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      Methods of suicide: international suicide patterns derived from the WHO mortality database Translated title: Métodos de suicidio: comparación internacional a partir de la base de datos de mortalidad de la OMS Translated title: Méthodes de suicide: détermination de schémas internationaux de suicide à partir de la base de données de mortalité de l'OMS

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          Abstract

          OBJECTIVE: Accurate information about preferred suicide methods is important for devising strategies and programmes for suicide prevention. Our knowledge of the methods used and their variation across countries and world regions is still limited. The aim of this study was to provide the first comprehensive overview of international patterns of suicide methods. METHODS: Data encoded according to the International Classification of Diseases (10th revision) were derived from the WHO mortality database. The classification was used to differentiate suicide methods. Correspondence analysis was used to identify typical patterns of suicide methods in different countries by providing a summary of cross-tabulated data. FINDINGS: Poisoning by pesticide was common in many Asian countries and in Latin America; poisoning by drugs was common in both Nordic countries and the United Kingdom. Hanging was the preferred method of suicide in eastern Europe, as was firearm suicide in the United States and jumping from a high place in cities and urban societies such as Hong Kong Special Administrative Region, China. Correspondence analysis demonstrated a polarization between pesticide suicide and firearm suicide at the expense of traditional methods, such as hanging and jumping from a high place, which lay in between. CONCLUSION: This analysis showed that pesticide suicide and firearm suicide replaced traditional methods in many countries. The observed suicide pattern depended upon the availability of the methods used, in particular the availability of technical means. The present evidence indicates that restricting access to the means of suicide is more urgent and more technically feasible than ever.

          Translated abstract

          OBJETIVO: La disponibilidad de información precisa sobre los métodos de suicidio más frecuentes es importante para idear estrategias y programas de prevención del mismo. Nuestros conocimientos sobre los métodos empleados y las diferencias entre países y regiones mundiales siguen siendo limitados. La finalidad de este estudio fue trazar el primer panorama general de los perfiles de métodos de suicidio en el plano internacional. MÉTODOS: A partir de la base de datos de mortalidad de la OMS se obtuvieron datos codificados de acuerdo con la Clasificación Internacional de Enfermedades (10ª revisión). Dicha clasificación se utilizó para diferenciar los métodos de suicidio. Se empleó el método de análisis de correspondencias para determinar los perfiles de los métodos de suicidio en los diferentes países mediante un resumen de los datos de tabulación cruzada. RESULTADOS: Se observó que el envenenamiento por plaguicidas era frecuente en muchos países asiáticos y en América Latina, mientras que la intoxicación medicamentosa era frecuente en los países nórdicos y en el Reino Unido. El ahorcamiento era el método de suicidio preferido en Europa oriental, al igual que las armas de fuego en los Estados Unidos y el salto al vacío en ciudades y sociedades urbanas como la Región Administrativa Especial de Hong Kong, China. El análisis de correspondencias reveló una polarización entre el suicidio con plaguicidas y el suicidio por arma de fuego, situándose entre ambos y en retroceso los métodos tradicionales, como el ahorcamiento y el salto al vacío. CONCLUSÍON: Este análisis muestra que el suicidio con plaguicidas y el suicidio por arma de fuego tienden a reemplazar a los métodos tradicionales en muchos países. El perfil de métodos de suicidio depende de la disponibilidad de los métodos empleados, en particular de la disponibilidad de medios técnicos. La evidencia aquí aportada indica que la restricción del acceso a los medios de suicidio es más urgente y técnicamente viable que nunca.

