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Published in: Social Psychiatry and Psychiatric Epidemiology 11/2008

01-11-2008 | ORIGINAL PAPER

Time trends in suicide mortality vary in choice of methods

An analysis of 145,865 fatal suicide cases in Germany 1991–2002

Authors: Jens Baumert, Natalia Erazo, Esther Ruf, Karl-Heinz Ladwig

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 11/2008

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Abstract

Background

Overall, decreasing suicide mortality rates were observed in the last decades in most Western populations. However, it remains unclear, whether these favourable trends occurred uniformly in particular suicide methods. Therefore, the present study evaluated time trends of suicide mortality by method in Germany over the period 1991–2002.

Methods

A total of 145,865 fatal suicide cases of men and women aged ≥15 years and with available suicide method were recorded by the Federal Statistical Office of Germany (suicides coded “death following a suicide attempt” were excluded). Based on these data, seven different suicide methods were defined. Poisson regression was used to estimate the age-adjusted annual percentage change (AAPC) of the number of each suicide method.

Results

The most frequently used suicide methods in both sexes were hanging, strangling or suffocation (HSS) with 55.8% in men and 39.9% in women, followed by self-poisoning. Statistically significant declines of the number of suicides were observed, in descending order, for self-poisoning, drowning and HSS in both sexes. In contrast, methods using firearm discharges or stab with a sharp object remained in roughly constant level. Modifications of time trends were observed for several methods by age classes.

