This table contains 126720 series, with data for years 2000 - 2000 (not all combinations necessarily have data for all years). This table contains data described by the following dimensions (Not all combinations are available): Age group (12 items: Total; 15 years and over;20 to 34 years;20 to 24 years;15 to 19 years ...), Sex (3 items: Both sexes; Females; Males ...), Suicidal thoughts and attempts (5 items: Total; suicidal thoughts and attempts; Suicide; considered in past 12 months; Suicide; attempted in past 12 months; Suicide; never contemplated ...), Characteristics (8 items: Number of persons; Low 95% confidence interval; number of persons; Coefficient of variation for number of persons; High 95% confidence interval; number of persons ...).

BackgroundIn Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate of completed suicides, indicating major gender differences in lethality of suicidal behaviour. The aim of this study was to analyse the extent to which these gender differences in lethality can be explained by factors such as choice of more lethal methods or lethality differences within the same suicide method or age. In addition, we explored gender differences in the intentionality of suicide attempts.Methods and FindingsMethods. Design: Epidemiological study using a combination of self-report and official data. Setting: Mental health care services in four European countries: Germany, Hungary, Ireland, and Portugal. Data basis: Completed suicides derived from official statistics for each country (767 acts, 74.4% male) and assessed suicide attempts excluding habitual intentional self-harm (8,175 acts, 43.2% male).Main Outcome Measures and Data Analysis. We collected data on suicidal acts in eight regions of four European countries participating in the EU-funded “OSPI-Europe”-project (www.ospi-europe.com). We calculated method-specific lethality using the number of completed suicides per method * 100 / (number of completed suicides per method + number of attempted suicides per method). We tested gender differences in the distribution of suicidal acts for significance by using the χ2-test for two-by-two tables. We assessed the effect sizes with phi coefficients (φ). We identified predictors of lethality with a binary logistic regression analysis. Poisson regression analysis examined the contribution of choice of methods and method-specific lethality to gender differences in the lethality of suicidal acts.Findings Main ResultsSuicidal acts (fatal and non-fatal) were 3.4 times more lethal in men than in women (lethality 13.91% (regarding 4106 suicidal acts) versus 4.05% (regarding 4836 suicidal acts)), the difference being significant for the methods hanging, jumping, moving objects, sharp objects and poisoning by substances other than drugs. Median age at time of suicidal behaviour (35–44 years) did not differ between males and females. The overall gender difference in lethality of suicidal behaviour was explained by males choosing more lethal suicide methods (odds ratio (OR) = 2.03; 95% CI = 1.65 to 2.50; p < 0.000001) and additionally, but to a lesser degree, by a higher lethality of suicidal acts for males even within the same method (OR = 1.64; 95% CI = 1.32 to 2.02; p = 0.000005). Results of a regression analysis revealed neither age nor country differences were significant predictors for gender differences in the lethality of suicidal acts. The proportion of serious suicide attempts among all non-fatal suicidal acts with known intentionality (NFSAi) was significantly higher in men (57.1%; 1,207 of 2,115 NFSAi) than in women (48.6%; 1,508 of 3,100 NFSAi) (χ2 = 35.74; p < 0.000001).Main limitations of the studyDue to restrictive data security regulations to ensure anonymity in Ireland, specific ages could not be provided because of the relatively low absolute numbers of suicide in the Irish intervention and control region. Therefore, analyses of the interaction between gender and age could only be conducted for three of the four countries. Attempted suicides were assessed for patients presenting to emergency departments or treated in hospitals. An unknown rate of attempted suicides remained undetected. This may have caused an overestimation of the lethality of certain methods. Moreover, the detection of attempted suicides and the registration of completed suicides might have differed across the four countries. Some suicides might be hidden and misclassified as undetermined deaths.ConclusionsMen more often used highly lethal methods in suicidal behaviour, but there was also a higher method-specific lethality which together explained the large gender differences in the lethality of suicidal acts. Gender differences in the lethality of suicidal acts were fairly consistent across all four European countries examined. Males and females did not differ in age at time of suicidal behaviour. Suicide attempts by males were rated as being more serious independent of the method used, with the exceptions of attempted hanging, suggesting gender differences in intentionality associated with suicidal behaviour. These findings contribute to understanding of the spectrum of reasons for gender differences in the lethality of suicidal behaviour and should inform the development of gender specific strategies for suicide prevention.

