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Hatton VR, Clark E, Huber RS. Temporal Patterns in Youth Suicide Deaths Reported in the National Violent Death Reporting System. J Adolesc Health 2024; 74:1049-1052. [PMID: 38402474 DOI: 10.1016/j.jadohealth.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/23/2023] [Accepted: 12/22/2023] [Indexed: 02/26/2024]
Abstract
PURPOSE Suicide is a leading cause of death in children and adolescents. Prevention efforts may benefit from examining temporal patterns and precipitating circumstances of youth suicide deaths. The purpose of this study was to investigate if there are distinct temporal patterns of suicide death for youth. METHODS We examined the distributions of suicide deaths across months of the year and days of the week in youth ages 10-18 using data from the National Violent Death Reporting System. RESULTS We found that youth suicides peaked during March, April, and October on Monday, Tuesday, and Wednesday. When disaggregated by separate years of age, we discovered unique patterns in 18-year-olds and 10-year-olds. Suicides peaked during July for 18-year-olds and on Saturday for 10-year-olds. DISCUSSION These findings suggest a need to examine temporal patterns by separate years of age, as grouping ages together may mask unique trends.
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Affiliation(s)
- Victoria R Hatton
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah
| | - Elaine Clark
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah; Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | - Rebekah S Huber
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah; Department of Psychiatry, Oregon Health & Science University, Portland, Oregon; Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon.
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Park GWV, Cho SI. Monday peak is unique to suicide? Comparison of weekly distribution by causes of death using national representative cohort database. Suicide Life Threat Behav 2023; 53:613-627. [PMID: 37166224 DOI: 10.1111/sltb.12968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/16/2023] [Accepted: 04/15/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION The excess suicide mortality on Monday was reported in numerous studies. However, it is uncertain that the uneven weekly distribution of deaths is observed among suicide, or common among various causes of death. METHODS Weekly distributions of suicide and other causes of death from 2012 to 2017 in South Korea were compared. Logistic regression models were fitted to investigate the association between causes of death and day-of-the-week effects. We also fitted conditional logistic regression models after age and gender matching. RESULTS A total of 1,622,213 deaths, including 80,492 suicide decedents, were analyzed. A total of 16.0% of suicide deaths occurred on Monday, whereas 12.4% on Saturday and 13.0% on Sunday. Suicide decedents were more likely to die on Monday than other causes of deaths after controlling sociodemographic factors in unmatched data. However, there was no evidence of excess suicide deaths on Mondays than other days in contrast to matched death controls. CONCLUSION While the increase in mortality on Mondays was not unique to suicide, our findings have suicide prevention implications. Mental health practitioners should consider providing additional mental health resources on earlier working days. Workplace mental health programs to reduce psychological burdens of employees could help to prevent suicide during working days.
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Affiliation(s)
- Gun Woo Victor Park
- Division of Public Health, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Sung-Il Cho
- Division of Public Health, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Institute for Health and Environment, Seoul National University, Seoul, South Korea
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Britton PC, Bohnert KM, Denneson LM, Ganoczy D, Ilgen MA. Analysis of veterans crisis line data: Temporal factors associated with the initiation of emergency dispatches. Suicide Life Threat Behav 2023; 53:538-545. [PMID: 37032606 DOI: 10.1111/sltb.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE To identify temporal patterns of emergency dispatches as initiated by Veteran Crisis Line (VCL) responders and among moderate- and high-risk contacts. METHODS Incidence rate ratios (IRRs) were used to examine the incidence of emergency dispatches among all 1,437,543 VCL contacts across 2019-2020. RESULTS Emergency dispatches were initiated in 57,077 (4.0%) contacts. IRRs were elevated during Labor Day, IRR (95% CI) = 1.33 (1.15-1.54), and Independence Day, IRR (95% CI) = 1.22 (1.05-1.43), weekends, Saturdays, IRR (95% CI) = 1.04 (1.01-1.08), Sunday (reference), and 6 pm to 11:59 pm, IRR (95% CI) = 1.06 (1.04-1.09). IRRs for moderate- and high-risk contacts were higher on Memorial Day, IRR (95% CI) = 1.16 (1.00-1.33), Sunday (reference), and 6 pm to 11:59 pm (reference). CONCLUSIONS The initiation of emergency dispatches fluctuates over time and were highest during Labor Day and Independence Day, weekends, and evenings. Moderate- and high-risk contact also fluctuate over time and were highest on Memorial Day, Sundays, and midnight to 5:59 am. VCL policy makers can use knowledge of temporal fluctuations to allocate public health resources for increased efficiency and greatest impact; however, additional research on temporal stability and generalizability is needed.
