Violent deaths among the young: recent trends in suicide, homicide, and accidents.

Violent deaths (suicide, homicide, and accidents) are the leading cause of death in people aged 1--39 in the United States. All three types of violent death may represent suicidal tendencies. Among early (10--14 years), middle (15--19), and late (20--24) adolescents, suicide and homicide rates increased with age and have doubled from 1961 to 1975. Accident rates increased with age but have changed little over the 15-year period. Suicide, homicide, and accidents increased dramatically between the 10--14-year-old age group and the 15--19-year-old age group; suicide and homicide rates were remarkably parallel over time; and suicide rates among young white people were higher and increased more than those among young nonwhite people.     

Relationship between suicide, homicide and accidental deaths among the aged in Finland in 1951-1979

Time trends for suicide, homicide and accident mortality among the Finnish population 65 years or over in 1951-1979 are presented. From 1951 to 1967 suicide, motor-vehicle accident mortality and overall accident mortality among elderly males tended to follow more or less similar patterns. In 1951-1979 male suicide rates correlated positively and significantly over time with male motor-vehicle accident mortality and with male total accident mortality. The results from this mortality analysis in the elderly population are compared with those obtained by Holinger et al. in the total population. There is also a brief discussion of the methodological problems of the study. The results suggest that self-destructive tendencies are not a central variable in female accident mortality among the aged population. On the other hand, it is possible that they play some role in motor-vehicle accident mortality in the aged male population. No suggestions about self-destructive tendencies in homicides among the aged could be made.     

The impact of the economy on suicide and homicide rates in Japan and the United States.

A time series study of socioeconomic correlates of suicide and homicide in Japan and the USA from 1953 to 1982 revealed cross-national differences. Divorce rates were positively associated with rates of personal violence in the USA but negatively associated with these rates in Japan. Unemployment and female labor force participation also correlated differently with rates of personal violence in the two nations suggesting that different theories may be necessary to account for the variation in rates of personal violence in different societies.     

Who kills whom in Portugal?

To clarify the relationship between people who have committed homicide and been convicted (murderers) and homicide victims, and between murderers and suicide victims, their profiles were compared in Portugal from 1970 to 1987. Correlations were found between the age group, marital status and occupation of murderers and homicide victims. Murderers and suicide victims were only correlated by occupation. Since 1983, there has been a trend towards an increasing prevalence of murderers among younger people and single people, and of homicide victims among older people. The correlation between murderers and suicide victims can be explained by alcoholism, and murderers tend to kill their relatives and peers as a result of conflict situations. The emerging trend towards young people murdering old and defenceless people points towards a colder and financially motivated killer, perhaps increasingly among young drug addicts.     

Suicide Trends in Singapore: 1955–2004

The objective of this study was to investigate suicide trends in Singapore between 1955 and 2004. Suicide cases were identified from the Registry of Birth and Death, Singapore, and analyzed using Poisson regression. Overall, suicide rates in Singapore remained stable between 9.8–13.0/100,000 over the last 5 decades. Rates remain highest in elderly males, despite declines among the elderly and middle-aged males in recent years. Rates in ethnic Chinese and Indians were consistently higher than in Malays. While the rates among female Indians and Chinese have declined significantly between 1995 and 2004, some increase was noted in female Malays. Although there was no increase in overall suicide rates, risk within certain population segments has changed over time.     

Epidemiology of suicide in the elderly population in Italy: 1958-1988

In this study we analyzed suicide rates. based on official ISTAT data published in the Health Statistics Year Book, relating to the Italian population aged over sixty-five, divided up into groups of five years, from 1958 to 1988. We calculated the rates of death by suicide (per 100,000 subjects) for each year and then. standardizing by sex, the mortality rates relative to each method of suicide for the overall population over sixty-five. Analysis of the results obtained shows that there was an increase in the suicide phenomenon in the elderly population in Italy over the tested period. The rates are at least three times higher in men than in women. The highest rates are reported for elderly men, but it seems that there has been a greater proportional increase with regard to the number of suicides committed by elderly women. The increase was statistically significant in both sexes (men: 0.81. p < 0.001, women: 0.85. p < 0.001). Over the thirty year study period, substantial changes have come about in the suicide methods used by old people. There seems to be an increase in poisoning by car exhaustion gases, poisoning by solid or liquid substances, jumping from heights. hanging, and the use of firearms. Apart from our prediction for the next twenty years (we calculated an increase of about 26.8%), it seems that suicidal behaviour is indeed on the increase among the elderly.     