An association of higher body mass index (BMI) with lower risk of attempted and completed suicide has been reported. In contrast, increasing BMI has been found to be associated with depression and other risk factors for suicidal behavior. We aimed to investigate this possible paradox in a cohort comprising 49 000 Swedish men. BMI, mental health, lifestyle and socioeconomic measures were recorded at conscription in 1969–70, at ages 18–20. Information on attempted suicide 1973–2008 and completed suicide 1971–2008 was obtained from national records. Hazard ratios (HR) were estimated by Cox proportional hazard models. We found that each standard deviation (SD) increase in BMI was associated with a 12% lower risk of later suicide attempt (HR 0.88, 95% CI 0.83–0.94). Associations were somewhat weaker for completed suicide and did not reach conventional levels of statistical significance (HR 0.93, 95% CI 0.85–1.01). Adjustment for a wide range of possible confounding factors had little effect on the associations. Lower BMI at conscription was also associated with higher prevalence of psychiatric diagnoses, low emotional control and depressed mood. Our results confirm previous findings regarding the association of higher BMI with a reduced risk of suicide, extending them to show similar findings in relation to suicide attempts. The associations were little affected by adjustment for a range of possible confounding factors. However, we found no evidence that high BMI was associated with an increased risk of depression cross-sectionally or longitudinally.

This short report uses data on drug-related emergency department (ED) visits from the Drug Abuse Warning Network (DAWN) to examine the trends and characteristics of ED visits involving drug-related suicide attempts among ED patients aged 45-64 in 2011. The report discusses the patterns for male and female patients, the drugs most frequently involved in the suicide attempt-related ED visits, and the outcome of the visits. Findings from 2011 are compared with 2005 data. The report notes that current suicide prevention public health efforts are directed at primarily young people and the elderly, but that the findings of this analysis--the increase in drug-related suicide attempts among adults ages 45-64--underscore the importance of understanding risk factors and developing appropriate prevention strategies for this age group.

This short report uses data on drug-related emergency department (ED) visits from the Drug Abuse Warning Network (DAWN) to examine the trends and characteristics of ED visits involving drug-related suicide attempts among ED patients aged 45-64 in 2011. The report discusses the patterns for male and female patients, the drugs most frequently involved in the suicide attempt-related ED visits, and the outcome of the visits. Findings from 2011 are compared with 2005 data. The report notes that current suicide prevention public health efforts are directed at primarily young people and the elderly, but that the findings of this analysis--the increase in drug-related suicide attempts among adults ages 45-64--underscore the importance of understanding risk factors and developing appropriate prevention strategies for this age group.

IntroductionThe majority of people who die by suicide have never seen a mental health professional or been diagnosed with a mental illness. To date, this majority group has largely been ignored, with most existing research focusing on predictors of suicide such as past suicide attempts. Identifying the characteristics of people who die by suicide without receiving services, often with a fatal first attempt, is crucial to reduce suicide rates through guiding improvements to service pathways and “just in time” interventions.MethodsIn this systematic review, PsycInfo, PubMed, CINAHL, and Web of Science were searched for peer-reviewed articles published from 1980 to 1st March 2021. Included studies examined predictors of non-receipt of formal mental health services among people who died by suicide. Data were extracted from published reports and the quality of included studies was assessed using a modified version of the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies. This review was registered with PROSPERO, CRD 42021226543.ResultsSixty-seven studies met inclusion criteria, with sample sizes ranging from 39 to 193,152 individuals. Male sex, younger or older age, and rural location were consistently associated with non-receipt of mental health services. People not receiving mental health services were also less likely to have a psychiatric diagnosis, past suicidal behavior or contact with general health services, and more likely to use violent means of suicide. There was some evidence that minority ethnicity and psychosocial stressors were associated with service non-receipt.ConclusionPeople who die by suicide without receiving mental health services are likely to have diverse profiles, indicating the need for multifaceted approaches to effectively support people at risk of suicide. Identifying the needs and preferences of individuals who are at risk of suicide is crucial in developing new support pathways and services, and improving the quality of existing services.Systematic Review Registrationhttp://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021226543.