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Affiliation(s)
- Peter C Britton
- Department of Veteran Affairs, VISN 2 Center of Excellence for Suicide Prevention, Finger Lakes Healthcare System, Canandaigua, New York, USA
- Department of Psychiatry, University of Rochester Medical School, Rochester, New York, USA
| | - Kipling M Bohnert
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
- Department of Veteran Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Lauren M Denneson
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, Oregon, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Dara Ganoczy
- Department of Veteran Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Mark A Ilgen
- Department of Veteran Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Kim D. Economic cycle, fertility, and seasonal pattern of suicide rates in South Korea from 1995 to 2015. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0949-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kim E, Cho SE, Na KS, Jung HY, Lee KJ, Cho SJ, Han DG. Blue Monday Is Real for Suicide: A Case-Control Study of 188,601 Suicides. Suicide Life Threat Behav 2019; 49:393-400. [PMID: 29349806 DOI: 10.1111/sltb.12429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 10/30/2017] [Indexed: 11/30/2022]
Abstract
Many studies have reported that suicides tend to occur on Mondays. However, owing to a lack of controls, conclusive findings on the potential effects of a day of the week on suicides have been lacking. We analyzed public data for causes of death from 1997 to 2015 in the Republic of Korea. Accidental death was used as a control group. The probability of suicide on each day of the week according to age group was calculated. A total of 377,204 deaths (188,601 suicides and 188,603 accidental deaths) were used. The frequency of suicide was highest on Monday and decreased throughout the week until Saturday. Accidental death was highest on Saturday and showed no variations according to weekday. For people in their teens and 20s, the probabilities of suicide on Monday were 9% and 10% higher, respectively, than those on Sunday. As age increased, the differences in suicide probability according to the day of the week were attenuated. The so-called Blue Monday effect is real, particularly for people in their teens and 20s. Suicide prevention strategies that aim to attenuate the burden and stress of Mondays should be planned.
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Affiliation(s)
- Eunkyong Kim
- Department of Occupation and Environmental Medicine, Korea Workers' Compensation & Welfare Service Ansan Hospital, Ansan, Korea
| | - Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea.,Incheon Metropolitan Suicide Prevention Center, Incheon, Korea
| | - Han-Yong Jung
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Korea
| | - Kang-Joon Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae-Guen Han
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
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Griffin E, Dillon CB, O'Regan G, Corcoran P, Perry IJ, Arensman E. The paradox of public holidays: Hospital-treated self-harm and associated factors. J Affect Disord 2017; 218:30-34. [PMID: 28456074 DOI: 10.1016/j.jad.2017.04.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/31/2017] [Accepted: 04/24/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. METHODS Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. RESULTS A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. LIMITATIONS It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. CONCLUSIONS Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings.
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Affiliation(s)
- Eve Griffin
- National Suicide Research Foundation, Cork, Ireland.
| | | | | | - Paul Corcoran
- Department of Epidemiology and Public Health, University College Cork, Ireland; Department of Obstetrics and Gynaecology, University College Cork, Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, University College Cork, Ireland
| | - Ella Arensman
- National Suicide Research Foundation, Cork, Ireland; Department of Epidemiology and Public Health, University College Cork, Ireland
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Akkaya-Kalayci T, Kapusta ND, Waldhör T, Blüml V, Poustka L, Özlü-Erkilic Z. The association of monthly, diurnal and circadian variations with suicide attempts by young people. Child Adolesc Psychiatry Ment Health 2017; 11:35. [PMID: 28781609 PMCID: PMC5537930 DOI: 10.1186/s13034-017-0171-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 06/18/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that there may be an association between monthly, diurnal and circadian changes and suicidal behaviours. METHODS In the present study we analysed retrospectively records of 2232 youth, who were treated in emergency units of state hospitals in Istanbul/Turkey after attempting suicide. RESULTS The majority of the suicide attempters were females (81.6%). In both sexes, suicide attempts most frequently occurred at the beginning of the calendar week and between evening and midnight. CONCLUSIONS This study shows that suicide attempts in youth follow diurnal and circadian changes. As suicide attempts of youth most frequently occurred at the beginning of the calendar week and between evening and midnight, health services such as specialized counselling for youth should especially be available during this time.
