Psychiatry in Slovenia

Reduction in suicide mortality following a new national alcohol policy in Slovenia: an interrupted time-series analysis

OBJECTIVES

We assessed the impact on suicide mortality of a new national policy in Slovenia that limits the availability of alcohol.

METHODS

We obtained monthly total, male, and female suicide counts in Slovenia between January 1997 and December 2005 and then employed autoregressive integrated moving average (ARIMA) techniques to model the effect of the alcohol policy (implemented in March 2003).

RESULTS

There was a significant decrease in the total number of monthly suicides following the policy's implementation. Subsequent analyses revealed this association to be caused solely by the impact on male suicides. Specifically, there was an immediate and permanent reduction of 3.6 male suicides per month (95% confidence interval = -0.4, -6.9), or approximately 10% of the preintervention average. The policy had no statistically significant effect on female suicides.

CONCLUSIONS

Our results show the effectiveness of this specific policy in reducing male suicides in Slovenia and also hint at the potential of public policy in reducing the public health burden of alcohol-related harm more generally.

Suicide attempts among adolescents in northeastern Slovenia: a 25 year report

Slovenia is one of the countries with the highest national suicide rates (30/100,000/year). The rate of suicide attempts is accordingly high, for both adolescents and adults. Suicidal children and adolescents from the four North-eastern regions of Slovenia are hospitalised at the Child and Adolescent Psychiatry Unit of the General Hospital Maribor. The aim of this study was to show the pattern of changes in these hospitalisations along 25 years.

METHOD

The data was collected retrospectively, using chart review of this unit by a psychiatrist for the years 1978 through 2004.

RESULTS

The data consists of two different samples. The first sample contains gender distribution (n = 774) from 1978 to mid 2004 with 664 girls and 110 boys, and the second sample (n = 1,477) consisted of suicide attempts as well as alcohol (n = 772) and drug abuse (n = 115) data for the last decade. The number of hospitalisations was increasing in a wavy curve with average 7,5 times more admitted girls than boys. In 98%, the suicide method was intoxication, and most were additionally diagnosed with "adolescent crisis" (ICD-10: F93.8).

CONCLUSION

The rise in the number of admitted suicidal adolescents was partly consequent to the improvement of their detection maybe because 25 years ago most of these cases were recorded as "accidental poisonings" and did not include the diagnosis of a suicide attempt. The socio-economic changes characteristic of a country in transition also contributed to this increase, as did the development of the Unit with more trained staff and advanced treatment.