BackgroundPsychotic disorders increase the risk for premature mortality with up to 40% of this mortality attributable to suicide. Although suicidal ideation (SI) and suicidal behavior (SB) are high in persons with psychotic disorders in sub-Saharan Africa, there is limited data on the risk of suicide and associated factors among persons with psychotic disorders.MethodsWe assessed SI and SB in persons with psychotic disorders, drawn from a large case-control study examining the genetics of psychotic disorders in a Kenyan population. Participants with psychotic disorders were identified using a clinical review of records, and the diagnosis was confirmed with the Mini-International Neuropsychiatric Interview (MINI). We conducted bivariate and multivariate logistic (for binary suicide outcomes) or linear regression (for suicide risk score) analysis for each of the suicide variables, with demographic and clinical variables as determinants.ResultsOut of 619 participants, any current SI or lifetime suicidal attempts was reported by 203 (32.8%) with psychotic disorders, of which 181 (29.2%) had a lifetime suicidal attempt, 60 (9.7%) had SI in the past month, and 38 (20.9%) had both. Family history of suicidality was significantly associated with an increased risk of suicidality across all the following four outcomes: SI [OR = 2.56 (95% CI: 1.34–4.88)], suicidal attempts [OR = 2.01 (95% CI: 1.31–3.06)], SI and SB [OR = 2.00 (95% CI: 1.31–3.04)], and suicide risk score [beta coefficient = 7.04 (2.72; 11.36), p = 0.001]. Compared to persons aged <25 years, there were reduced odds for SI for persons aged ≥ 25 years [OR = 0.30 (95% CI: 0.14–0.62)] and ≥ 45 years [OR = 0.32 (95% CI: 0.12–0.89)]. The number of negative life events experienced increased the risk of SI and SB [OR = 2.91 (95% CI: 1.43–5.94)] for 4 or more life events. Higher negative symptoms were associated with more suicidal attempts [OR = 2.02 (95%CI: 1.15–3.54)]. Unemployment was also associated with an increased risk for suicidal attempts [OR = 1.58 (95%CI: 1.08–2.33)] and SI and SB [OR = 1.68 (95% CI: 1.15–2.46)].ConclusionSuicidal ideation and SB are common in persons with psychotic disorders in this African setting and are associated with sociodemographic factors, such as young age and unemployment, and clinical factors, such as family history of suicidality. Interventions targeted at the community (e.g., economic empowerment) or at increasing access to care and treatment for persons with psychotic disorders may reduce the risk of suicide in this vulnerable population group.

Suicidal ideation (SI) often precedes and predicts suicide attempt and death, is the most common suicidal phenotype and is over-represented in veterans. The genetic architecture of SI in the absence of suicide attempt (SA) is unknown, yet believed to have distinct and overlapping risk with other suicidal behaviors. We performed the first GWAS of SI without SA in the Million Veteran Program (MVP), identifying 99,814 SI cases from electronic health records without a history of SA or suicide death (SD) and 512,567 controls without SI, SA or SD. GWAS was performed separately in the four largest ancestry groups, controlling for sex, age and genetic substructure. Ancestry-specific results were combined via meta-analysis to identify pan-ancestry loci. Four genome-wide significant (GWS) loci were identified in the pan-ancestry meta-analysis with loci on chromosomes 6 and 9 associated with suicide attempt in an independent sample. Pan-ancestry gene-based analysis identified GWS associations with DRD2, DCC, FBXL19, BCL7C, CTF1, ANNK1, and EXD3. Gene-set analysis implicated synaptic and startle response pathways (q’s<0.05). European ancestry (EA) analysis identified GWS loci on chromosomes 6 and 9, as well as GWS gene associations in EXD3, DRD2, and DCC. No other ancestry-specific GWS results were identified, underscoring the need to increase representation of diverse individuals. The genetic correlation of SI and SA within MVP was high (rG = 0.87; p = 1.09e-50), as well as with post-traumatic stress disorder (PTSD; rG = 0.78; p = 1.98e-95) and major depressive disorder (MDD; rG = 0.78; p = 8.33e-83). Conditional analysis on PTSD and MDD attenuated most pan-ancestry and EA GWS signals for SI without SA to nominal significance, with the exception of EXD3 which remained GWS. Our novel findings support a polygenic and complex architecture for SI without SA which is largely shared with SA and overlaps with psychiatric conditions frequently comorbid with suicidal behaviors.