Conclusions

The present study demonstrates different time trends for suicide methods. Further examinations are recommended in particular concerning possible reasons for the choice of a suicidal method.
Literature
1.
go back to reference Anderson RN, Smith BL (2003) Deaths: leading causes for 2001. National Vital Stat Rep 52:1–86 Anderson RN, Smith BL (2003) Deaths: leading causes for 2001. National Vital Stat Rep 52:1–86
2.
go back to reference Baumert JJ, Erazo N, Ladwig KH (2005) Sex- and age-specific trends in mortality from suicide and undetermined death in Germany 1991–2002. BMC Public Health 5:61PubMedCrossRef Baumert JJ, Erazo N, Ladwig KH (2005) Sex- and age-specific trends in mortality from suicide and undetermined death in Germany 1991–2002. BMC Public Health 5:61PubMedCrossRef
3.
go back to reference Baumert J, Erazo N, Ladwig KH (2006) Ten-year incidence and time trends of railway suicides in Germany from 1991 to 2000. Eur J Public Health 16:173–178PubMedCrossRef Baumert J, Erazo N, Ladwig KH (2006) Ten-year incidence and time trends of railway suicides in Germany from 1991 to 2000. Eur J Public Health 16:173–178PubMedCrossRef
4.
go back to reference Bertolote JM (2001) Suicide in the world: an epidemiological overview: 1959 – 2000. In: Wasserman D (ed.) Suicide–an unnecessary death. Martin Dunitz, London, pp 3–10 Bertolote JM (2001) Suicide in the world: an epidemiological overview: 1959 – 2000. In: Wasserman D (ed.) Suicide–an unnecessary death. Martin Dunitz, London, pp 3–10
5.
go back to reference Bille-Brahe U, Jessen G (1994) Suicide in Denmark, 1922–1991: the choice of method. Acta Psychiatr Scand 90:91–96PubMedCrossRef Bille-Brahe U, Jessen G (1994) Suicide in Denmark, 1922–1991: the choice of method. Acta Psychiatr Scand 90:91–96PubMedCrossRef
6.
go back to reference Breslow NE, Day NE (1987) Statistical methods in cancer research. Vol II–the design and analysis of cohort studies. IARC, Lyon Breslow NE, Day NE (1987) Statistical methods in cancer research. Vol II–the design and analysis of cohort studies. IARC, Lyon
7.
go back to reference Cantor CH, Baume PJ (1998) Access to methods of suicide: what impact? Aust NZ J Psychiatry 32:8–14 Cantor CH, Baume PJ (1998) Access to methods of suicide: what impact? Aust NZ J Psychiatry 32:8–14
9.
go back to reference Fischer EP, Comstock GW, Monk MA, Sencer DJ (1993) Characteristics of completed suicides: implications of differences among methods. Suicide Life Threat Behav 23:91–100PubMed Fischer EP, Comstock GW, Monk MA, Sencer DJ (1993) Characteristics of completed suicides: implications of differences among methods. Suicide Life Threat Behav 23:91–100PubMed
10.
go back to reference Granizo JJ, Guallar E, Rodriguez-Artalejo F (1996) Age-period-cohort analysis of suicide mortality rates in Spain, 1959–1991. Int J Epidemiol 25:814–820PubMedCrossRef Granizo JJ, Guallar E, Rodriguez-Artalejo F (1996) Age-period-cohort analysis of suicide mortality rates in Spain, 1959–1991. Int J Epidemiol 25:814–820PubMedCrossRef
11.
go back to reference Guaiana G, D’Avanzo B, Barbui C (2002) Update of suicide trends in Italy from 1986–1996. Soc Psychiatry Psychiatr Epidemiol 37:267–270PubMedCrossRef Guaiana G, D’Avanzo B, Barbui C (2002) Update of suicide trends in Italy from 1986–1996. Soc Psychiatry Psychiatr Epidemiol 37:267–270PubMedCrossRef
12.
go back to reference Gunnell D, Middleton N (2003) National suicide rates as an indicator of the effect of suicide on premature mortality. Lancet 362:961–962PubMedCrossRef Gunnell D, Middleton N (2003) National suicide rates as an indicator of the effect of suicide on premature mortality. Lancet 362:961–962PubMedCrossRef
13.
go back to reference Gunnell D, Middleton N, Frankel S (2000) Method availability and the prevention of suicide: a re-analysis of secular trends in England and Wales 1950–1975. Soc Psychiatry Psychiatr Epidemiol 35:437–443PubMedCrossRef Gunnell D, Middleton N, Frankel S (2000) Method availability and the prevention of suicide: a re-analysis of secular trends in England and Wales 1950–1975. Soc Psychiatry Psychiatr Epidemiol 35:437–443PubMedCrossRef
14.
go back to reference Huchcroft SA, Tanney BL (1988) Sex-specific suicide trends in Canada, 1971–1985. Int J Epidemiol 17:839–843PubMedCrossRef Huchcroft SA, Tanney BL (1988) Sex-specific suicide trends in Canada, 1971–1985. Int J Epidemiol 17:839–843PubMedCrossRef
15.
go back to reference Kapusta ND, Zorman A, Etzersdorfer E, Ponocny-Seliger E, Jandl-Jager E, Sonneck G (2008) Rural-urban differences in Austrian suicides. Soc Psychiatry Psychiatr Epidemiol 43:311–318PubMedCrossRef Kapusta ND, Zorman A, Etzersdorfer E, Ponocny-Seliger E, Jandl-Jager E, Sonneck G (2008) Rural-urban differences in Austrian suicides. Soc Psychiatry Psychiatr Epidemiol 43:311–318PubMedCrossRef
16.
go back to reference Kposowa AJ, McElvain JP (2006) Gender, place, and method of suicide. Soc Psychiatry Psychiatr Epidemiol 41:435–443PubMedCrossRef Kposowa AJ, McElvain JP (2006) Gender, place, and method of suicide. Soc Psychiatry Psychiatr Epidemiol 41:435–443PubMedCrossRef
17.
go back to reference Ladwig KH, Baumert JJ (2004) Patterns of suicidal behaviour in a metro subway system: a study of 306 cases injured by the Munich subway, 1980–1999. Eur J Public Health 14:291–295PubMedCrossRef Ladwig KH, Baumert JJ (2004) Patterns of suicidal behaviour in a metro subway system: a study of 306 cases injured by the Munich subway, 1980–1999. Eur J Public Health 14:291–295PubMedCrossRef
