The Rate of Fatality and Demographic Characteristics Associated With Various Suicide Methods
A Community-Based Study in Northern Taiwan
Abstract
Background: Understanding lethality and risk factors of suicide methods is an initial step in suicide prevention. Aims: To investigate the fatality rate and demographic characteristics of various suicide methods. Method: This study enrolled consecutive individuals with episodes of suicide attempts registered in a surveillance database in a city with a high rate of suicide mortality in Taiwan, from January 1, 2006, to December 31, 2010. In total, 3,089 suicide attempt events (including 2,583 nonfatal suicides and 506 completed suicides) occurred during the study period. Results: Overall, the fatality rate of suicides was 16.4%. Charcoal burning accounted for the most suicide deaths (37.6%), with a fatality rate of 50.1%. Suicide by hanging carried the highest fatality rate (81.2%). Males tended to choose more lethal methods and had higher fatality rates compared with females. Elders and married persons were less likely to attempt suicide by charcoal burning. The case fatality ratio increased along with age among suicide attempts, but not in those using charcoal burning. Conclusion: The choice of suicide methods and lethality might be influenced by one’s demographic characteristics. Results from this study may provide clues for establishing suicide prevention strategies such as restricting access to common lethal suicide methods in the high-risk group.
References
2003). Suicide and serious suicide attempts in youth: A multiple-group comparison study. American Journal of Psychiatry, 160, 1093–1099.
(2010). Factors influencing the decision to use hanging as a method of suicide: Qualitative study. British Journal of Psychiatry, 197, 320–325.
(2012). Gender differences in suicide methods. Social Psychiatry and Psychiatric Epidemiology, 47, 857–869.
(2009). What does psychological autopsy study tell us about charcoal burning suicide – a new and contagious method in Asia? Suicide and Life-Threatening Behavior, 39, 633–638.
(2010). The evolution of the epidemic of charcoal-burning suicide in Taiwan: A spatial and temporal analysis. PLOS Medicine, 7, e1000212.
(2009). A community-based study of case fatality proportion among those who carry out suicide acts. Social Psychiatry and Psychiatric Epidemiology, 44, 1005–1011.
(2011). Mortality and suicide after self-harm: Community cohort study in Taiwan. British Journal of Psychiatry, 198, 31–36.
(2012). Decomposing the widening suicide gender gap: An experience in Taipei City, Taiwan. Journal of Affective Disorders, 136, 868–874.
(2009). Methods of suicide in different psychiatric diagnostic groups. Journal of Affective Disorders, 118, 196–200.
(2005). Lifetime risk of suicide ideation and attempts in an Australian community: Prevalence, suicidal process, and help-seeking behaviour. Journal of Affective Disorders, 86, 215–224.
(2013). The WHO START Study. Crisis, 34, 156–163.
(2008). Lethality of suicide methods. Injury Prevention, 14, 39–45.
(2010). Suicide prevention by limiting access to methods: A review of theory and practice. Social Science & Medicine, 70, 1626–1632.
(2005). The epidemiology and prevention of suicide by hanging: A systematic review. International Journal of Epidemiology, 34, 433–442.
(2009). Suicide. Lancet, 373, 1372–1381.
(2010). Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample. Journal of Affective Disorders, 127, 274–280.
(2009). Who uses firearms as a means of suicide? A population study exploring firearm accessibility and method choice. BMC Medicine, 7, 52.
(2008). Suicide by charcoal burning in Taiwan: Implications for means substitution by a case-linkage study. Social Psychiatry and Psychiatric Epidemiology, 43, 286–290.
(2010). The leading methods of suicide in Taiwan, 2002–2008. BMC Public Health, 10, 480.
(2006). Association between the accessibility to lethal methods and method-specific suicide rates: An ecological study in Taiwan. Journal of Clinical Psychiatry, 67, 1074–1079.
(2008). Suicide mortality trends by sex, age and method in Taiwan, 1971–2005. BMC Public Health, 8, 6.
(2007). Charcoal burning suicides in Hong Kong and urban Taiwan: An illustration of the impact of a novel suicide method on overall regional rates. Journal of Epidemiology & Community Health, 61, 248–253.
(2011). Suicide categories by patterns of known risk factors: A latent class analysis. Archives of General Psychiatry, 68, 935–941.
(2005). Suicide prevention strategies: A systematic review. JAMA, 294, 2064–2074.
(2012). Suicide mortality in the United States: The importance of attending to method in understanding population-level disparities in the burden of suicide. Annual Review of Public Health, 33, 393–408.
(2004). The epidemiology of case fatality rates for suicide in the northeast. Annals of Emergency Medicine, 43, 723–730.
(2008). Suicide and suicidal behavior. Epidemiologic Review, 30, 133–154.
(2011). Gender differences in age, period, and birth-cohort effects on the suicide mortality rate in Japan, 1985–2006. Asia-Pacific Journal of Public Health, 23, 581–587.
(2010). Suicide by charcoal burning in Taiwan, 1995–2006. Journal of Affective Disorders, 120, 254–257.
(1996). Analyzing bivariate repeated measures for discrete and continuous outcome variables. Biometrics, 52, 740–750.
(2009). Sociodemographic and psychopathological risk factors for repetition of attempted suicide: A 5-year follow-up study. Archives of Suicide Research, 13, 201–213.
(2003). Lethality of firearms relative to other suicide methods: A population based study. Journal of Epidemiology & Community Health, 57, 120–124.
(2000). Suicide acts in 8 states: Incidence and case fatality rates by demographics and method. American Journal of Public Health, 90, 1885–1891.
(2010). Epidemiological trends of suicide and attempted suicide by poisoning in the US: 2000–2008. Leg Medicine (Tokyo), 12, 177–183.
(2011). Suicide epidemics: The impact of newly emerging methods on overall suicide rates – a time trends study. BMC Public Health, 11, 314.
(2011). Why do people choose charcoal burning as a method of suicide? An interview based study of survivors in Taiwan. Journal of Affective Disorders, 131, 402–407.
(2013). Suicides by jumping from a height in Hong Kong: A review of coroner court files. Social Psychiatry and Psychiatric Epidemiology, 49, 211–219.
(2009). Suicides by jumping from iconic bridges in Hong Kong. Crisis, 30, 79–84.
(2012). Suicide methods in Asia: Implications in suicide prevention. International Journal of Environmental Research and Public Health, 9, 1135–1158.
(2009). Clinical characteristics, precipitating stressors, and correlates of lethality among suicide attempters. Chang Gung Medical Journal, 32, 543–552.
(2012). A decompositional analysis of the relative contribution of age, sex and methods of suicide to the changing patterns of suicide in Taipei City, 2004–2006. Injury Prevention, 18, 187–192.
(2010). Restricting the means of suicide by charcoal burning. British Journal of Psychiatry, 196, 241–242.
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