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Affiliation(s)
- Türkan Akkaya-Kalayci
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Nestor D. Kapusta
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Thomas Waldhör
- 0000 0000 9259 8492grid.22937.3dDepartment for Epidemiology, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
| | - Victor Blüml
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Luise Poustka
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Zeliha Özlü-Erkilic
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Cavanagh B, Ibrahim S, Roscoe A, Bickley H, While D, Windfuhr K, Appleby L, Kapur N. The timing of general population and patient suicide in England, 1997-2012. J Affect Disord 2016; 197:175-81. [PMID: 26994435 DOI: 10.1016/j.jad.2016.02.055] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/29/2016] [Accepted: 02/26/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND There have been conflicting findings on temporal variation in suicide risk and few have examined the phenomenon in clinical populations. The study investigated seasonal and other temporal patterns using national data. METHODS Data on 73,591 general population and 19,318 patient suicide deaths in England between 1997 and 2012 were collected through the National Confidential Inquiry into Suicide examining suicide rates in relation to month of the year, day of the week, and individual days of national or religious significance. RESULTS Suicide incidence fell over successive months of the year and there was evidence of an overall spring peak. Monday was associated with the highest suicide rates and in the patient population this effect appeared to be more pronounced in those aged over 50 or those who lived alone. Suicide risk was significantly lower during Christmas, particularly for women. There was a peak in suicide on New Year's Day in the general population. Other 'special days' were not associated with a change in suicide incidence. LIMITATIONS We were limited to identifying associations between the variables investigated and were unable to explore causal mechanisms. We did not carry out comprehensive multi-variable adjustment in our regression models. CONCLUSIONS There is substantial seasonal and temporal variation in suicide deaths, and there appears to be some evidence in the clinical as well as the general population in England. Clinical services should be aware of the risk of suicide just after the weekend, especially in people who live alone, and the potential need for closer supervision during this period.
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Affiliation(s)
| | - Saied Ibrahim
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
| | - Alison Roscoe
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Harriet Bickley
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - David While
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Kirsten Windfuhr
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Louis Appleby
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Nav Kapur
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK; Manchester Mental Health and Social Care Trust, Manchester, UK
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Silveira ML, Wexler L, Chamberlain J, Money K, Spencer RMC, Reich NG, Bertone-Johnson ER. Seasonality of suicide behavior in Northwest Alaska: 1990-2009. Public Health 2016; 137:35-43. [PMID: 27021788 DOI: 10.1016/j.puhe.2016.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 02/06/2016] [Accepted: 02/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Suicide is a leading cause of death worldwide, and disproportionately affects Indigenous populations. Seasonal suicide patterns are variable in the literature, and could offer novel approaches to the timing and focus of prevention efforts if better understood. With a suicide surveillance system in place since 1989, this study offers an unprecedented opportunity to explore seasonal variations in both fatal and non-fatal suicide behavior in an Indigenous Arctic region. STUDY DESIGN Cross-sectional. METHODS In this descriptive study, we analyzed data collected from 1990 to 2009 in the rural northwest region of Alaska, both graphically and using the chi-squared test for multinomials. RESULTS We found a significant monthly variation for suicide attempts, with a peak in suicide behavior observed between April and August (P = 0.0002). Monthly variation was more pronounced among individuals ≤29 years of age, and was present in both males and females, although the seasonal pattern differed by sex. CONCLUSIONS Our findings of a significant seasonal pattern in suicide behavior, with monthly variation (summer peak) in non-fatal suicide behavior among younger age groups, and among both males and females can assist planners in targeting subpopulations for prevention at different times of the year.
