Trends In Suicide Rates Research Articles

Did the introduction and increased prescribing of antidepressants lead to changes in long-term trends of suicide rates?

BackgroundEcological studies have explored associations between suicide rates and antidepressant prescriptions in the population, but most of them are limited as they analyzed short-term correlations that may be spurious. The aim of this long-term study was to examine whether trends in suicide rates changed in three European countries when the first antidepressants were introduced in 1960 and when prescription rates increased steeply after 1990 with the introduction of the serotonin reuptake inhibitors (SSRIs).MethodsData were extracted from the WHO Mortality Database. Suicide rates were calculated for people aged 10–89 years from 1951–2015 for Italy, 1955–2016 for Austria and 1951–2013 for Switzerland. Trends in suicide rates stratified by gender were analyzed using joinpoint regression models.ResultsThere was a general pattern of long-term trends that was broadly consistent across all three countries. Suicide rates were stable or decreasing during the 1950s and 1960s, they rose during the 1970s, peaked in the early 1980s and thereafter they declined. There were a few notable exceptions to these general trends. In Italian men, suicide rates increased until 1997, then fell sharply until 2006 and increased again from 2006 to 2015. In women from all three countries, there was an extended period during the 2000s when suicide rates were stable. No trend changes occurred around 1960 or 1990.ConclusionsThe introduction of antidepressants around 1960 and the sharp increase in prescriptions after 1990 with the introduction of the SSRIs did not coincide with trend changes in suicide rates in Italy, Austria or Switzerland.

Gender difference in suicide in Taiwan over a century: a time trend analysis in 1905–1940 and 1959–2012

BackgroundSuicide rates are higher in men than in women in most countries, although the gender ratios vary markedly worldwide. We investigated long-term trends in suicide rates and the male-to-female ratios...

Social media use, economic recession and income inequality in relation to trends in youth suicide in high-income countries: a time trends analysis

BackgroundSuicide rates have risen in young people in several high-income countries over the last decade. Reasons for the increases are unclear. MethodsWe analysed trends in suicide rates in 15-24 year olds over the period 2000-2017 in high-income countries with populations >20 million using Joinpoint analysis. We investigated differences in the following population-level exposures between countries that are and are not experiencing suicide rates rises: 1) 2008 economic recession as indexed by changes in GDP; 2) Gini income inequality; 3) daily social media use. ResultsFour of the 11 countries studied are experiencing youth suicide rate rises: Australia, Canada, the UK, the USA. The year the increase began ranged from 2003 (95% confidence interval: 2002, 2007) in the UK to 2009 (95% CI: 2007, 2012) in Australia. There was little evidence of an association between social media use and youth suicide trends, and inconsistent evidence regarding the impact of the 2008 economic recession. Suicide rate rises were seen in countries with higher GDP per capita (Wilcoxon rank sum (WRS) z=-2.27; p=0.02) and income inequality (WRS z=-2.45; p=0.01) in 2008. LimitationsSuicide data were only available until 2016/2017. Social media and income inequality data were not available for all study years. The effect of other important factors were not investigated due to a lack of comparable data. ConclusionsOur analyses indicate that the most populous high-income countries experiencing a rise in youth suicide rates are predominantly English-speaking, with higher levels of income inequality and GDP. These findings provide preliminary evidence regarding possible contributory factors to guide further research.

Quantifying the contributions of age, sex, methods, and urbanicity to the changing suicide rate trends in South Korea, 2001–2016

Suicide rates in South Korea have been one of the highest in the world. The aim of this study is to quantify the contributions of age, sex, method, and place of residence to the trends of the suicide rates between 2001 and 2016 in South Korea. Using the suicide data obtained from the South Korean National Death Registration data set for the years 2001-2016, a Joinpoint regression analysis was conducted to determine if there was a significant change in the trend of suicide rates. Next, a decomposition analysis method was used to quantify the contributions of age, sex, method, and places of residence to the changes in the suicide rates. Suicide rates increased between 2001 and 2010, and decreased between 2010 and 2016. Among all the age groups, the 65-79 age group contributed most to the rise (18% in men and 7% in women) and fall (-15% in men and -14% in women) of suicide rates. Men contributed much more than women to the increasing trend of suicide rate (63.0% vs. 37.0%). Hanging was the key method of suicide, dominating the ups and downs of the suicide rates. The rates of suicide by pesticide poisoning have been decreasing since 2005 and suicide by charcoal burning continued to increase against a decreasing trend of suicide rate during the period of 2010-2016. The gap of the metropolitan-city-rural suicide rates was narrowing during the period under study, although the rural areas remained to have the highest suicide rates. The ups and downs of suicide rates in South Korea were not uniform across different sociodemographic groups. Age, sex, method, and place of residence contributed differently to the changes in suicide rates. Suicide prevention measures can be more focused on certain age-sex-method-region subgroups.