Causes, social backgrounds and consequences of use of alcohol by alcoholics. Topics: profile of requirements of a preferred occupation; occupation learned and current occupation; terms of employment; most important person to relate to; characterization of relation with person to relate to; housing situation; expectations of preferred leisure activities; determination and self-confidence; expected effects of continued or terminated use of alcohol on the relation with person to relate to, on personal well-being and on professional life; occasions to drink; effects of alcohol dependency up to now on various areas of life; occurrence of illnesses due to alcohol, symptoms and complaints; convictions in connection with use of alcohol; drinking habits of parents during personal childhood or youth as well as currently; reasons for interest in therapy; earlier participation in various forms of therapy and judgement on their effectiveness; number of hospital stays due to alcohol; contacts with self-help groups; frequency of use of pain-killers, sleeping pills and tranquilizers; amount of time since last use of alcohol; age at first use of alcohol as well as at first intoxication; point in time, as of which greater quantities of alcohol are consumed; preferred drink; daily consumption of beer, schnapps, liqueur and wine; rapid or slow consumption; first use of alcohol immediately after getting up; regularity of use of alcohol; length of abstinence after intoxication; influence of alcohol on one´s own personality; maintaining a supply of alcohol; changes noted in the effect of alcohol; place of consumption; regular use of alcohol with a partner, in company of others or alone; openness regarding one´s personal alcohol problem; sensitivity to criticism expressed due to the use of alcohol; planned future dealing with alcohol; thoughts of suicide; reasons for an earlier suicide attempt; judgement on childhood; social origins; comparison of personal professional career with that of parents or partner. Also encoded were: first contact; date of interview; mode of funds transfer; problem definition by patient; effects desired from alcohol; negative experiences with alcohol; increased use of alcohol; attempts to control oneself; control by others; prior treatments; social surroundings; conspicuousness in various socialization phases, partnerships and sexuality; judgement on the motivation for therapy. Anlässe, soziale Hintergründe und Folgen des Alkoholkonsums von Alkoholikern. Themen: Anforderungsprofil an einen präferierten Beruf; wichtigste Bezugsperson; Charakterisierung der Beziehung zur Bezugsperson; Ansprüche an präferierte Freizeitaktivitäten; Zielstrebigkeit und Selbstvertrauen; erwartete Auswirkungen eines fortgesetzten bzw. eines beendeten Alkoholkonsums auf die Beziehung zur Bezugsperson, auf das eigene Befinden und auf das Berufsleben; Trinkanlässe; bisherige Auswirkungen der Alkoholabhängigkeit auf verschiedene Lebensbereiche; Auftreten alkoholbedingter Krankheiten, Symptome und Beschwerden; Verurteilungen im Zusammenhang mit Alkoholkonsum; Trinkgewohnheiten der Eltern während der eigenen Kindheit bzw. Jugend sowie derzeitig; Gründe für ein Interesse an einer Therapie; frühere Teilnahme an verschiedenen Therapieformen und Beurteilung deren Wirksamkeit; Anzahl der alkoholbedingten Krankenhausaufenthalte; Kontakte zu Selbsthilfegruppen; Häufigkeit der Einnahme von Schmerz-, Schlaf- und Beruhigungsmitteln; Zeitdauer seit dem letzten Alkoholkonsum; Alter beim ersten Alkoholkonsum sowie beim ersten Rausch; Zeitpunkt, seitdem vermehrt Alkohol getrunken wird; bevorzugte Getränke; täglicher Konsum von Bier, Schnaps, Likör und Wein; hastiger oder langsamer Konsum; erster Alkoholkonsum direkt nach dem Aufstehen; Regelmäßigkeit des Alkoholkonsums; Dauer der Abstinenz nach einem Rausch; Einfluß des Alkohols auf die eigene Persönlichkeit; Vorratshaltung von Alkohol; festgestellte Veränderungen in der Wirkung des Alkohols; Konsumort; regelmäßiger Alkoholkonsum mit einem Partner, in Gesellschaft oder alleine; Offenheit gegenüber dem eigenen Alkoholproblem; Empfindlichkeit gegenüber geäußerter Kritik wegen des Alkoholkonsums; geplanter zukünftiger Umgang mit Alkohol; Suizidgedanken; Gründe für einen bisherigen Suizidversuch; Beurteilung der Kindheit. Demographie: Geburtsjahr; Geschlecht; Behandlungsstatus; soziale Herkunft; Vergleich der eigenen beruflichen Karriere im Vergleich zu der der Eltern bzw. des Partners; erlernter und gegenwärtiger Beruf; Beschäftigungsverhältnis; Familienstand; Wohnstatus. Zusätzlich verkodet wurden: Erstgespräch; Interviewdatum; Überweisungsmodus; Problemdefinition des Patienten; durch Alkohol angestrebte Wirkungen; negative Erlebnisse mit Alkohol; vermehrter Alkoholkonsum; Selbstkontrollversuche; Fremdkontrolle; bisherige Behandlungen; soziales Umfeld; Auffälligkeit in verschiedenen Sozialisationsphasen, Partnerschaften und Sexualität; Beurteilung der Therapie-Motivation.

