directly affects individuals' health and, unsurprisingly, studies have proposed an association between unemployment and suicide. However, a statistical model examining the relationship between unemployment and suicide by considering specific time trends among age-sex-country subgroups over wider world regions is still lacking. We aimed to enhance knowledge of the specific effect of unemployment on suicide by analysing global public data classified according to world regions. We retrospectively analysed public data for suicide, population, and economy from the WHO mortality database and the International Monetary Fund's world economic outlook database from 2000 to 2011. We selected 63 countries based on sample size and completeness of the respective data and extracted the information about four age groups and sex. To check stability of findings, we conducted an overall random coefficient model including all study countries and four additional models, each covering a different world region. Despite differences in the four world regions, the overall model, adjusted for the unemployment rate, showed that the annual relative risk of suicide decreased by 1·1% (95% CI 0·8-1·4) per year between 2000 and 2011. The best and most stable final model indicated that a higher suicide rate preceded a rise in unemployment (lagged by 6 months) and that the effect was non-linear with higher effects for lower baseline unemployment rates. In all world regions, the relative risk of suicide associated with unemployment was elevated by about 20-30% during the study period. Overall, 41,148 (95% CI 39,552-42,744) suicides were associated with unemployment in 2007 and 46,131 (44,292-47,970) in 2009, indicating 4983 excess suicides since the economic crisis in 2008. Suicides associated with unemployment totalled a nine-fold higher number of deaths than excess suicides attributed to the most recent economic crisis. Prevention strategies focused on the unemployed and on employment and its conditions are necessary not only in difficult times but also in times of stable economy. University of Zurich.

Time trend by region of suicides and suicidal thoughts among Greenland Inuit

BackgroundSuicides remain a major public health problem in Greenland. Their increase coincides with the modernization since 1950. Serious suicidal thoughts are reported by a significant proportion of participants in countrywide surveys.ObjectiveTo analyze the time trend by region of suicides and suicidal thoughts among the Inuit in Greenland.DesignData included the Greenland registry of causes of death for 1970–2011 and 2 cross-sectional health surveys carried out in 1993–1994 and 2005–2010 with 1,580 and 3,102 Inuit participants, respectively.ResultsSuicide rates were higher among men than women while the prevalence of suicidal thoughts was higher among women. Suicide rates for men and women together increased from 1960 to 1980 and have remained around 100 per 100,000 person-years since then. The regional pattern of time trend for suicide rates varied with an early peak in the capital, a continued increase to very high rates in remote East and North Greenland and a slow increase in villages relative to towns on the West Coast. Suicidal thoughts followed the regional pattern for completed suicides. Especially for women there was a noticeable increasing trend in the villages. The relative risk for suicide was highest among those who reported suicidal thoughts, but most suicides happened outside this high-risk group.ConclusionSuicide rates and the prevalence of suicidal thoughts remain high in Greenland but different regional trends point towards an increased marginalization between towns on the central West Coast, villages and East and North Greenland. Different temporal patterns call for different regional strategies of prevention.

Applying and comparing empirical and full Bayesian models in study of evaluating relative risk of suicide among counties of Ilam province.

Introduction:Disease mapping includes a set of statistical techniques that provides maps based on estimates of diseases rates. Bayesian ones are the most important models in this field. They consider prior information on changes in the disease rates in overall map and spatial pattern of the disease. These include a broad range of models with their own formulation, characteristics, strengths, and weaknesses. In the present study, we explain and compare three important and widely-used Bayesian models in the study of evaluating relative risk of suicide in Ilam province.Materials and Methods:In this applied-ecological research, suicide incidence in Ilam province in 2008 and 2009 was analyzed by use of Gamma-Poisson, Log-normal, and BYM Bayesian models. Models were fitted to data using WinBUGS software.Results:Fitting the three models showed that Darehshahr and Shirvan-Chrdavol had the highest and the lowest relative risk of suicide, respectively (relative risks based on Gamma-Poisson, Log-normal, and BYM models were 2.243, 2.275, and 2.279 for Dareshahr and 0.321, 0.321, and 0.319 for Shirvan-Chrdavol, respectively).Conclusion:Despite some differences in estimates, the ranks of relative risks in counties in all three models are the same. The counties based on the relative risks of suicide from the most to the least are: Darehshahr, Ilam, Dehloran, Eyvan, Abdanan, Mehran, Malekshahi, and Shirvan-Chrdavol.

