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Published in: BMC Public Health 1/2005

Open Access 01-12-2005 | Research article

Sex- and age-specific trends in mortality from suicide and undetermined death in Germany 1991–2002

Authors: Jens J Baumert, Natalia Erazo, Karl-Heinz Ladwig

Published in: BMC Public Health | Issue 1/2005

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Abstract

Background

Over the last decade, significant downward linear time trends in suicide mortality were observed in most Western countries. To date, it is not established whether those favourable time trends developed homogeneously for sex and age groups and how they were affected by the number of undetermined deaths.

Methods

Data on suicide mortality and undetermined death from 1991 to 2002 in Germany were obtained from the German Federal Statistical Office. For each year, the age-standardised suicide rate (SR), undetermined death rate (UDR) and total rate (SR+UDR) was calculated by direct standardisation separately for men and women. Time trends were analyzed by Poisson regression estimating the average annual percentage change (AAPC) of the rates for sex and four age groups (15–24, 25–44, 45–74, ≥ 75 years).

Results

A significant decline of the SR was observed in all age groups but was less pronounced among the younger ages, particularly among men aged 15–24 years (AAPC -0.7%, p = 0.041). The SR in the oldest male age group (≥ 75 years) declined much stronger (AAPC -3.5%, p < 0.001). In women, the AAPC of the SR ranged from -1.7% to -4.6%. The average annual percentage changes in the age groups 25 – 74 years did not differ substantially for SR and SR+UDR. In contrast, due to an increase of undetermined deaths for subjects ≥ 75 years, time trends in this age group were affected by the number of undetermined deaths, especially in women.