Effects of age and gender on elderly suicide rates in Catholic and Orthodox countries: an inadvertent neglect?

When compared to suicide rates in the general population, it may be expected that elderly suicide rates would be lower in Catholic and Orthodox societies than in non-Catholic or non-Orthodox countries because of religious affiliations and extended family traditions. National suicide rates in the general population were compared with rates in the sub-population of those aged over 75 years. Proportionately, there are significantly higher suicide rates in elderly men in Catholic and Orthodox countries, compared to rates in other countries, with a trend for similar findings among women. There may be important implications on health and social policy and clinical practice in the efforts to reduce suicide rates among elderly people.     

Suicide, homicide and the quality of life in various countries

Based on the theory of Henry & Short, it was predicted that suicide rates should be higher and homicide rates lower in countries where the quality of life is better. In 1980, for a sample of 43 countries, this prediction was confirmed for some components of the quality of life (psychological well-being) but not for other components (political stability, defense and economy, and cultural diversity). However, changes in the quality of life from 1970 to 1980 were not related to changes in suicide or homicide rates.     

Suicide and the continental divide

Cross-cultural research is one avenue for investigating suicide. with Canada and the United States being obvious units for comparison. Studies of rates and patterns. homicide and suicide, facts and myths, psychological aspects. psychopathology, attitudes towards suicide and domestic and economic variables are reported. It is concluded that Canada has a higher rate and different pattern of suicide than the United States. Although there may be numerous similarities (e.g., psychological aspects. psychopathology), differences were noted in the relation between homicide and suicide, the attitudes toward suicide (e.g., Canadian young people, Canada's highest at risk group, see suicide as more normal and as an acceptable solution to issues than their American counterparts), and domestic stress, i.e., marriage. A historical explanation is provided as an avenue to understand these cultural differences in suicide.     

Comparison of suicide in people aged 65-74 and 75+ by gender in England and Wales and the major Western countries 1979-1999

BACKGROUND: The factors most strongly associated with suicide are age and gender--more men than women, and, more people over 65 kill themselves. As a number of Governments have targets to reduce suicide levels we compare elderly suicide rates over a 20-year period in England and Wales. And the major Western countries focusing upon age and gender. METHOD: WHO mortality data were used to calculate three-year average General Population Suicide Rates (GPSR) for 1979-1981 to 1997-1999 and rates of people aged 65-74 and 75+ suicide by gender to provide ratios of change and a statistical comparison of England and Wales and the Major Western countries over the period. RESULTS: Male GSPR: '65-74' suicide ratios fell significantly in six countries and in three for the '75+'. Female GSPR: '65-74' suicide ratios fell in every country except Spain. Proportionately, there were more suicides in the over 65s in countries with an 'extended family' tradition, Spain, Italy, Germany, France and Japan, than in the five 'secular' countries. England and Wales male '65-74' suicide fell significantly more than Canada, France, Germany, Italy, Japan, Spain, Netherlands and the USA, and did significantly better than the other countries for all female senior citizen suicides. CONCLUSION: Suicide of the over-65s has improved in seven countries, especially in England and Wales, who had the greatest proportional reduction, which reflects well upon the psycho-geriatric and community services. However, in all countries, male 65-74 rates did not match the female out so extra efforts are needed to improve male rates.     