Hospitalisation for chronic obstructive pulmonary disease and risk of suicide: a population-based case–control study

ObjectivesTo examine risk of suicide among individuals with hospitalised chronic obstructive pulmonary disease (COPD) and to profile differences according to sex, age, psychiatric history, and recency and frequency of COPD...

Association of poor subjective sleep quality with risk for death by suicide during a 10-year period: a longitudinal, population-based study of late life.

Older adults have high rates of sleep disturbance, die by suicide at disproportionately higher rates compared with other age groups, and tend to visit their physician in the weeks preceding suicide death. To our knowledge, to date, no study has examined disturbed sleep as an independent risk factor for late-life suicide. To examine the relative independent risk for suicide associated with poor subjective sleep quality in a population-based study of older adults during a 10-year observation period. A longitudinal case-control cohort study of late-life suicide among a multisite, population-based community sample of older adults participating in the Established Populations for Epidemiologic Studies of the Elderly. Of 14 456 community older adults sampled, 400 control subjects were matched (on age, sex, and study site) to 20 suicide decedents. Primary measures included the Sleep Quality Index, the Center for Epidemiologic Studies-Depression Scale, and vital statistics. Hierarchical logistic regressions revealed that poor sleep quality at baseline was significantly associated with increased risk for suicide (odds ratio [OR], 1.39; 95% CI, 1.14-1.69; P < .001) by 10 follow-up years. In addition, 2 sleep items were individually associated with elevated risk for suicide at 10-year follow-up: difficulty falling asleep (OR, 2.24; 95% CI, 1.27-3.93; P < .01) and nonrestorative sleep (OR, 2.17; 95% CI, 1.28-3.67; P < .01). Controlling for depressive symptoms, baseline self-reported sleep quality was associated with increased risk for death by suicide (OR, 1.30; 95% CI, 1.04-1.63; P < .05). Our results indicate that poor subjective sleep quality is associated with increased risk for death by suicide 10 years later, even after adjustment for depressive symptoms. Disturbed sleep appears to confer considerable risk, independent of depressed mood, for the most severe suicidal behaviors and may warrant inclusion in suicide risk assessment frameworks to enhance detection of risk and intervention opportunity in late life.

The use of regression methods for the investigation of trends in suicide rates in Hungary between 1963 and 2011.

Suicide rates in Hungary have been analyzed from different aspects in recent decades. However, only descriptive rates have been reported. The aim of our epidemiological study was to characterize the pattern of annual rates of suicide in Hungary during the period 1963-2011 by applying advanced statistical methods. Annual suicide rates per 100,000 population (>6years) for gender, age group and suicide method were determined from published frequency tables and reference population data obtained from the Hungarian Central Statistical Office. Trends and relative risks of suicide were investigated using negative binomial regression models overall and in stratified analyses (by gender, age group and suicide method). Joinpoint regression analyses were additionally applied to characterize trends and to find turning points during the period 1963-2011. Overall, 178,323 suicides (50,265 females and 128,058 males) were committed in Hungary during the investigated period. The risk of suicide was higher among males than females overall, in all age groups and for most suicide methods. The annual suicide rate exhibited a significant peak in 1982 and remained basically constant after 2006. Different segmented patterns were observed for the suicide rates in the various age groups. Suicide rates revealed segmented linear pattern. This is the first detailed trend analysis with risk estimates obtained via joinpoint and negative binomial regression methods simultaneously for age-specific suicide frequencies in Hungary.

Adverse conditions at the workplace are associated with increased suicide risk

ObjectiveThe present study addressed potential harms of a negative working environment for employed subjects. The main aim was to evaluate if adverse working conditions and job strain are related to an increase in suicide mortality. MethodsThe study population consisted of 6817 participants drawn from the MONICA/KORA Augsburg, Germany, surveys conducted in 1984–1995, being employed at baseline examination and followed up on average for 12.6 years. Adverse working conditions were assessed by an instrument of 16 items about chronobiological, physical and psychosocial conditions at the workplace, job strain was assessed as defined by Karasek. Suicide risks were estimated by Cox regression adjusted for suicide-related risk factors. ResultsA number of 28 suicide cases were observed within follow-up. High levels of adversity in chronobiological/physical working conditions significantly increased the risk for suicide mortality (HR 3.28, 95% CI 1.43–7.54) compared to low/intermediate levels in a model adjusted for age, sex and survey (p value 0.005). Additional adjustment for living alone, low educational level, smoking, high alcohol consumption, obesity and depressed mood attenuated this effect (HR 2.73) but significance remained (p value 0.022). Adverse psychosocial working conditions and job strain, in contrast, had no impact on subsequent suicide mortality risk (p values > 0.200). ConclusionsA negative working environment concerning chronobiological or physical conditions at the workplace had an unfavourable impact on suicide mortality risk, even after controlling for relevant suicide-related risk factors. Employer interventions aimed to improve workplace conditions might be considered as a suitable means to prevent suicides among employees.