          Translated abstract

          OBJECTIF: Il importe de disposer d'informations précises sur les méthodes de suicide préférentiellement appliquées pour concevoir des stratégies et des programmes de prévention du suicide. Nos connaissances sur les méthodes utilisées et sur leurs variations d'un pays ou d'une région du monde à l'autre sont encore limitées. Cette étude a pour objectif de fournir un panorama complet des schémas internationaux de méthodes de suicide. MÉTHODES: Des données, encodées selon la Classification internationale des maladies (10e révision), ont été tirées de la base de données de mortalité de l'OMS. Cette classification a servi à différencier les méthodes de suicide. L'analyse de correspondance a été utilisée pour identifier les schémas typiques de méthodes de suicide dans les différents pays, en fournissant un résumé des données tabulées. RÉSULTATS: L'empoisonnement par un pesticide est courant dans de nombreux pays d'Asie et en Amérique latine, tandis que l'empoisonnement médicamenteux est fréquent dans les pays nordiques et au Royaume-Uni. La méthode de suicide privilégiée est la pendaison en Europe de l'Est, le recours à une arme à feu aux États-Unis d'Amérique et le saut d'un endroit élevé dans les grandes villes et dans les sociétés urbaines comme la Région administrative spéciale de Hong-Kong, en Chine. L'analyse de correspondance a mis en évidence une polarisation entre le suicide au pesticide et le suicide par arme à feu, aux dépens des méthodes traditionnelles telles que la pendaison et le saut d'un endroit élevé, qui se situent entre les deux. CONCLUSION: L'analyse montre que le suicide au pesticide et le suicide par arme à feu ont remplacé les méthodes traditionnelles dans de nombreux pays. Le schéma de suicide observé dépend de la disponibilité des méthodes utilisées et notamment des moyens techniques de suicide. Ces éléments montrent que restreindre l'accès aux moyens de suicide est plus urgent et plus faisable techniquement que jamais.

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          Most cited references59

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          Self poisoning with pesticides.

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            Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries.

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              Patterns and problems of deliberate self-poisoning in the developing world.

              Deliberate self-harm is a major problem in the developing world, responsible for around 600 000 deaths in 1990. The toxicity of available poisons and paucity of medical services ensure that mortality from self-poisoning is far greater in the tropics than in the industrialized world. Few data are available on the poisons most commonly used for self-harm in different parts of the world. This paper reviews the literature on poisoning, to identify the important poisons used for self-harm in these regions. Pesticides are the most important poison throughout the tropics, being both common and associated with a high mortality rate. In some regions, particular pesticides have become the most popular method of self-harm, gaining a notoriety amongst both health-care workers and public. Self-poisoning with medicines such as benzodiazepines and antidepressants is common in urban areas, but associated with few deaths. The antimalarial chloroquine appears the most significant medicine, self-poisoning being common in both Africa and the Pacific region, and often fatal. Paracetamol (acetaminophen) is used in many countries but in few has it reached the popularity typical of the UK. Domestic and industrial chemicals are responsible for significant numbers of deaths and long-term disabilities world-wide. Self-poisoning with plant parts, although uncommon globally, is locally popular in some regions. Few of these poisons have specific antidotes. This emphasizes the importance of determining whether interventions aimed at reducing poison absorption actually produce a clinical benefit, reducing death and complication rates. Future research to improve medical management and find effective ways of reducing the incidence of self-harm, together with more widespread provision of interventions proven to be effective, could rapidly reduce the number of deaths from self-poisoning in the developing world.
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                Author and article information

                Journal
                bwho
                Bulletin of the World Health Organization
                Bull World Health Organ
                World Health Organization (Genebra, Genebra, Switzerland )
                0042-9686
                September 2008
                : 86
                : 9
                : 726-732
                Affiliations
                [01] Zurich orgnamePsychiatric University Hospital Switzerland
                [03] Baden orgnamePsychiatric Services of the Canton of Aargau Switzerland
                [04] Zurich orgnameUniversity of Zurich orgdiv1Institute of Social and Preventive Medicine Switzerland
                [02] Basel orgnameSwiss Tropical Institute Switzerland
                Article
                S0042-96862008000900017 S0042-9686(08)08600917
                10.2471/BLT.07.043489
                18797649
                5f32c532-e5d1-4d9c-80d1-3b66f8980390

                History
                : 31 January 2008
                : 29 January 2008
                : 26 April 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 7
                Product

                SciELO Public Health

                Self URI: Full text available only in PDF format (EN)
                Categories
                Research

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