Self-injurious behavior (SIB) among adolescents is an important public health issue worldwide. It is still uncertain whether homogeneous subgroups of SIB can be identified and whether constellations of SIBs can co-occur due to the high heterogeneity of these behaviors. In this study, a cross-sectional study was conducted on a large school-based sample and latent class analysis was performed (n = 10,069, mean age = 15 years) to identify SIB classes based on 11 indicators falling under direct SIB (DSIB), indirect SIB (ISIB), and suicide attempts (SAs). Social and psychological characteristics of each subgroup were examined after controlling for age and gender. Results showed that a four-class model best fit the data and each class had a distinct pattern of co-occurrence of SIBs and external measures. Class 4 (the baseline/normative group, 65.3%) had a low probability of SIB. Class 3 (severe SIB group, 3.9%) had a high probability of SIB and the poorest social and psychological status. Class 1 (DSIB+SA group, 14.2%) had similar scores for external variables compared to class 3, and included a majority of girls [odds ratio (OR) = 1.94]. Class 2 (ISIB group, 16.6%) displayed moderate endorsement of ISIB items, and had a majority of boys and older adolescents (OR = 1.51). These findings suggest that SIB is a heterogeneous entity, but it may be best explained by four homogenous subgroups that display quantitative and qualitative differences. Findings in this study will improve our understanding on SIB and may facilitate the prevention and treatment of SIB.

BackgroundThe prevalence of late-life depression (LLD) is high, and its most dangerous, serious, and fatal comorbidity is suicide. Therefore, the present study systematically investigates the risk factors for suicide in individuals with LLD, offering empirical support for the development of preventive interventions against suicidal behavior.MethodsPubMed, Web of Science, the Cochrane Library, PsycInfo, CNKI, Wan Fang Data, VIP, and CBM databases were searched from the inception of each database to February 2025 to identify observational studies of risk factors for suicide in LLD patients. The Newcastle–Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) were used to ensure study quality. Stata 18.0 software was used to perform a meta-analysis and sensitivity analysis to compute the pooled odds ratio.ResultsA total of 12 studies (eight case–control, two cross-sectional, and two longitudinal studies), with a quality level of medium or above, were included in the analysis. Depression severity (OR = 3.485, 95% CI: 1.385 to 8.769, P = 0.008) was identified as a significant risk factor for suicide in LLD. The age of onset (OR = 0.969, 95% CI: 0.905 to 1.039, P = 0.378) was not statistically significant for the risk of suicide in LLD. The descriptive analysis revealed that suicidal ideation, educational level, N3 sleep duration, odor identification dysfunction, alcohol drinking history, cognitive function, history of major trauma, history of suicide attempts, and high-density lipoprotein were associated with an increased suicide risk in LLD.ConclusionOur meta-analysis has revealed a variety of factors influencing suicide risk in LLD patients. Clinical staff should strengthen the assessment and screening of risk factors and take timely intervention and targeted treatment to reduce the risk of suicide in LLD.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251040029.