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Affiliation(s)
- M L Silveira
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - L Wexler
- Division of Community Health Education, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
| | - J Chamberlain
- Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - K Money
- Women's Psychological Services, USA
| | - R M C Spencer
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - N G Reich
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - E R Bertone-Johnson
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
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Fountoulakis KN, Savopoulos C, Zannis P, Apostolopoulou M, Fountoukidis I, Kakaletsis N, Kanellos I, Dimellis D, Hyphantis T, Tsikerdekis A, Pompili M, Hatzitolios AI. Climate change but not unemployment explains the changing suicidality in Thessaloniki Greece (2000-2012). J Affect Disord 2016; 193:331-8. [PMID: 26796233 DOI: 10.1016/j.jad.2016.01.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 12/26/2015] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Recently there was a debate concerning the etiology behind attempts and completed suicides. The aim of the current study was to search for possible correlations between the rates of attempted and completed suicide and climate variables and regional unemployment per year in the county of Thessaloniki, Macedonia, northern Greece, for the years 2000-12. MATERIAL AND METHODS The regional rates of suicide and attempted suicide as well as regional unemployment were available from previous publications of the authors. The climate variables were calculated from the daily E-OBS gridded dataset which is based on observational data RESULTS Only the male suicide rates correlate significantly with high mean annual temperature but not with unemployment. The multiple linear regression analysis results suggest that temperature is the only variable that determines male suicides and explains 51% of their variance. Unemployment fails to contribute significantly to the model. There seems to be a seasonal distribution for attempts with mean rates being higher for the period from May to October and the rates clearly correlate with temperature. The highest mean rates were observed during May and August and the lowest during December and February. Multiple linear regression analysis suggests that temperature also determines the female attempts rate although the explained variable is significant but very low (3-5%) CONCLUSION Climate variables and specifically high temperature correlate both with suicide and attempted suicide rates but with a different way between males and females. The climate effect was stronger than the effect of unemployment.
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Affiliation(s)
| | - Christos Savopoulos
- 1st Propedeutic Dept of Internal Medicine, School of Medicine, Aristotle University, AHEPA Hospital, Thessaloniki, Greece.
| | - Prodromos Zannis
- Department of Meteorology and Climatology, School of Geology, Aristotle University of Thessaloniki, Greece.
| | | | - Ilias Fountoukidis
- Internal Medicine Department, Agios Pavlos Hospital, Thessaloniki, Greece.
| | - Nikolaos Kakaletsis
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Greece.
| | - Ilias Kanellos
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Greece.
| | - Dimos Dimellis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece.
| | - Thomas Hyphantis
- Department of Psychiatry, Ioannina School of Medicine, Ioannina, Greece.
| | - Athanasios Tsikerdekis
- Department of Meteorology and Climatology, School of Geology, Aristotle University of Thessaloniki, Greece.
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Apostolos I Hatzitolios
- 1st Propedeutic Dept of Internal Medicine, School of Medicine, Aristotle University, AHEPA Hospital, Thessaloniki, Greece.
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Fernández-Niño JA, Astudillo-García CI, Bojorquez-Chapela I, Morales-Carmona E, Montoya-Rodriguez AA, Palacio-Mejia LS. The Mexican Cycle of Suicide: A National Analysis of Seasonality, 2000-2013. PLoS One 2016; 11:e0146495. [PMID: 26752641 PMCID: PMC4709116 DOI: 10.1371/journal.pone.0146495] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 12/17/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Suicide is a complex and multifactorial phenomenon with growing importance to public health. An increase in its occurrence has been observed in Mexico over the past 10 years. The present article analyzes the secular trend in suicide at the national level between the years 2000 and 2013. MATERIALS AND METHODS All suicides during the study period (n = 64,298, of which 82.11% were men) were characterized using a spectral decomposition of the time series and a wavelet analysis to evaluate the effect of seasonal changes, type of area (urban versus rural) and sex. RESULTS A seasonal pattern was observed with statistically significant cycles every 12 months, where peaks were identified in May but only for men in urban zones as of the year 2007. In addition, specific days of the year were found to have a higher frequency of suicides, which coincided with holidays (New Year, Mother's Day, Mexican Independence Day and Christmas). CONCLUSION A wavelet analysis can be used to decompose complex time series. To the best of our knowledge, this is the first application of this technique to the study of suicides in developing countries. This analysis enabled identifying a seasonal pattern among urban men in Mexico. The identification of seasonal patterns can help to create primary prevention strategies, increase the dissemination of crisis intervention strategies and promote mental health. These strategies could be emphasized during specific periods of the year and directed towards profiles with a higher risk.
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Affiliation(s)
- Julián Alfredo Fernández-Niño
- Information Center for Decisions in Public Health (CENIDSP), National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | | | | | - Evangelina Morales-Carmona
- Information Center for Decisions in Public Health (CENIDSP), National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | | | - Lina Sofia Palacio-Mejia
- Information Center for Decisions in Public Health (CENIDSP), National Institute of Public Health of Mexico, Cuernavaca, Mexico
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Relationship of suicide rates with climate and economic variables in Europe during 2000-2012. Ann Gen Psychiatry 2016; 15:19. [PMID: 27508001 PMCID: PMC4977895 DOI: 10.1186/s12991-016-0106-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 07/22/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate. METHODS Data from 29 European countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression. RESULTS The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female suicides correlated with low temperature. DISCUSSION The current study reports that the climatic effect (cold climate) is stronger than the economic one, but both are present. It seems that in Europe suicidality follows the climate/temperature cline which interestingly is not from south to north but from south to north-east. This raises concerns that climate change could lead to an increase in suicide rates. The current study is essentially the first successful attempt to explain the differences across countries in Europe; however, it is an observational analysis based on aggregate data and thus there is a lack of control for confounders.