Trends in Suicide Mortality in South Africa, 1997 to 2016.

Suicide rates worldwide are declining; however, less is known about the patterns and trends in mortality from suicide in sub-Saharan Africa. This study evaluates trends in suicide rates and years of potential life lost from death registration data in South Africa from 1997 to 2016. Suicide (X60–X84 and Y87) was coded using the 10th Revision of the International Classification of Diseases (ICD-10). Changes in mortality rate trends were analysed using joinpoint regression analysis. The 20-year study examines 8573 suicides in South Africa, comprising 0.1% of all deaths involving persons 15 years and older. Rates of suicide per 100,000 population were 2.07 in men and 0.49 in women. Joinpoint regression analyses showed that, while the overall mortality rate for male suicides remained stable, mortality rates due to hanging and poisoning increased by 3.9% and 3.5% per year, respectively. Female suicide mortality rates increased by 12.6% from 1997 to 2004 before stabilising; while rates due to hanging increased by 3.0% per year. The average annual YPLL due to suicide was 9559 in men and 2612 in women. The results show that suicide contributes substantially to premature death and demonstrates the need for targeted interventions, especially among young men in South Africa.

Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends

BackgroundPesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides from agricultural use has been successful in reducing total suicide numbers in several South Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of highly hazardous pesticides and explore how they might relate to suicide rates across India.MethodsInformation on pesticide regulation was collated from agriculture departments of the central government and all 29 state governments (excluding union territories). National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate the trends in suicide rates nationally and in Kerala, in view of the robust measures Kerala has taken to restrict a number of HHPs, to identify any effect on suicides.ResultsAs of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization toxicity criteria. Despite many highly hazardous pesticides still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995 to 2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49–0.54) and total suicides nationally by 2014 (0.90, 0.87–0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected rate of pesticide suicides (0.45, 0.42–0.49), but no change to the already decreasing trend in total suicides (1.02, 1.00–1.05) after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect – lower than expected pesticide suicides (0.79, 0.64–0.99), but no change to the decreasing trend of total suicides (0.97, 0.93–1.02) in 2010. There was no evidence of a decline in agricultural outputs following the bans.ConclusionHighly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of highly hazardous pesticides could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

Suicide and associated psychosocial correlates among university students in Taiwan: A mixed-methods study

The trend of suicide rates among young adults has been increasing worldwide. The study aimed to identify the suicide risks and associated psychosocial factors in a large university in Taiwan. This is a mixed-methods study using both questionnaire survey and two open-ended questions for the exploration of qualitative data. An online survey was conducted between two periods of the same semester in 2018 to collect different sources of stress and other suicide correlates. The measurement scales included the 9-item Concise Mental Health Checklist, the University Stress Screening Tool in Taiwan and the Chinese Maudsley Personality Inventory. The participants were required to fulfill two open-ended questions about stress experience and depressive symptoms in the previous month in the end of the questionnaire, which was analyzed using thematic analysis. A total of 857 university students were recruited (67.9% female participants). Over a quarter of participants were under poor mental health status and more than 60% experienced stressful events in the prior year. A higher suicide risk and neurotic trait was noticed compared to the general public. These results were consistent with the qualitative findings. While identifying several risk factors that cumulatively conduced to higher suicide risks, neuroticism served as a key element in the increased suicide risk among the university students. Suicide prevention strategies for university students should highlight stress management for those with neurotic trait and early suicide risk identification.