18.
go back to reference Lester D (1990) Changes in the methods used for suicide in 16 countries from 1960 to 1980. Acta Psychiatr Scand 81:260–261PubMedCrossRef Lester D (1990) Changes in the methods used for suicide in 16 countries from 1960 to 1980. Acta Psychiatr Scand 81:260–261PubMedCrossRef
19.
go back to reference Lester D, Beck AT (1980) What the suicide’s choice of method signifies. Omega 11:271–277 Lester D, Beck AT (1980) What the suicide’s choice of method signifies. Omega 11:271–277
20.
go back to reference Levi F, La Vecchia C, Lucchini F, Negri E, Saxena S, Maulik PK, Saraceno B (2003) Trends in mortality from suicide, 1965–99. Acta Psychiatr Scand 108:341–349PubMedCrossRef Levi F, La Vecchia C, Lucchini F, Negri E, Saxena S, Maulik PK, Saraceno B (2003) Trends in mortality from suicide, 1965–99. Acta Psychiatr Scand 108:341–349PubMedCrossRef
21.
go back to reference McCullagh P, Nelder JA (1989) Generalized linear models. 2nd edn, University Press, Cambridge McCullagh P, Nelder JA (1989) Generalized linear models. 2nd edn, University Press, Cambridge
22.
go back to reference Moens GF (1984) The rise of suicide mortality in Belgium between 1968–72 and 1978–81: age, sex and geographical characteristics. Int J Epidemiol 13:243–245PubMedCrossRef Moens GF (1984) The rise of suicide mortality in Belgium between 1968–72 and 1978–81: age, sex and geographical characteristics. Int J Epidemiol 13:243–245PubMedCrossRef
23.
go back to reference Moens GF, Loysch MJ, Honggokoesoemo S, van de Voorde H (1989) Recent trends in methods of suicide. Acta Psychiatr Scand 79:207–215PubMedCrossRef Moens GF, Loysch MJ, Honggokoesoemo S, van de Voorde H (1989) Recent trends in methods of suicide. Acta Psychiatr Scand 79:207–215PubMedCrossRef
24.
go back to reference Ohberg A, Lonnqvist J, Sarna S, Vuori E, Penttila A (1995) Trends and availability of suicide methods in Finland. Proposals for restrictive measures. Br J Psychiatry 166:35–43PubMedCrossRef Ohberg A, Lonnqvist J, Sarna S, Vuori E, Penttila A (1995) Trends and availability of suicide methods in Finland. Proposals for restrictive measures. Br J Psychiatry 166:35–43PubMedCrossRef
25.
go back to reference Spicer RS, Miller TR (2000) Suicide acts in 8 states: incidence and case fatality rates by demographics and method. Am J Public Health 90:1885–1891PubMedCrossRef Spicer RS, Miller TR (2000) Suicide acts in 8 states: incidence and case fatality rates by demographics and method. Am J Public Health 90:1885–1891PubMedCrossRef
26.
go back to reference Stark C, Hopkins P, Gibbs D, Rapson T, Belbin A, Hay A (2004) Trends in suicide in Scotland 1981–1999: age, method and geography. BMC Public Health 4:49PubMedCrossRef Stark C, Hopkins P, Gibbs D, Rapson T, Belbin A, Hay A (2004) Trends in suicide in Scotland 1981–1999: age, method and geography. BMC Public Health 4:49PubMedCrossRef
28.
go back to reference Sutton L, Hawton K, Simkin S, Turnbull P, Kapur N, Bennewith O, Gunnell D. (2005) Gunshot suicides in England–a multicentre study based on coroners’ records. Soc Psychiatry Psychiatr Epidemiol 40:324–328PubMedCrossRef Sutton L, Hawton K, Simkin S, Turnbull P, Kapur N, Bennewith O, Gunnell D. (2005) Gunshot suicides in England–a multicentre study based on coroners’ records. Soc Psychiatry Psychiatr Epidemiol 40:324–328PubMedCrossRef
29.
go back to reference Tamosiunas A, Reklaitiene R, Virviciute D, Sopagiene D (2006) Trends in suicide in a Lithuanian urban population over the period 1984–2003. BMC Public Health 6:184PubMedCrossRef Tamosiunas A, Reklaitiene R, Virviciute D, Sopagiene D (2006) Trends in suicide in a Lithuanian urban population over the period 1984–2003. BMC Public Health 6:184PubMedCrossRef
30.
go back to reference Wiedenmann A, Weyerer S (1993) The impact of availability, attraction and lethality of suicide methods on suicide rates in Germany. Acta Psychiatr Scand 88:364–368PubMedCrossRef Wiedenmann A, Weyerer S (1993) The impact of availability, attraction and lethality of suicide methods on suicide rates in Germany. Acta Psychiatr Scand 88:364–368PubMedCrossRef
31.
go back to reference World Health Organization (WHO) (1977) The ninth revision of the international classification of diseases (ICD-9). World Health Organization, Geneva World Health Organization (WHO) (1977) The ninth revision of the international classification of diseases (ICD-9). World Health Organization, Geneva
32.
go back to reference World Health Organization (WHO) (1992) The tenth revision of the international classification of diseases (ICD-10). World Health Organization, Geneva World Health Organization (WHO) (1992) The tenth revision of the international classification of diseases (ICD-10). World Health Organization, Geneva
Metadata
Title
Time trends in suicide mortality vary in choice of methods
An analysis of 145,865 fatal suicide cases in Germany 1991–2002
Authors
Jens Baumert
Natalia Erazo
Esther Ruf
Karl-Heinz Ladwig
Publication date
01-11-2008
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 11/2008
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-008-0380-7

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