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    Gustavo Turecki, David A. Brent, David Gunnell, Rory C. O’Connor, María A. Oquendo, Jane Pirkis et al.
    Seena Fazel, Bo Runeson

    Suicide accounts for approximately 1.5% of deaths per year worldwide. Risk factors are known for populations, and psychological models address individual risks; the models and tools for assessing suicide risk are imperfect but provide some guidance.

    Peeter Värnik

    INTRODUCTION: Over the past 20 years the WHO has considerably improved world mortality data. There are still shortcomings but more countries now report data and world-wide estimates are regularly made. METHODS: Data about mortality have been retrieved from the WHO …

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    INTRODUCTION: Over the past 20 years the WHO has considerably improved world mortality data. There are still shortcomings but more countries now report data and world-wide estimates are regularly made. METHODS: Data about mortality have been retrieved from the WHO world database. Worldwide injury mortality estimates for 2008 as well as trends of the suicide rate from 1950 to 2009 were analysed. RESULTS: Suicides in the world amount to 782 thousand in 2008 according to the WHO estimate, which is 1.4% of total mortality and 15% of injury mortality. The suicide rate for the world as a whole is estimated at 11.6 per 100,000 inhabitants. The male-female rate ratio of suicide is estimated to be highest in the European Region (4.0) and the lowest in the Eastern Mediterranean region (1.1). Among males the highest suicide rate in the 15-29 age group is in the SE Asian region, in the 45-59 age group in European males and for ages above 60 in the Western Pacific region. Females from SE Asia have a remarkably high suicide rate among 15-29-year-olds and from age 45 in the Western Pacific region. The leading country is currently Lithuania, with a suicide rate of 34.1 per 100,000 inhabitants. Also among males the suicide rate is the highest in Lithuania at 61.2. Among females South Korea with 22.1 is at the top of world suicide rates. CONCLUSIONS: During the past six decades, according to the WHO Japan, Hungary, and Lithuania have topped the list of world countries by suicide rate, but if the current trends continue South Korea will overtake all others in a few years. The heart of the problem of suicide mortality has shifted from Western Europe to Eastern Europe and now seems to be shifting to Asia. China and India are the biggest contributors to the absolute number of suicides in the world.

    Keith E Hawton

    Qin et al et al's (2000, this issue) epidemiological 's (2000, this issue) epidemiological study of risk factors for suicide in males and study of risk factors for suicide in males and females in Denmark reminds us that there females …

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    Qin et al et al's (2000, this issue) epidemiological 's (2000, this issue) epidemiological study of risk factors for suicide in males and study of risk factors for suicide in males and females in Denmark reminds us that there females in Denmark reminds us that there are important gender differences in suicidal are important gender differences in suicidal behaviour.These reflect not only differences behaviour.These reflect not only differences in aetiology, which were the primary focus in aetiology, which were the primary focus of the Danish study, but also other import-of the Danish study, but also other important variations by gender in relation to risk, ant variations by gender in relation to risk, the nature of suicidal behaviour and its the nature of suicidal behaviour and its prevention and treatment.prevention and treatment.

    Matthew K. Nock, Guilherme Luiz Guimaraes Borges, Evelyn J. Bromet, C. B. Cha, Ronald C. Kessler, S. Lee

    Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of …

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    Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.

    Wayne S. Fenton

    Suicide is the single largest cause of premature death among individuals with schizophrenia. Furthermore, epidemiological data indicate that nearly 80% of patients with the diagnosis of schizophrenia will experience a major depressive episode at some time during their lifetime. This …

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    Suicide is the single largest cause of premature death among individuals with schizophrenia. Furthermore, epidemiological data indicate that nearly 80% of patients with the diagnosis of schizophrenia will experience a major depressive episode at some time during their lifetime. This report reviews recent findings relative to the risk of suicide in schizophrenia, including data from the Chestnut Lodge longitudinal study of schizophrenia subtypes and symptom domains. Paradoxically, those patients with schizophrenia who are most likely to recover or experience a good outcome are also those at greatest risk for suicide. The reduction of morbidity and mortality in schizophrenia should include depression and suicidality as targets for both psychopharmacological and psychosocial treatment.