Suicide mortality in relation to dietary intake of n-3 and n-6 polyunsaturated fatty acids and fish: equivocal findings from 3 large US cohort studies.

Intake of n-3 and n-6 polyunsaturated fatty acids (PUFAs) has been implicated in the pathogenesis of depression. We sought to estimate the association between intake of fish and n-3 and n-6 PUFAs and suicide mortality over the course of long-term follow-up. In this prospective cohort study, biennial questionnaires were administered to 42,290 men enrolled in the Health Professionals Follow-up Study (1988-2008), 72,231 women enrolled in the Nurses' Health Study (1986-2008), and 90,836 women enrolled in Nurses' Health Study II (1993-2007). Dietary fish and n-3 and n-6 PUFA intakes were assessed every 4 years using a validated food-frequency questionnaire. Suicide mortality was ascertained through blind physician review of death certificates and hospital or pathology reports. Adjusted relative risks of suicide mortality were estimated with multivariable Cox proportional hazards models and pooled across cohorts using random-effects meta-analysis. The pooled multivariable relative risks for suicide among persons in the highest quartile of intake of n-3 or n-6 PUFAs, relative to the lowest quartile, ranged from 1.08 to 1.46 for n-3 PUFAs (Ptrend = 0.11-0.52) and from 0.68 to 1.19 for n-6 PUFAs (Ptrend = 0.09-0.54). We did not find evidence that intake of n-3 PUFAs or fish lowered the risk of completed suicide.

THE LONG-TERM RISK OF SUICIDE FOLLOWING FIRST ONSET PSYCHOSIS AND POTENTIAL EARLY RISK FACTORS

People with psychotic disorders are at an increased risk of suicide, but there is little understanding of suicidal ideation (SI) in this population. The Interpersonal Psychological Theory of Suicide posits that perceived burdensomeness (PB) and thwarted belonginess (TB) contribute to SI. To our knowledge there are no studies using ecological momentary assessment (EMA) to assess these interpersonal risk factors in a sample of individuals with psychotic disorders. This study investigated the validity and variability of PB and TB, and whether SI, EMA-measured psychotic symptoms, mood, and social context relate to PB and TB.Ninety-six participants with a psychotic disorder, including mood disorders with psychosis completed in-lab assessments of current SI, and then EMA surveys on a smartphone 3×/day for 10 days, answering questions about burdensomeness, belongingness, symptoms (i.e., hearing voices, experiencing suspiciousness), mood (i.e., happy, sad), and social context.Burdensomeness varied within-participants less than belongingness (t (95) = -3.74, p=< .001). Participants with SI had higher mean burdensomeness ratings (t (94) = -2.70, p < .01) and lower mean belongingness ratings (t (94) = 3.68, p < .001) than did participants without SI. Being with others, greater psychotic experiences, less happiness, and greater sadness related to greater burdensomeness. SI status, being alone, greater psychotic experiences, less happiness, and greater sadness related to less belongingness.This study examined the real-time influences of SI and psychotic symptoms on burdensomeness and belongingness. Hearing voices, suspiciousness, mood, and SI are related to interpersonal suicide-related risk factors. In this sample, social context had a differential effect on burdensomeness and belongingness.

Risk of suicide according to level of psychiatric treatment: a nationwide nested case–control study

Knowledge of the epidemiology of suicide is a necessary prerequisite of suicide prevention. We aimed to conduct a nationwide study investigating suicide risk in relation to level of psychiatric treatment. Nationwide nested case-control study comparing individuals who died from suicide between 1996 and 2009 to age-, sex-, and year-matched controls. Psychiatric treatment in the previous year was graded as "no treatment," "medicated," "outpatient contact," "psychiatric emergency room contact," or "admitted to psychiatric hospital." There were 2,429 cases and 50,323 controls. Compared with people who had not received any psychiatric treatment in the preceding year, the adjusted rate ratio (95 % confidence interval) for suicide was 5.8 (5.2-6.6) for people receiving only psychiatric medication, 8.2 (6.1-11.0) for people with at most psychiatric outpatient contact, 27.9 (19.5-40.0) for people with at most psychiatric emergency room contacts, and 44.3 (36.1-54.4) for people who had been admitted to a psychiatric hospital. The gradient was steeper for married or cohabiting people, those with higher socioeconomic position, and possibly those without a history of attempted suicide. Psychiatric admission in the preceding year was highly associated with risk of dying from suicide. Furthermore, even individuals who have been in contact with psychiatric treatment but who have not been admitted are at highly increased risk of suicide.