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Abstract
BACKGROUND Seasonal as well as weekly cycles in suicide have been described, replicated and poorly understood for a long time. In Western countries, suicides are typically least frequent on weekends and most frequent on Mondays and Tuesdays. To improve understanding of this phenomenon a strategy is required which focuses on anomalous findings beyond the regular patterns. Here, we focused on instances where the weekly suicide patterns disappear or are interrupted. METHODS We used data from Swiss and Austrian mortality statistics for the periods 1969-2010 and 1970-2010, respectively. First, the data were cross-tabulated by days of the week and the available socio-demographic information (sex, age, religious affiliation and region). Second, time series of cumulated daily frequencies of suicide were analysed by seasonal Autoregressive Integrated Moving Average (ARIMA) models which included intervention effects accounting for Easter and Pentecost (Whit) holidays. RESULTS First, the cross tabulations showed that weekly cycles may be smoothed above all in young persons and smoothed in drowning, jumping and car gas exhaustion suicides. Second, the ARIMA analyses displayed occasional preventive effects for holidays Saturdays and Sundays, and more systematic effects for holiday Mondays. There were no after effects on Tuesdays following holiday Mondays. CONCLUSIONS In general, the weekend dip and the Monday backlog effect in suicide show striking similarities to the Advent season effect and are interpretable within the same template. The turning points between low and high frequencies possibly provide promising frames for the timing of prevention activities.
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Murphy OC, Kelleher C, Malone KM. Demographic trends in suicide in the UK and Ireland 1980–2010. Ir J Med Sci 2014; 184:227-35. [DOI: 10.1007/s11845-014-1092-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 02/14/2014] [Indexed: 11/24/2022]
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Seasonality of suicidal behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:531-47. [PMID: 22470308 PMCID: PMC3315262 DOI: 10.3390/ijerph9020531] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/11/2012] [Accepted: 01/26/2012] [Indexed: 11/28/2022]
Abstract
A seasonal suicide peak in spring is highly replicated, but its specific cause is unknown. We reviewed the literature on suicide risk factors which can be associated with seasonal variation of suicide rates, assessing published articles from 1979 to 2011. Such risk factors include environmental determinants, including physical, chemical, and biological factors. We also summarized the influence of potential demographic and clinical characteristics such as age, gender, month of birth, socioeconomic status, methods of prior suicide attempt, and comorbid psychiatric and medical diseases. Comprehensive evaluation of risk factors which could be linked to the seasonal variation in suicide is important, not only to identify the major driving force for the seasonality of suicide, but also could lead to better suicide prevention in general.
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Casey P, Gemmell I, Hiroeh U, Fulwood C. Seasonal and socio-demographic predictors of suicide in Ireland: a 22 year study. J Affect Disord 2012; 136:862-7. [PMID: 22018639 DOI: 10.1016/j.jad.2011.09.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 09/20/2011] [Accepted: 09/20/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Seasonal influences on suicide have been studied for many years with inconclusive and contradictory findings. METHODS Data on suicide in Ireland from 1980 to 2002 was examined to ascertain the contribution of season and demographic variables to suicide. Using Poisson regression modelling and sinusoidal analysis a small seasonal effect (7% from peak to trough) was identified but age, gender, marital status and residence were much larger contributors. The seasonal contribution increased in the latter half of the period under study. There was also a small seasonal effect for method of suicide. The suicide rate was highest in the 40-44 age group after controlling for confounders. LIMITATIONS Because this was an ecological study, information on other possible contributors, such as mental illness was not available. CONCLUSIONS These findings are discussed in light of international studies. Continuing studies are required to confirm the trend in increasing seasonality in Ireland. Since suicide is highest in those who are middle aged, preventive strategies should be directed to this group.