Suicide risk during the COVID-19 pandemic

Although it is still too early and uncertain to accurately predict the outcomes of the COVID-19 pandemic on suicide rates, the main principles guiding suicide prevention during the pandemic are that 1) suicide is preventable, 2) the time for action for mental health is now, and 3) the worldwide concerted efforts ensure a better outcome. Although a unique universal effect of pandemic on suicide is unlikely, the current data suggest that the impact will vary over time and can depend on individual socioeconomic context, ethnicity and mental health, country economic power, and global collaborations to actively promote resilience and effective response, such as the International COVID-19 Suicide Prevention Research Collaboration.We need to address both emerging risk factors, and the potential increase of pre-pandemic risk factors for suicide. Moreover, the effective tackling of the issue requires a better understanding of the preexisting trends in suicide rates, more effective and comprehensive assessment tools, effective adjustment of previous evidence-based prevention strategies to the pandemic context, and the effective inclusion of social risk factors generating inequities in access to resources and care. Most universal strategies for suicide prevention are government-based, while selective and indicated strategies dwell on appropriate government funding of mental and social health care services; hence, the key role of policies driven by global collaborative research and spearheaded by governments in the effective tackling of suicide prevention during the pandemic. In Romania, the pandemic increased the impact of preexisting societal and community risk factors, along with barriers to appropriate family, community and professional help. Therefore, TelVerde Antisuicide emerges as an important means for suicide prevention. This resource provided by the Romanian Alliance for Suicide Prevention (a non-governmental organization) significantly improves suicide prevention on all levels, thus contributing to filling the gap created by the lack of a national, government-driven suicide prevention strategy.

SUICIDE TRENDS AND DISPARITIES AMONG OLDER ADULTS IN THE UNITED STATES, 2008-2017

Background: Suicide ranks within the top fifteen causes of death among adults 55 and older in the United States and is a growing concern in the face of social isolation and other end-of-life issues. This study examined differences and trends in suicide rates and methods among older adults in the U.S. Methods: Suicide mortality rates from 2008-2017 were derived from the Multiple Cause of Death files in the CDC’s WONDER database. Suicide deaths were identified from the underlying causes of death using ICD-10 codes. Age-adjusted death rates (per 100,000) were calculated. Older adults were grouped into four age categories: 55-64, 65-74, 75-84, and 85+ years. Percent change in suicide rates between 2008-2017 were examined, which were then stratified by gender and top suicide methods. Results: Suicide rates increased by 16% among adults 55 years of age and older from 2008 to 2017 (15.4 vs 17.8 per 100,000 respectively). In 2017, the suicide rate among older adults was 27% higher than the general population (14.0 per 100,000). Suicide rates were significantly higher among men relative to women for those ages 85+ (14:1 ratio of males-to-females). However, females in the 65-74 age group experienced the highest increase of suicide rate (41%) compared to other females or males across age groups. The most common method of suicide was firearms, followed by poisoning and suffocation. Suffocation had the highest increase over time (37%). Conclusion: Rising suicide rates among older adults suggest the need for tailored intervention strategies that address upstream suicide-related risk factors.

Trends in suicide rates in Brazil from 1997 to 2015.

Objectives:To analyze time trends of suicide rates in Brazil overall and in Brazilian states and compare the estimated suicide rates projected for 2020 with the World Health Organization (WHO) Mental Health Action Plan target.Methods:This was an ecological time-series study from 1997 to 2015, stratified by Brazilian states, specific age groups, and sex. Data were obtained from the Mortality Information System (Sistema de Informações sobre Mortalidade [SIM]) of the Brazilian Ministry of Health. Polynomial regression models were used to analyze the trends in suicide rates and to project suicide rates for 2020.Results:Considering 224 units of analysis, 21 (9.4%) showed a decreasing trend, 108 (48.2%) were stable, and 95 (42.4%) showed an increasing trend. Thus, 67% of units of analysis will not meet the WHO target in 2020. Mean suicide rates were higher in males than in females. People aged 60 years and older presented the highest suicide rates, while 84.7% of total deaths by suicide occurred among 15-to-59-year-olds.Conclusion:Overall, 90.6% of units of analysis had a stable or increasing trend in suicide rates from 1997 to 2015. If these trends remain, most of Brazil will fail to achieve the WHO-recommended reduction in suicide rates by 2020.