Suicide in young adults: psychiatric and socio-economic factors from a case–control study

BackgroundSuicide in young adults remains an important public health issue in Australia. The attributable risks associated with broader socioeconomic factors, compared to more proximal psychiatric disorders, have not been considered previously in individual-level studies of young adults. This study compared the relative contributions of psychiatric disorder and socio-economic disadvantage associated with suicide in terms of relative and attributable risk in young adults.MethodA population-based case–control study of young adults (18–34 years) compared cases of suicide (n = 84) with randomly selected controls (n = 250) from population catchments in New South Wales (Australia), with exposure information collected from key informant interviews (for both cases and controls). The relative and attributable risk of suicide associated with ICD-10 defined substance use, affective, and anxiety disorder was compared with educational achievement and household income, adjusting for key confounders. Prevalence of exposures from the control group was used to estimate population attributable fractions (PAF).ResultsStrong associations were evident between mental disorders and suicide for both males and females (ORs 3.1 to 18.7). The strongest association was for anxiety disorders (both males and females), followed by affective disorders and substance use disorders. Associations for socio-economic status were smaller in magnitude than for mental disorders for both males and females (ORs 1.1 to 4.8 for lower compared to high SES groups). The combined PAF% for all mental disorders (48% for males and 52% for females) was similar in magnitude to socio-economic status (46% for males and 58% for females).ConclusionSocio-economic status had a similar magnitude of population attributable risk for suicide as mental disorders. Public health interventions to reduce suicide should incorporate socio-economic disadvantage in addition to mental illness as a potential target for intervention.

EPA-1517 - Physical disorders as predictors of suicide in older adults

Objective The aim of the study was to examine the association between specific physical diseases and suicide in older adults as well as to assess whether depression or perceived burdensomeness might be causal mechanisms. Method Individual-level register data on all older adults aged 60 years and over living in Denmark during 1990-2009 (N=2,301,709) was assessed using survival analysis. Relative risks of suicide were assessed for a total of 38 physical disorders while adjusting for age, period, conjugal status, income, physical comorbidity, and psychiatric disorders among others depression. Impact was examined within short and long term after diagnose. Results In all, 6,012 deaths due to suicide were observed during more than 22 mill. person-years. Presence of a physical disorders resulted in a 51% and 39% higher suicide rates for older adult men and women, respectively. Men with no physical disorders had a suicide rate of 33.0 [CI- 95%: 31.6-34.4] vs. 49.7 [47.3-52.1] among those with 1-3 physical disorders. For older adult women the corresponding figures were 14.1 [13.1- 15.2] and 19.6 [18.5-20.6], respectively. Significantly higher rate ratios of suicide were identified for lung cancer, intestinal cancer, chronic obstructive pulmonary disorders (COPD), liver disease, and male genital disorders when compared to persons with no diagnose. Men and women diagnosed with COPD experienced a 1.8 [CI- 95%: 1.6-2.1] and 1.8 [CI-95%: 1.5-2.2] fold higher risk of suicide during first three years, respectively. Conclusion Elevated risks of suicide were identified in numerous physical disorders, also when adjusting for psychiatric comorbidity.

EPA-0042 - Suicide clusters augmentation through media

Background ‘Werther effect’ is a term synonymous with suicide clusters, following a trend for suicide instigated by a historic book. Depending on cluster size, they can be named’point’ or’mass’ clusters. These phenomena, typically affecting adolescents, can have substantial emotional consequences for a community. There is a paucity of comprehensive literature in this area, hence our aim was to investigate cluster triggers and demographics. Method A comprehensive review using a PubMed search was undertaken. Search terms were’suicide cluster’,’recent suicide’ and’suicide outbreaks’. As this was a review paper ethical approval was waived. Results Saman et al (1992) describe two ‘high risk’ spatial clusters which translated to a 38% increase in relative suicide risk. They also describe how suicide method is remarkably consistent within a cluster supported by Exeter and Boyle (2006). Qi et al (2006), in comparison to Saman et al, demonstrated how clusters may have variable risk groups, with differing correlations between age of females and suicide rates. All studies highlighted the central part media played in commencement of suicide clusters. Conclusion With globally increasing levels of mental health issues, the recession and other demands of 21 st century living, rates of suicide could increase and knowledge in this area is therefore vital at the level of government resource allocation and for the health care professionals delivering care on a daily basis. We found a strong correlation with media exposure and subsequent suicide clusters.