A regional analysis of suicide and homicide rates in the USA: Search for broad cultural patterns

Summary A number of recent studies have explored correlates of suicide rates (and less often homicide rates) over the continental states of the USA. Each study typically selects one variable as the focus. The present study sought to explore the relationship between rates of personal violence and all of the socioeconomic variables utilized in previous research. Suicide rates and homicide rates were found to have very different correlates. Suicide rates varied most strongly with social instability, while homicide rates varied most strongly with a southern subculture.     

Suicide in the elderly in Kaniyambadi block, Tamil Nadu, South India

BACKGROUND: Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles in investigating suicide in the developing world. Very high rates of suicide have been recorded in the region in the general population and among younger people. OBJECTIVE: This paper describes the suicide rate among the elderly in Kaniyambadi block, Tamil Nadu, South India for the years 1994-2002 using verbal autopsies. METHOD: The setting for the study was a comprehensive community health program in a development block in rural South India. The main outcome measure was death by suicide diagnosed by a detailed verbal autopsy and census, birth and death data to identify the population base. RESULTS: The average annual suicide rate was 189 per 100,000 for people over 55 years of age. The ratio of male to female suicides was 1: 0.66. The age-specific suicide rate for men and women increased with age. Hanging (52%) and poisoning with organo-phosphorus compounds (39%) were the commonest methods employed for committing suicide. Significantly more women chose drowning or burning than men who preferred poisoning or hanging (chi2 19.75; df 1; p < 0.001). CONCLUSIONS: The suicide rate documented in this study among the elderly is very high. The reasons for the high suicide rate observed in older people are not known. There is a need to develop innovative strategies to reduce deaths by suicide.     

Elderly suicide rates in Asian and English-speaking countries

OBJECTIVE: Asian culture venerates elderly people. It was hypothesized that elderly suicides would be proportionately lower in Asian societies than in English-speaking countries (ESC). METHOD: Elderly (i.e. aged 75 years or more) to general population suicide ratios were compared for six Asian societies and six ESC, based upon the latest 5-year suicide rates. RESULTS: Males: The general population suicide rate was highest in rural China (227 per million) and third highest in Japan (217 per million), but other countries with high rates were all ESC (ranging from 224 to 198 per million). Asian countries had the six highest elderly suicide rates, 1327-1373 per million, whilst the highest ESC elderly rate was in the United States (507 per million). Asian societies had the widest range of elderly/general ratios, ranging from 6.62 to 2.6. Females: The overall suicide rates were higher in Asian countries (57-95 per million) than in ESC (40-56 per million). Asian elderly suicide rates differed (932 per million in rural China to 154 per million in Korea) but the highest ESC rate was in Australia (76 per million). The Asian countries elderly/general ratios ranged from 5.82 : 1 to 2.70 : 1, but the widest ESC ratio was 1.71 : 1, in the United Kingdom. CONCLUSION: There is a need for country-specific prevention measures in elderly people, and particularly for older women in Asian countries.     

Psychiatric illness in homicide victims.

The authors studied the demographic characteristics and history of psychiatric treatment of 214 homicide victims and 67 suicide victims. Thirty-two (15%) of the homicide victims and 12 (18%) of the suicide victims had a record of psychiatric care; these rates were higher than the treatment rate of the general population. The authors suggest that there may be a connection between the occurrence of homicide and the increased frequency of psychiatric disorders among victims of this crime.     

Trends in Attempted Suicide in Adolescents and Young Adults in Gent, 1986–1995

This paper describes gender-specific trends in the occurrence and methods of attempted suicide in adolescents and young adults between 1986 and 1995 in Gent. The overall pattern emerging from this study is that following a decrease in the rates of attempted suicide in the second half of the 1980s, rates have clearly increased in the 1990s, especially among adolescent males. A slight predominance of female attempters was found in the 15 to 19 age group while among young adults the female to male ratio was approximately 1.0. Deliberate self-poisoning was involved in the vast majority of attempts, although among young adults significantly more males than females used deliberate self-injury to attempt suicide. In view of increasing rates of suicide among young people in many countries and of the association between attempted suicide and suicide, further study of trends and characteristics of attempted suicide among young people is warranted.     