Conclusion

Observing downward trends in suicide mortality with lower declines for younger subjects, prevention strategies should focus in particular on younger subjects.
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Literature
1.
go back to reference Chishti P, Stone DH, Corcoran P, Williamson E, Petridou E, EUROSAVE Working Group: Suicide mortality in the European Union. European J Public Health. 2003, 13: 108-114. 10.1093/eurpub/13.2.108.CrossRef Chishti P, Stone DH, Corcoran P, Williamson E, Petridou E, EUROSAVE Working Group: Suicide mortality in the European Union. European J Public Health. 2003, 13: 108-114. 10.1093/eurpub/13.2.108.CrossRef
2.
go back to reference Levi F, La Vecchia C, Lucchini F, Negri E, Saxena S, Maulik PK, Saraceno B: Trends in mortality from suicide, 1965–99. Acta Psychiatica Scandinavica. 2003, 108: 341-349. 10.1034/j.1600-0447.2003.00147.x.CrossRef Levi F, La Vecchia C, Lucchini F, Negri E, Saxena S, Maulik PK, Saraceno B: Trends in mortality from suicide, 1965–99. Acta Psychiatica Scandinavica. 2003, 108: 341-349. 10.1034/j.1600-0447.2003.00147.x.CrossRef
4.
go back to reference Mann J: A current perspective of suicide and attempted suicide. Annals Internal Med. 2002, 136: 302-311.CrossRef Mann J: A current perspective of suicide and attempted suicide. Annals Internal Med. 2002, 136: 302-311.CrossRef
5.
go back to reference Guaiana G, D'Avanzo B, Barbui C: Update of suicide trends in Italy from 1986 to 1996. Soc Psychiatry Psychiatr Epidemiol. 2002, 37: 267-270. 10.1007/s001270200018.CrossRefPubMed Guaiana G, D'Avanzo B, Barbui C: Update of suicide trends in Italy from 1986 to 1996. Soc Psychiatry Psychiatr Epidemiol. 2002, 37: 267-270. 10.1007/s001270200018.CrossRefPubMed
6.
go back to reference Gunnell D, Middleton N: National suicide rates as an indicator of the effect of suicide on premature mortality. Lancet. 2003, 362: 961-962. 10.1016/S0140-6736(03)14367-X.CrossRefPubMed Gunnell D, Middleton N: National suicide rates as an indicator of the effect of suicide on premature mortality. Lancet. 2003, 362: 961-962. 10.1016/S0140-6736(03)14367-X.CrossRefPubMed
8.
go back to reference World Health Organization (WHO): The Ninth Revision of the International Classification of Diseaeses (ICD-9). 1977, Geneva: World Health Organization World Health Organization (WHO): The Ninth Revision of the International Classification of Diseaeses (ICD-9). 1977, Geneva: World Health Organization
9.
go back to reference World Health Organization (WHO): The Tenth Revision of the International Classification of Diseaeses (ICD-10). 1992, Geneva: World Health Organization World Health Organization (WHO): The Tenth Revision of the International Classification of Diseaeses (ICD-10). 1992, Geneva: World Health Organization
10.
go back to reference Breslow NE, Day NE: Statistical Methods in Cancer Research. The Design and Analysis of Cohort Studies. 1987, Lyon: IARC, II: Breslow NE, Day NE: Statistical Methods in Cancer Research. The Design and Analysis of Cohort Studies. 1987, Lyon: IARC, II:
11.
go back to reference McCullagh P, Nelder JA: Generalized linear models. 1989, Cambridge: University Press, 2CrossRef McCullagh P, Nelder JA: Generalized linear models. 1989, Cambridge: University Press, 2CrossRef
12.
go back to reference SAS: SAS/STAT. User's Guide, Version 8. 2000, Cary, NC: SAS Institute Inc SAS: SAS/STAT. User's Guide, Version 8. 2000, Cary, NC: SAS Institute Inc
13.
go back to reference Granizo JJ, Guallar E, Rodriguez-Artalejo F: Age-period-cohort analysis of suicide mortality rates in Spain, 1959–1991. Int J Epidemiol. 1996, 25: 814-820.CrossRefPubMed Granizo JJ, Guallar E, Rodriguez-Artalejo F: Age-period-cohort analysis of suicide mortality rates in Spain, 1959–1991. Int J Epidemiol. 1996, 25: 814-820.CrossRefPubMed
14.
go back to reference Moens GF: The rise of suicide mortality in Belgium between 1968–72 and 1978–81: age, sex and geographical characteristics. Int J Epidemiol. 1984, 13: 243-245.CrossRefPubMed Moens GF: The rise of suicide mortality in Belgium between 1968–72 and 1978–81: age, sex and geographical characteristics. Int J Epidemiol. 1984, 13: 243-245.CrossRefPubMed
15.
go back to reference Huchcroft SA, Tanney BL: Sex-specific suicide trends in Canada, 1971–1985. Int J Epidemiol. 1988, 17: 839-843.CrossRefPubMed Huchcroft SA, Tanney BL: Sex-specific suicide trends in Canada, 1971–1985. Int J Epidemiol. 1988, 17: 839-843.CrossRefPubMed
16.
