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      Worldwide trends in suicide mortality, 1955-1989.

      Acta Psychiatrica Scandinavica

      Adult, Africa, epidemiology, Age Factors, Asia, Australia, Canada, Cross-Cultural Comparison, Europe, Female, Humans, Male, Medical Records, Middle Aged, New Zealand, Retrospective Studies, Sex Factors, South America, Suicide, statistics & numerical data, United States

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          Abstract

          Patterns and trends in suicide mortality for the period 1955-89 for 57 countries (28 from Europe, the former Soviet Union, Canada, the United States, 14 Latin American countries, 8 from Asia and 2 from Africa, Australia and Oceania) were analyzed on the basis of official death certification data included in the World Health Organization mortality database. Over the most recent calendar quinquennium (1985-1989), Hungary had the highest rate for men (52.1 per 100,000, all ages, world standard), followed by Sri Lanka (49.6), Finland (37.2) and a number of central European countries. North American, Japan, Australia and New Zealand and several European countries had intermediate suicide rates (between 15 and 25 per 100,000), whereas overall mortality from suicide was low in the United Kingdom, southern Europe, Latin America and reporting countries and areas from Africa and Asia, except Japan, Singapore and Hong Kong. The pattern for women was similar, although the absolute values were considerably lower. The highest values were in Sri Lanka (19.0 per 100,000), followed by Hungary (17.6) and several other central European countries, with rates between 9 and 15 per 100,000. Female suicide rates were comparatively elevated in Japan, Hong Kong, Singapore and Cuba. With respect to trends over time, the figures were relatively favourable in less developed areas of the world, including Latin America and several countries from Asia, with the major exception of Sri Lanka. Of concern are, in contrast, the upward trends, particularly for elderly men in Canada, the United States, Australia and New Zealand and, mostly, the substantial rises over most recent decades of suicide rates in young cohorts of males in Japan and several European countries, Australia and New Zealand. These trends were often in contrast with more favourable patterns in women, and can be discussed in terms of ethnic, cultural and socioeconomic factors, aspects of psychiatric care or availability of instruments and methods of suicide.

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          Most cited references 8

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          Suicide and unemployment in Australia 1907-1990.

          Ever since Durkheim postulated a relationship between economic change and suicide there has been evidence of a general association between aggregate data on unemployment and the frequency of suicide. Quantitatively, however, the association has been variable and it is clear that due to differing cultural, social and individual determinants of suicide, the relationship is complex. Methodological difficulties abound with interpretation of aggregate data. Australian records for most of the present century are suitable for examining secular trends in suicide and unemployment by age group and gender to gain an indication of the extent to which both parameters may be causally related. An aggregate/ecological study was designed to incorporate quantitative and qualitative strategies. Annual age-adjusted male and female suicide rates and annual unemployment rates were derived for the period 1907-1990. Female suicide rates were generally stable throughout the period, whereas those for males demonstrated sharp fluctuations with the peaks coinciding with times of high unemployment. The association between suicide and unemployment for 15-24 year old males was comparatively high for the recent period, 1966-1990. The increasingly youthful contribution to male suicide was demonstrated by a rise in the loss of life years during 1973-1984. Despite the inability of any investigation based on aggregate data to establish an unequivocable causal relationship, no evidence was detected to suggest that relatively high population levels of unemployment were not related to the occurrence of suicide.
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            The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study.

            The presence of guns in the home, the type of gun, and the method of storage were all hypothesized to be associated with risk for adolescent suicide. Case-control study. The case group consisted of 47 adolescent suicide victims. The two psychiatric inpatient control groups were 47 suicide attempters and 47 never-suicidal psychiatric controls, frequency-matched to the suicide victims on age, gender, and county of origin. The cases were a consecutive community sample, whereas the inpatients were drawn from a university psychiatric hospital. Odds of the presence of guns in the home of suicide victims (cases) relative to controls. Guns were twice as likely to be found in the homes of suicide victims as in the homes of attempters (adjusted odds ratio, 2.1; 95% confidence interval, 1.2 to 3.7) or psychiatric controls (adjusted odds ratio, 2.2; 95% confidence interval, 1.4 to 3.5). Handguns were not associated with suicide to any statistically significantly greater extent than long guns. There was no difference in the methods of storage of firearms among the three groups, so that even guns stored locked, or separate from ammunition, were associated with suicide by firearms. The availability of guns in the home, independent of firearms type or method of storage, appears to increase the risk for suicide among adolescents. Physicians should make a clear and firm recommendation that firearms be removed from the homes of adolescents judged to be at suicidal risk.
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              Suicide and unemployment in Italy: Description, analysis and interpretation of recent trends

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