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Affiliation(s)
- Patricia Casey
- University College Dublin, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
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Corcoran P, Nagar A. Suicide and marital status in Northern Ireland. Soc Psychiatry Psychiatr Epidemiol 2010; 45:795-800. [PMID: 19763365 DOI: 10.1007/s00127-009-0120-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 08/06/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Studies show marriage to be protective against suicide though with variation in the extent to which suicide rates are higher among the never married, separated or divorced and widowed. We examined suicide in Northern Ireland by marital status and examined whether the observed variation differed by sex and age. METHODS Data relating to all 1,398 suicide deaths (ICD-9 E950-959 and ICD-10 X60-84) registered in 1996-2005 were analysed using Poisson regression. RESULTS The total, male and female age-standardised suicide rates were 8.4, 13.6 and 3.3 per 100,000, respectively. Never marrying increased male suicide risk and its effect increased with age (incidence rate ratio (IRR) among 20-34 year-olds = 1.47, 95% confidence interval (CI) = 1.19-1.84; IRR among over 55 year-olds = 2.33, 95% CI = 1.55-3.50). Never marrying was a risk factor for women only if aged 20-34 years (IRR = 3.05, 95% CI = 1.70-5.47). Among over 55 year-olds, widowhood increased risk of male suicide only (IRR = 2.47, 95% CI = 1.64-3.70) whereas divorce was associated with an almost threefold increase in male (IRR = 2.61, 95% CI = 1.39-4.88) and female (IRR = 2.57, 95% CI = 0.89-7.42) suicide relative to married persons. The effect of divorce was far more pronounced in 20-34 year-old men (IRR = 5.59, 95% CI = 3.58-8.67) and women (IRR = 9.46, 95% CI = 3.81-23.37). CONCLUSIONS In Northern Ireland, marriage protects both sexes against suicide though men more so than women. Divorced young men, in particular, are a population at high risk of suicide.
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Affiliation(s)
- Paul Corcoran
- National Suicide Research Foundation, College Road, Cork, Ireland.
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18
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Corcoran P, Arensman E. A Study of the Irish System of Recording Suicide Deaths. CRISIS 2010; 31:174-82. [DOI: 10.1027/0027-5910/a000026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Many studies have examined the reliability of national suicide statistics. Aims: To examine the Irish system of certifying suicide deaths and data collected by it. Methods: Data were recorded from a police form (Form 104) completed and sent to the Irish Central Statistics Office (CSO) after all inquested deaths that occurred in Ireland in 2002. Results: Of the approximately 1,800 inquested deaths, 6% (and 4% of suicides) were not included in routine mortality statistics because of late registration. Of the 495 deaths thought by the police to be suicide, 485 (98%) were so recorded by the CSO. Information relating to medical history and contributory factors was provided in just 54% and 34% of suicides, respectively. Suicide deaths showed significant variation by weekday (excess on Mondays) and calendar month (summer peak). The peak suicide rate (35 per 100,000) was among men aged 25–34 years. Persons separated, living alone, and unemployed had significantly elevated suicide rates. Conclusions: There is a need for a better understanding of national suicide recording systems, as this study has provided for Ireland. Such systems may routinely provide data relating to sociodemographic factors but not relating to medical and psychosocial factors.
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Affiliation(s)
- Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- Department of Psychiatry, School of Medicine, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
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Ajdacic-Gross V, Bopp M, Ring M, Gutzwiller F, Rossler W. Seasonality in suicide--a review and search of new concepts for explaining the heterogeneous phenomena. Soc Sci Med 2010; 71:657-66. [PMID: 20573433 DOI: 10.1016/j.socscimed.2010.05.030] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2009] [Revised: 01/28/2010] [Accepted: 05/24/2010] [Indexed: 10/19/2022]
Abstract
Seasonality is one of the oldest and most resistant-to-elucidation issues in suicide research. However, in recent years epidemiological research has yielded new results, which provide new perspectives on the matter. This qualitative review summarizes research published since the 1990 s. In particular, the focus is on studies dealing with the historical change of seasonality, cross-sectional comparisons including method-specific diversity, and the association with weather variables and other putative covariates. Recent research has shown that in Western countries the seasonality of suicide is tending to diminish and may, eventually, disappear. It can no longer be considered a universal and homogeneous phenomenon. In addition, different major seasonal cycles have now been determined which mainly depend on different suicide methods. Just as in the epidemiology of suicide methods, the (seasonal) availability and perceived adequacy of methods emerge as the major driving force beyond the seasonal phenomena in suicide.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Psychiatric University Hospital Zurich, Department of Clinical and Social Psychiatry, Militarstr. 8, 8004 Zurich, Switzerland.