ObjectiveChronic pain is a leading cause of disability, severely impairing an individual’s daily activity and quality of life. In addition, this condition may contribute to suicidal thoughts by leading to neuropsychological impairments, a perceived lack of meaning in life, and pain-related catastrophizing. This systematic review aimed to comprehensively investigate the prevalence and associated factors of suicidal behaviors (SBs) including suicidal ideation (SI) and suicide attempt (SA) or its complete, in individuals with chronic pain.MethodsFive electronic databases were searched up to October 4, 2022. Only observational studies investigating the prevalence of SB in individuals with chronic pain were included. The methodological quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. A meta-analysis was conducted to quantify the prevalence of SB in the population, and the command “Metaprop” was used in STATA/MP 16. In addition, factors explaining the association between chronic pain and SB identified through regression analysis were investigated.ResultsA total of 19 studies were included in this review (N = 3,312,343). The pooled lifetime prevalence of SI and SA was 28.90% (95% confidence interval, 17.95 to 41.26%) and 10.83% (5.72 to 17.30%), respectively, in a mixed sample comprising various chronic pain conditions. Importantly, the pooled prevalence of past 2-week SI was as high as 25.87% (18.09 to 34.50%). The methodological quality of the included studies was not optimal, and studies using validated SB assessment tools were lacking. Potential protective factors against SB in this population included pain coping and self-efficacy, older age, certain race/ethnicity groups, and marriage.ConclusionThis systematic review and meta-analysis demonstrated the high prevalence of SB in individuals with chronic pain. Specifically, around 1 in 4 individuals with chronic pain had SI within the last 2 weeks. However, there was considerable heterogeneity in the pooled prevalence of SB in this population.

Introduction: Argentinean quarantine during the COVID-19 pandemic is one of the most long-lasting worldwide. We focused on the first 80-days of this quarantine on Argentinean women. Our aims were to analyze differences in general mental health state (MHS) indicators, by the (1) sites of residence with different prevalence of COVID-19 cases, and (2) quarantine duration; (3) to assess multiple relationships between each general MHS indicator and potentially affecting factors.Methods: We used a cross-sectional design with convenience successive sampling (N = 5,013). The online survey included a socio-demographic questionnaire (elaborated ad hoc) with standardized and validated self-reported questionnaires (General Health Questionnaire, Kessler Psychological Distress Scale) measuring the MHS indicators: self-perceived health, psychological discomfort, social functioning and coping, and psychological distress.Results: Worse self-perceived health and higher psychological discomfort affected significantly more women residing in sites with high prevalence of COVID-19 cases, compared to those residing in sites with intermediate prevalence, but effect sizes were small. Mean scores of all general MHS indicators were significantly worse for longer quarantine sub-periods (up to 53, 68, and 80-day duration) than for shorter sub-periods (up to seven, 13, and 25-day duration). Being a younger age, having mental disorder history, and longer quarantine durations were associated to worsening MHS, while the lack of previous suicide attempt has a protective effect.Discussion: Our findings show that a worse MHS during quarantine may not be attributed to the objective risk of contagion (measured greater or less), and under quarantine, women MHS—as indicated by group central tendency measures—got worse as time went by. This strongly suggests that special attention needs to be paid to younger women and to women with history of mental disorder. Along with physical health, mental health must be a priority for the Government during and after quarantine and the COVID-19 pandemic.