Assessing the impact of the economic crises in 1997 and 2008 on suicides in Hong Kong, Taiwan and South Korea using a strata-bootstrap algorithm

ABSTRACTThe Asian economic crises of 1997 and the 2008 Global Financial Crisis (GFC) had far-reaching impacts on Asian and other global economies. Turmoil in the banking and finance sectors led to downturns in stock markets, resulting in bankruptcies, house repossessions and high unemployment. These crises have been shown to be correlated with a deterioration in mental health and an increase in suicides, and it is important to understand the implication of these impacts and how such recessions affect the health of affected populations. With the benefit of hindsight, did lessons learned from the negative effects of the 1997 Asian economic recession impact the aftermath of the 2008 GFC in Asian countries? Utilising a framework based on a simple strata-bootstrap algorithm using daily data – where available – we investigate the trend in suicide rates over time in three different populations (Hong Kong, Taiwan and South Korea), and examine whether there were any changes in the pattern of suicide rates in each country subsequent to both the 1997 Asian and 2008. We find that each country responded differently to each of the crises and the suicide rates for certain age-gender specific groups in each country were more affected.

The epidemiology of suicide in the elderly population in Southern Iran, 2011-2016.

The epidemiology of suicide within the elderly is unique to each cultural setting. In most countries, despite the higher rate of suicide attempts among adolescents and young people, the rate of suicide deaths in the elderly is higher than other age groups. The purpose of this study was to investigate the suicide rates among persons 65 years and above in Fars, Iran. In this cross-sectional study, we investigated suicide cases (65 years and older) during 2011-2016 in Fars, Iran. The data were collected from the Mental Health and Suicide Surveillance Systems of Fars province, using filled forms that included suicide and demographic information. After eliminating duplications, suicidal rates were calculated. Of 299 suicide attempts, 64.9% were men, and 69.6% were urban residents. The rate of suicide attempts and deaths were 21.47 and 4.52 per 100,000 population, respectively; and the case fatality rate (CFR) of suicide was 21.07% during the study period. The rate of suicide attempts and deaths in this population showed an increase during the study years. Considering the increasing trend of suicide rates in the elderly in Fars, Iran, measures should be taken to facilitate the access of this group to the mental health care system and psychological counseling.

Suicide Rates Among Adolescents and Young Adults in the United States, 2000-2017

This study uses Centers for Disease Control and Prevention (CDC) data to characterize trends in suicide rates among adolescents and young adults aged 15 to 24 years in the United States and to determine if the increase in suicide rates observed in years 2000-2016 is continuing.

The trend in mortality due to suicide in urban and rural areas of Colombia, 1979-2014

Introduction: Suicide is a serious social and public health problem that affects the population in most countries in the world. Differences in suicide rates in rural and urban areas have been previously described. Objective: To study the trend of mortality rates by suicide in Colombia, in rural and urban areas by gender, age group, and suicide method during the years 1979-2014. Materials and methods: We conducted a temporal trend ecologic study using death certificates from the Departamento Administrativo Nacional de Estadística, DANE. Specific and adjusted by age and gender mortality rates were calculated. We estimated negative binomial and inflection point regression models to study the trends in mortality rates stratified by gender, age group, and suicide method. Results: A total of 56,448 suicides was reported in Colombia between 1979 and 2014. The risk of suicide was higher in urban areas for men, individuals between 25 and 44 years, and 65 and over; and for those who used hanging as the suicide method. Also, the risk of suicide was higher in the rural area for men between 45 and 64 years old, and those who used firearms, sharp weapons, hanging, and others as suicide methods. The trend of suicide rates in urban areas showed its maximum peak in 1999 and in the rural ones in 2000. Then, in the two areas, there was a gradual decrease. Hanging in both areas presented a tendency to rise in men. Conclusions: Suicide has shown a tendency toward reduction after the year 2000, with differences between urban and rural areas.

Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016

Suicide is a leading cause of death among youth aged 10 to 19 years in the United States, with rates traditionally higher in male than in female youth. Recent national mortality data suggest this gap may be narrowing, which warrants investigation. To investigate trends in suicide rates among US youth aged 10 to 19 years by age group, sex, race/ethnicity, and method of suicide. Cross-sectional study using period trend analysis of US suicide decedents aged 10 to 19 years from January 1, 1975, to December 31, 2016. Data were analyzed for periods defined by statistically significant changes in suicide rate trends. Suicide rates were calculated using population estimates. Period trends in suicide rates by sex and age group were assessed using joinpoint regression. Incidence rate ratios (IRRs) were estimated using negative binomial regression comparing male and female suicide rates within periods. From 1975 to 2016, we identified 85 051 youth suicide deaths in the United States (68 085 male [80.1%] and 16 966 female [19.9%]) with a male to female IRR of 3.82 (95% CI, 3.35-4.35). Following a downward trend until 2007, suicide rates for female youth showed the largest significant percentage increase compared with male youth (12.7% vs 7.1% for individuals aged 10-14 years; 7.9% vs 3.5% for individuals aged 15-19 years). The male to female IRR decreased significantly across the study period for youth aged 10 to 14 years (3.14 [95% CI, 2.74-3.61] to 1.80 [95% CI, 1.53-2.12]) and 15 to 19 years (4.15 [95% CI, 3.79-4.54] to 3.31 [95% CI, 2.96-3.69]). Significant declining trends in the male to female IRR were found in non-Hispanic white youth aged 10 to 14 years (3.27 [95% CI, 2.68-4.00] to 2.04 [95% CI, 1.45-2.89]) and non-Hispanic youth of other races aged 15 to 19 years (4.02 [95% CI, 3.29-4.92] to 2.35 [95% CI, 2.00-2.76]). The male to female IRR for firearms increased significantly for youth aged 15 to 19 years (χ2 = 7.74; P = .02 for sex × period interaction). The male to female IRR of suicide by hanging or suffocation decreased significantly for both age groups (10-14 years: χ2 = 88.83; P < .001 for sex × period interaction and 15-19 years: χ2 = 82.15; P < .001 for sex × period interaction). No significant change was found in the male to female IRR of suicide by poisoning across the study period. A significant reduction in the historically large gap in youth suicide rates between male and female individuals underscores the importance of interventions that consider unique differences by sex. Future research examining sex-specific factors associated with youth suicide is warranted.

Trend analysis of suicide among children, adolescent and young adults in Ecuador between 1990 and 2017

Analyze the long-term sex specific trends in suicide rates for Ecuadorian children, adolescents and young people, as well as to describe the evolution of the male/female ratio between 1990 and 2017. Population and mortality data were obtained from the National Institute of Statistics and Censuses of Ecuador. Suicide rates were calculated for each year, age group (10-14, 15-19, 20-24 years) and sex. We used the Joinpoint Regression Program 4.6.0.2 to analyze temporal trends and report annual percent change (APC) by each age group and sex. An average of 313 suicides per year happened in Ecuador between 1990 and 2017, with increases of 480% in young boys and 322 % in girls aged between 10-14, 111% in male adolescents and 57% in young adults, while there was a decrease in adolescent girls (19%) and young adults (37%). The suicide rate increased annually among boys (APC = 5.10%) and girls (2.57%), as well as for male adolescents (3.07%) and young adults (10.42%), while for female adolescents (0.81%, not significant) and young women (1.16%) the trend decreased after reaching a peak around 2006. While up until the beginning of the XXI century young females aged between 10 and 19 years had higher suicide rates, during the last decade men had higher rates across all age groups (between 1.5:1 and 4.3:1 in 2017). Suicide in the population under 25 years in Ecuador is a major public health issue and increased between 1990 and 2017, particularly among children, and males between 15-24 years. The intersectorial strategy proposed in 2018 in order to reduce suicide is pending further evaluation and interpretation.

Geographical and Temporal Variation of Suicide in India, 2006-2015: An Investigation of Factors Associated with Suicide Risk Difference across States/Union Territories.