go back to reference Stark C, Hopkins P, Gibbs D, Rapson T, Belbin A, Hay A: Trends in suicide in Scotland 1981 – 1999: age, method and geography. BMC Public Health. 2004, 4: 49-10.1186/1471-2458-4-49.CrossRefPubMedPubMedCentral Stark C, Hopkins P, Gibbs D, Rapson T, Belbin A, Hay A: Trends in suicide in Scotland 1981 – 1999: age, method and geography. BMC Public Health. 2004, 4: 49-10.1186/1471-2458-4-49.CrossRefPubMedPubMedCentral
17.
go back to reference Zacharakis CA, Madianos MG, Papadimitriou GN, Stefanis CN: Suicide in Greece 1980–1995: patterns and social factors. Soc Psychiatry Psychiatr Epidemiol. 1998, 33: 471-476. 10.1007/s001270050081.CrossRefPubMed Zacharakis CA, Madianos MG, Papadimitriou GN, Stefanis CN: Suicide in Greece 1980–1995: patterns and social factors. Soc Psychiatry Psychiatr Epidemiol. 1998, 33: 471-476. 10.1007/s001270050081.CrossRefPubMed
18.
19.
go back to reference Morgan OWC, Griffiths C, Majeed A: Association between mortality from suicide in England and antidepressant prescribing: an ecological study. BMC Public Health. 2004, 4: 63-10.1186/1471-2458-4-63.CrossRefPubMedPubMedCentral Morgan OWC, Griffiths C, Majeed A: Association between mortality from suicide in England and antidepressant prescribing: an ecological study. BMC Public Health. 2004, 4: 63-10.1186/1471-2458-4-63.CrossRefPubMedPubMedCentral
20.
go back to reference Kelly CB, Ansari T, Rafferty T, Stevenson M: Antidepressant prescribing and suicide rate in Northern Ireland. Eur Psychiatry. 2003, 18: 325-328. 10.1016/j.eurpsy.2003.03.005.CrossRefPubMed Kelly CB, Ansari T, Rafferty T, Stevenson M: Antidepressant prescribing and suicide rate in Northern Ireland. Eur Psychiatry. 2003, 18: 325-328. 10.1016/j.eurpsy.2003.03.005.CrossRefPubMed
21.
go back to reference Lawrence D, Almeida OP, Hulse GK, Jablensky AV, Holman CD: Suicide and attempted suicide among older adults in Western Australia. Psychol Med. 2000, 30: 813-821. 10.1017/S0033291799002391.CrossRefPubMed Lawrence D, Almeida OP, Hulse GK, Jablensky AV, Holman CD: Suicide and attempted suicide among older adults in Western Australia. Psychol Med. 2000, 30: 813-821. 10.1017/S0033291799002391.CrossRefPubMed
22.
go back to reference Akechi T, Okamura H, Yamawaki S, Uchitomi Y: Why do some cancer patients with depression desire an early death and others do not?. Psychosomatics. 2001, 42: 141-145. 10.1176/appi.psy.42.2.141.CrossRefPubMed Akechi T, Okamura H, Yamawaki S, Uchitomi Y: Why do some cancer patients with depression desire an early death and others do not?. Psychosomatics. 2001, 42: 141-145. 10.1176/appi.psy.42.2.141.CrossRefPubMed
23.
go back to reference Charlton J: Trends and patterns in suicide in England and Wales. Int J Epidemiol. 1995, 24: 45-52.CrossRef Charlton J: Trends and patterns in suicide in England and Wales. Int J Epidemiol. 1995, 24: 45-52.CrossRef
24.
go back to reference Gunnell D, Lopatatzidis A, Dorling D, Wehner H, Southall H, Frankel S: Suicide and unemployment in young people. Analysis of trends in England and Wales, 1921–1995. Br J Psychiatry. 1999, 175: 263-270.CrossRefPubMed Gunnell D, Lopatatzidis A, Dorling D, Wehner H, Southall H, Frankel S: Suicide and unemployment in young people. Analysis of trends in England and Wales, 1921–1995. Br J Psychiatry. 1999, 175: 263-270.CrossRefPubMed
25.
go back to reference Gunnell D, Middleton N, Whitley E, Dorling D, Frankel S: Why are suicide rates rising in young men but falling in the elderly? – A time- series analysis of trends in England and Wales 1950–1998. Soc Sci Med. 2003, 57: 595-611. 10.1016/S0277-9536(02)00408-2.CrossRefPubMed Gunnell D, Middleton N, Whitley E, Dorling D, Frankel S: Why are suicide rates rising in young men but falling in the elderly? – A time- series analysis of trends in England and Wales 1950–1998. Soc Sci Med. 2003, 57: 595-611. 10.1016/S0277-9536(02)00408-2.CrossRefPubMed
26.
go back to reference Ohberg A, Lonnqvist J: Suicides hidden among undetermined deaths. Acta Psychiatr Scand. 1998, 98: 214-218.CrossRefPubMed Ohberg A, Lonnqvist J: Suicides hidden among undetermined deaths. Acta Psychiatr Scand. 1998, 98: 214-218.CrossRefPubMed
Metadata
Title
Sex- and age-specific trends in mortality from suicide and undetermined death in Germany 1991–2002
Authors
Jens J Baumert
Natalia Erazo
Karl-Heinz Ladwig
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2005
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-5-61

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