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Neuner T, Hübner-Liebermann B, Wolfersdorf M, Felber W, Hajak G, Spiessl H. Time patterns of inpatient suicides. Int J Psychiatry Clin Pract 2010; 14:95-101. [PMID: 24922468 DOI: 10.3109/13651500903506466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Objective. Time patterns of suicides have been investigated in many population-based studies, but there are no studies exploring time patterns of suicides during psychiatric inpatient stay up to now. Methods. All inpatient suicides (1998-2007) of a psychiatric university hospital were identified by the German psychiatric basic documentation system (DGPPNBADO). Descriptive and univariate analyses were performed to analyse time patterns of inpatient suicides. Results. No significant differences could be found for the occurrence of the 37 inpatient suicides due to season (χ(2)=1.595, P=0.696), month (χ(2)=4.838, P=0.958) or weekday (χ(2)=5.189, P=0.550) of suicide. Furthermore, we could not find an unequal distribution of suicides due to month of birth (χ(2)=12.622, P=0.337). 78.4% of inpatient suicides occurred within 50 days after admission. Fourteen inpatients committed suicide around public holidays, two around their birthday. Conclusions. Apart from a notably enhanced risk of suicide in the period after admission, we could not find any time patterns to be of high relevance to inpatient suicides. There may be more relevant risk factors than cyclic or temporal variations.
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Affiliation(s)
- Tanja Neuner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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Soman CR, Safraj S, Kutty VR, Vijayakumar K, Ajayan K. Suicide in South India: A community-based study in Kerala. Indian J Psychiatry 2009; 51:261-4. [PMID: 20048450 PMCID: PMC2802372 DOI: 10.4103/0019-5545.58290] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Studies from Tamil Nadu, South India, have reported the world's highest suicide rates. As per official reports, Kerala, another South Indian state has the highest suicide rate among the major states in India. OBJECTIVE The purpose of this analysis is to estimate the rates and age-specific incidence of suicide in a rural community in Kerala, under continuous observation for the last five years. SETTINGS AND DESIGN The study setting comprised of seven contiguous panchayats constituting a development block in Kerala. A prospective cohort study design was used. MATERIALS AND METHODS Through regular home visits, every death that occurred in the community was captured by local resident health workers and the cause of death assigned. STATISTICAL ANALYSIS Suicide rates by age and sex and relative share of suicide deaths to all-cause deaths in men and women were calculated. RESULTS During the five-year period from 2002 to 2007, 284 cases of suicide were reported. The suicide rates were 44.7/100,000 for males and 26.8/100,000 for females. Male to female suicide ratio was 1.7. Among females aged between 15 and 24, suicides constituted more than 50% of all deaths. Male to female ratio of suicide varied from 0.4 in children aged 14 years or less to 4.5 in the 45-54 year age group. CONCLUSION Our analysis shows that the level of under-reporting of suicides in rural Kerala is much less than that reported in Tamil Nadu.
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Affiliation(s)
- C R Soman
- Health Action by People, TC 7/1724, Temple Road, Kochulloor, Trivandrum, Kerala - 695 011, India
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Getting men's health onto a policy agenda - charting the development of a National Men's Health Policy in Ireland. JOURNAL OF MENS HEALTH 2009. [DOI: 10.1016/j.jomh.2009.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zonda T, Bozsonyi K, Veres E, Lester D, Frank M. The impact of holidays on suicide in Hungary. OMEGA-JOURNAL OF DEATH AND DYING 2009; 58:153-62. [PMID: 19227004 DOI: 10.2190/om.58.2.e] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The suicide rate on religious and public holidays was examined for 133,699 suicides for Hungary for the period 1970-2002. For both men and women, more suicides were committed on Monday, while fewer were committed on the weekends. More suicides occurred on New Year's Day than expected. On Christmas Day and on Easter Sunday and Monday, suicides were less frequent only for men, a result consistent with Durkheim's theory. There was less evidence for Gabennesch's broken promise effect on the days after the holidays. National holidays had no impact on the frequency of suicide.
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Affiliation(s)
- Tamás Zonda
- Hungarian Association for Suicide Prevention, Budapest, Hungary
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Affiliation(s)
- Robert M Bossarte
- Department of Community Medicine, West Virginia University, Morgantown, WV 26506, USA.
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