Suicide epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Studies show a high incidence of psychiatric disorders in suicide victims at the time of their death with the total figure ranging from 98% to 87.3% with mood disorders and substance abuse being the two most common. In schizophrenia suicide can be triggered by either the depression that is common with this disorder, or in response to command auditory hallucinations. Suicide among people suffering from bipolar disorder is often an impulse, which is due to the sufferer's extreme mood swings (one of the main symptoms of bipolar disorder), or also possibly an outcome of delusions occurring during an episode of mania or psychotic depression. Severe depression is considered a terminal illness due to the likelihood of suicide when left untreated.

Epidemiology and Demographics

According to official statistics, about a million people die by suicide annually, more than those murdered or killed in war. According to 2005 data, suicides in the U.S. outnumber homicides by nearly 2 to 1 and ranks as the 11th leading cause of death in the country, ahead of liver disease and Parkinson's disease.

Gender and suicide: In the Western world, males die much more often by means of suicide than do females, although females attempt suicide more often. This pattern has held for at least a century. Some medical professionals believe this stems from the fact that males are more likely to end their lives through effective violent means (guns, knives, hanging, etc.), while women primarily use more failure-prone methods such as overdosing on medications; again, this has been the case for at least a century.

Others ascribe the difference to inherent differences in male/female psychology. Greater social stigma against male depression and a lack of social networks of support and help with depression are often identified as key reasons for men's disproportionately higher level of suicides, since suicide as a "cry for help" is not seen by men as an equally viable option. Typically males die from suicide three to four times more often as females, and not unusually five or more times as often.

Excess male mortality from suicide is also evident from data from non-western countries. In 1979–81, 74 territories reported one or more cases of suicides. Two of these reported equal rates for both sexes: Seychelles and Kenya. Three territories reported female rates exceeding male rates: Papua New Guinea, Macau, French Guiana. The remaining 69 territories had male suicide rates greater than female suicide rates.

Barraclough found that the female rates of those aged 5–14 equaled or exceeded the male rates only in 14 countries, mainly in South America and Asia.

National suicide rates sometimes tend to remain stable. For example, the 1975 rates for Australia, Denmark, England, France, Norway, and Switzerland were within 3.0 per 100,000 of population from the 1875 rates. The rates in 1910–14 and in 1960 differed less than 2.5 per 100,000 of the population in Australia, Belgium, Denmark, England and Wales, Ireland, Japan, New Zealand, Norway, Scotland, South Africa, Spain, Sweden, and the Netherlands.

Suicides per 100,000 people per year

Rank	Country	Males	Females	Total	Year
1	Lithuania	70.1	14.0	40.2	2004
2	Belarus	63.3	10.3	35.1	2003
3	Russia	61.6	10.7	34.3	2004
4	Kazakhstan	51.0	8.9	29.2	2003
5	Hungary	44.9	12.0	27.7	2003
6	Guyana	42.5	12.1	27.2	2003
7	South Korea	N/A	N/A	26.1	2005
8	Slovenia	37.9	13.9	25.6	2004
9	Latvia	42.9	8.5	24.3	2004
10	Japan	35.6	12.8	24.0	2004

There are considerable differences in national suicide rates among various countries. Findings from two studies showed a range from 0 to more than 40 suicides per 100,000 of population.

National suicide rates, apparently universally, show a long-term upward trend. This trend has been well-documented in European countries. The trend for national suicide rates to rise slowly over time might be an indirect result of the gradual reduction in deaths from other causes, i.e. falling death rates from causes other than suicide uncover a previously hidden predisposition towards suicide. There may also be an explanation in the reduced stigma attached to survivors as suicide is no longer considered a crime or a sin. This may allow coroners to record more suicides as such and so increase stats.

Ethnic groups and suicide: In the USA, Asian-Americans are more likely to die by suicide than any other ethnic group. Caucasians die by suicide more often than African Americans do. This is true for both genders. Non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or Hispanics.

Age and suicide: In the USA, males over the age of seventy die by suicide more often than younger males. There is no such trend for females. Older non-Hispanic Caucasian men are much more likely to kill themselves than older men or women of any other group, which contributes to the relatively high suicide rate among Caucasians.

Season and suicide: People die by suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception. There is also potential risk of suicide in some people experiencing Seasonal affective disorder.