The truth about suicide in Portugal

It seems odd that male suicide rates have decreased in Portugal over the last few years, whereas the opposite has happened in most other countries. In order to investigate the reasons for such a decrease, suicide rates were compared with controversial cases (ICD-9 category E 980-989) and with homicide rates. The results show that, since 1980 and coinciding with the use of ICD-9, controversial cases have increased 12 and 21 times among males and females respectively. The profile of controversial cases is similar to that of suicide according to sex, age, marital status and season. Rates for homicide have remained steady and have a distinct profile. It is concluded that since 1980 there has been a significant underreporting of suicides in Portugal, which have been registered as controversial cases. The difficulty of investigating and preventing suicide with such statistical data is stressed; an improvement in suicide reporting and registering is urgently required.     

Overview of community-based studies of depression screening interventions among the elderly population in Japan

Objectives: In most Western and Asian countries, a higher risk of suicide is found among elderly people than those in other age groups. However, the treatment needs of elderly people who are at risk of committing suicide are not well understood. We conducted an overview of studies that assessed the impact of suicide prevention interventions on suicide rates in elderly people in Japan. We interpreted the results of these studies, as well as prominent findings associated with other successful interventions, within a framework of the suicidal process and preventive strategies.

Method: We assessed six quasi-experimental studies of community-based interventions providing universal depression screening, subsequent care, and education to elderly people in Japan, and performed a combined analysis of outcome data.

Results: Screening interventions were associated with lower suicide rates. We also found a gender difference in the response to subsequent psychiatric or primary care. Two types of interventions decreased the rate of suicide among elderly people: crisis helplines and screening interventions. These interventions featured a close link between universal, selective, and indicated prevention strategies, which reflect different approaches tailored to the size and risk profile of the target individuals.

Conclusion: Successful interventions appear to hinge on systematic links between multi-level prevention interventions. Multi-level interventions for depression screening may result in lower suicide rates among elderly individuals in communities, although primary care interventions alone appear to be insufficient in men. The benefit of linked multi-level prevention interventions may highlight the importance of the multiple steps and components of the suicidal process.     

Recent trends in elderly suicide rates in England and Wales

The proportion of elderly in the population is increasing due to increased life expectancy and falling birth rate, and suicide rates increase with age. This study examined the following in England and Wales: (i) recent trends in the elderly suicide rate; (ii) recent trends in method-specific elderly suicide rate; (iii) the relationship between elderly population size and elderly suicide rate in recent years; and (iv) the sex difference in overall and method-specific elderly suicide rate. Data on the various suicide variables were ascertained from the annually published mortality data for years 1985 to 1996. The main findings of this study were: (i) there is a trend towards decline in the overall pure and combined suicide rates for elderly men and women over the 12 year study period; (ii) the main contributors to this decline are suicides due to poisoning by solid and liquid substances (E950), hanging, strangulation and suffocation (E953), drowning (E954), firearms and explosives (E955), and jumping from high places (E957); (iii) the overall pure and combined suicide rates and that for most categories of suicide was higher in men compared to women; and (iv) suicide rates decreased with an increase in the elderly population size. Suicide rates can decline due to a number of reasons. The challenge now is to ensure further decline in suicide rates to meet the Our Healthier Nations target.     

The relationship between divorce, unemployment and female participation in the labour force and suicide rates in Australia and America.

Identical data sets for Australia and the USA from 1946 to 1984 were analysed to explore the association of unemployment rates, female participation in the labour force and divorce with suicide rates. While female participation in the labour force was related to suicide rates in Australia, unemployment was not. For the USA, both female participation in the labour force and unemployment were related to suicide rates.     

One hundred years of suicide in New Zealand

Suicide rates were obtained for New Zealand from 1889 to 1988. The overall rate for women has been stable since the 1930s, and the male rate showed marked peaks in the early 1930s and in the 1980s. Analysis of rates by age group revealed that the 1930 male peak was due to increases among the middle-aged and elderly men, and the current peak is due to increases among young men. Possible explanations for fluctuations in suicide rates over the last century are discussed.