Tracking Suicide Risk Factors Through Twitter in the US

Suicide is a leading cause of death in the United States. Social media such as Twitter is an emerging surveillance tool that may assist researchers in tracking suicide risk factors in real time. To identify suicide-related risk factors through Twitter conversations by matching on geographic suicide rates from vital statistics data. At-risk tweets were filtered from the Twitter stream using keywords and phrases created from suicide risk factors. Tweets were grouped by state and departures from expectation were calculated. The values for suicide tweeters were compared against national data of actual suicide rates from the Centers for Disease Control and Prevention. A total of 1,659,274 tweets were analyzed over a 3-month period with 37,717 identified as at-risk for suicide. Midwestern and western states had a higher proportion of suicide-related tweeters than expected, while the reverse was true for southern and eastern states. A strong correlation was observed between state Twitter-derived data and actual state age-adjusted suicide data. Twitter may be a viable tool for real-time monitoring of suicide risk factors on a large scale. This study demonstrates that individuals who are at risk for suicide may be detected through social media.

The Werther Effect of Two Celebrity Suicides: an Entertainer and a Politician

PurposeSuicide is a major health problem in Korea. Extensive media exposure of celebrity suicide may induce imitative suicide, a phenomenon called the Werther effect. We examined the increased suicide risk following the suicides of an entertainer and a politician, and identified the relative suicide risks. MethodsNews articles about the celebrity suicides were obtained from three major newspapers and analysed for quantitative and qualitative features. Imitative suicide risk was investigated by applying a Poisson time series autoregression model with suicide mortality data from the National Statistics Office for 1.5 years before and 1.5 years after each celebrity’s suicide. The period with a significantly increased number of suicides immediately after the celebrity’s suicide determined the Werther effect band. The relative risk during this period was examined for different ages, genders, and suicide methods.ResultsNews reports were more numerous and they contained more positive definitions about the entertainer’s suicide. The risk of suicide deaths rose markedly after both celebrity suicides. However, the Werther effect band was longer for the entertainer (6 weeks) than for the politician (4 weeks). The relative suicide risk was significant for almost all ages and both genders during that of both individuals. Use of the same suicide method was a prominent risk factor after both celebrity suicides. ConclusionsOur results confirm the existence of imitative suicide behaviours, suggesting a facilitation effect of media reports. Guidelines for responsible media reporting need to be implemented to enhance public mental health in Korea.

The impact of indiscriminate media coverage of a celebrity suicide on a society with a high suicide rate: Epidemiological findings on copycat suicides from South Korea

BackgroundThis study examines the extent to which the indiscriminate media coverage of the famous young actress Lee Eun-ju's suicide in 2005 affected suicides overall and in specific subgroups (by age, gender, and suicide method) in a suicide-prone society, South Korea. MethodsSouth Korea's 2003–2005 suicide data (n=34,237) were obtained from death certificate records of the National Statistical Office (NSO). Data was analyzed with Poisson time series auto-regression models. ResultsAfter adjusting for confounding factors (such as seasonal variation, calendar year, temperature, humidity, and unemployment rate), there was a significant increase in suicide (RR=1.40, 95%, CI=1.30–1.51, no. of excess mortalities=331; 95% CI=267–391) during the 4 weeks after Lee's suicide. This increase was more prominent in subgroups with similar characteristics to the celebrity. In particular, the relative risk of suicide during this period was the largest (5.24; 95% CI=3.31–8.29) in young women who used the same suicide method as the celebrity. Moreover, the incidence of these copycat suicides during the same time significantly increased in both genders and in all age subgroups among those who committed suicide using the same method as the celebrity (hanging). LimitationsIt is difficult to prove conclusively that the real motivation of the suicides was Lee's death. ConclusionsThe findings from this study imply that, if the media indiscreetly reports the suicide of a celebrity in a suicide-prone society, the copycat effect can be far-reaching and very strong, particularly for vulnerable people.