    Charlotte Wessel Skovlund, Lina Steinrud Mørch, Lars Vedel Kessing, Theis Lange, Øjvind Lidegaard

    OBJECTIVE: The purpose of this study was to assess the relative risk of suicide attempt and suicide in users of hormonal contraception. METHOD: The authors assessed associations between hormonal contraceptive use and suicide attempt and suicide in a nationwide prospective …

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    OBJECTIVE: The purpose of this study was to assess the relative risk of suicide attempt and suicide in users of hormonal contraception. METHOD: The authors assessed associations between hormonal contraceptive use and suicide attempt and suicide in a nationwide prospective cohort study of all women in Denmark who had no psychiatric diagnoses, antidepressant use, or hormonal contraceptive use before age 15 and who turned 15 during the study period, which extended from 1996 through 2013. Nationwide registers provided individually updated information about use of hormonal contraception, suicide attempt, suicide, and potential confounding variables. Psychiatric diagnoses or antidepressant use during the study period were considered potential mediators between hormonal contraceptive use and risk of suicide attempt. Adjusted hazard ratios for suicide attempt and suicide were estimated for users of hormonal contraception as compared with those who never used hormonal contraception. RESULTS: Among nearly half a million women followed on average for 8.3 years (3.9 million person-years) with a mean age of 21 years, 6,999 first suicide attempts and 71 suicides were identified. Compared with women who never used hormonal contraceptives, the relative risk among current and recent users was 1.97 (95% CI=1.85-2.10) for suicide attempt and 3.08 (95% CI=1.34-7.08) for suicide. Risk estimates for suicide attempt were 1.91 (95% CI=1.79-2.03) for oral combined products, 2.29 (95% CI=1.77-2.95) for oral progestin-only products, 2.58 (95% CI=2.06-3.22) for vaginal ring, and 3.28 (95% CI=2.08-5.16) for patch. The association between hormonal contraceptive use and a first suicide attempt peaked after 2 months of use. CONCLUSIONS: Use of hormonal contraception was positively associated with subsequent suicide attempt and suicide. Adolescent women experienced the highest relative risk.

    Gustavo Turecki, David A. Brent
    Eve K. Mościcki

    This article presents the epidemiology of suicide with a special focus on suicides among the elderly, and discusses the known risk factors for suicide within a framework designed to encourage a systematic approach to theory testing and prevention. Throughout the …

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    This article presents the epidemiology of suicide with a special focus on suicides among the elderly, and discusses the known risk factors for suicide within a framework designed to encourage a systematic approach to theory testing and prevention. Throughout the world, suicide rates are highest among the elderly. The risk factors for suicide can be classified as distal or proximal, and, within these broad categories, as sociodemographic, psychiatric, biological, familial, and situational. Mental and addictive disorders are the major risk factors for suicide in all age groups. Other risk factors include male gender, disrupted marital status, prior suicide attempt, reduced brain stem serotonergic activity, family history of psychiatric disorder or suicide, a firearm in the home, and a recent, severely stressful life event. Since risk factors for suicide rarely occur in isolation, prevention efforts are more likely to succeed if multiple risk factors are targeted.

    Edwin S. Shneidman, Norman L. Farberow

    T HE IMPORTANCE of the plhenomenoni of suicide is gauged by the fact that more than 20,000 people take their lives eaclh year ini the UInited States (1).Professional psychli- atric, psyclhological, anid social services might save many potentially suicidal persons …

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    T HE IMPORTANCE of the plhenomenoni of suicide is gauged by the fact that more than 20,000 people take their lives eaclh year ini the UInited States (1).Professional psychli- atric, psyclhological, anid social services might save many potentially suicidal persons if the danger is anticipated.In our continuiiing stud(ly of suicide at the Veteranis Admiinistration Neuropsyclhiatric Hospital in Los An1geles County, Calif. (2-4), we are attemiptinig to (is- cover a few of the daniger signals.A basic poinit of view imiplicit in our stuidy is that we believe suicide to be motivated by soci- ologic, cultural, ecologic, psychological, anti many other factors (5-8).Another basic p)oinit of view is our belief that meaninlgful sttudies of