Background:In India, about 130,000 people died by suicide in the year 2015. It is important to understand the variation of suicide across different parts of India and the trend of suicide rates over the years. The objectives of this study were to determine whether suicide rates in India showed temporal variation in the last decade and to determine whether suicide rates in India showed geographical variation across different states and union territories (UTs).Methods:Data on suicide rates for the years 2006–2015 were collected from the official publication of the National Crime Records Bureau. This study looked for time trend in suicide rates over the years. Further, the variation in suicide rates across different states/UTs in India and the factors associated with the variation were also analyzed.Results:The average suicide rate in India for the years 2006–2015 was 10.9/100,000 population. Overall, there was no significant variation in the suicide rate over time in the years studied. The average suicide rate varied widely across the states and UTs, between 0.91 and 43.92 per 100,000 population. The analysis revealed a positive association between suicide rates and accident rates for the above years. In addition, for the year 2011, a positive association between suicide rate and per capita state domestic product was noted.Conclusion:There was no variation in the suicide rate in India over time. However, there were significant regional differences. Reporting differences and economic factors could partially explain the differences.

Suicide among Italian police officers from 1995 to 2017.

Suicide rate in police officers is higher than in the general population worldwide. This paper assesses and analyzes the trends in suicide rates of Italian police officers from 1995 to 2017, comparing these with the trends of Italian general population. We reviewed all cases of active Italian police officers who died by suicide from 1995 through 2017 (N=271). We calculated age- and gender- specific suicide rates among police officers and the Italian general population. We carried out descriptive chi-squared analyses for categorical variables, and one-way ANOVA for continuous variables, performing a joinpoint regression to analize suicide trends. The mean police suicide rate was 11.78 per 100,000 individuals per year (95% CI=11.18-12.06). Joinpoint regression analyses of the period 1995-2017 showed that suicide rates of Italian police officers significantly decreased from 1995 to 2007 (annual percent change [APC]: -5.75%), followed by a period of a non-significant increase (APC: 3.9%). The period as a whole showed a non-significant decrease (APC: -1.7%). During 1995-2014, suicide rates were significantly higher among police officers vs. the age-adjusted general population (p<0.001), in male police vs. Italian male residents younger than 65 (p<0.001), and in female police vs. the female age-adjusted general population (p<0.05). Suicide rates among Italian police officers were significantly higher than those of the national resident population younger than 65 years. Annual suicide rate trends among Police showed a significant reduction in the period 1995-2007 followed by a stable trend until 2017. The entire period 1995-2017 showed a non-significant decreasing trend.

Trends and Spatial Patterns of Suicide Among Adolescent in Ecuador, 1997-2016.

Background:Suicide is a global public health problem, ranking among the top 20 leading causes of mortality.Objective:The aim of the present study is two-fold. Firstly, it describes the temporal trends of suicide in adolescents from 1997 to 2016 in Ecuador, allowing us to identify critical periods. Secondly, it analyzes the spatiotemporal clusters of high mortality rates and the spatial distribution due to suicide in the country, from 2011 to 2016.Methods:This is an ecological study; we included all death certificates of suicide among adolescents in the 10 - 19 age groups both sex, from the National Institute of Statistics and Census (INEC) database in Ecuador from 1997 to 2016. In order to assess the trend of suicide rates, we obtained Annual Percentage Changes (APCs) and average Annual Percent Changes (AAPCs) through Joinpoint regression analysis. Space-time scan statistics were used to identify high-risk clusters, and the spatial autocorrelation was evaluated through global Moran index.Results:Suicides at a national level increased from 165 deaths in 1997 to 286 deaths in 2016; rates increased from 12.7 to 23.3 per 100,000 population along with a significant increase of the trend at the national level (AAPC=3.7%; 95% CI: 2.1 to 5.2). We identified two significant spatial clusters for a high occurrence of suicide: the primary most likely cluster included 83 cantons (Risk Relative=2.28) while the second most likely cluster included 20 cantons (Risk Relative=1.74). The Global Moran I index for the study period showed a positive spatial autocorrelation (0.27; p = 0.001).Conclusion:Suicide rates in adolescents significantly increased over the 20-year study period; the spatial analysis indicates the presence of high occurrence clusters in the Amazon and Southern Highlands regions of the country. This growing phenomenon may be a reflection of the lack of policies and strategies focused on the adolescent’s mental health at a national level, added to factors such as family dysfunction, school failure, vulnerable ethnic groups, and immigration patterns.

Changing trends in suicide rates in South Korea from 1993 to 2016: a descriptive study

ObjectivesThe South Korean government has recently implemented policies to prevent suicide. However, there were few studies examining the recent changing trends in suicide rates. This study aims to examine the...