Changes in Scottish suicide rates during the Second World War.
BACKGROUND
It is believed that total reported suicide rates tend to decrease during wartime. However, analysis of suicide rates during recent conflicts suggests a more complex picture, with increases in some age groups and changes in method choice. As few age and gender specific analyses of more distant conflicts have been conducted, it is not clear if these findings reflect a change in the epidemiology of suicide in wartime. Therefore, we examined suicide rates in Scotland before, during and after the Second World War to see if similar features were present.


METHODS
Data on deaths in Scotland recorded as suicide during the period 1931-1952, and population estimates for each of these years, were obtained from the General Register Office for Scotland. Using computer spreadsheets, suicide rates by gender, age and method were calculated. Forward stepwise logistic regression was used to assess the effect of gender, war and year on suicide rates using SAS V8.2.


RESULTS
The all-age suicide rate among both men and women declined during the period studied. However, when this long-term decline is taken into account, the likelihood of suicide during the Second World War was higher than during both the pre-War and post-War periods. Suicide rates among men aged 15-24 years rose during the Second World War, peaking at 148 per million (41 deaths) during 1942 before declining to 39 per million (10 deaths) by 1945, while the rate among men aged 25-34 years reached 199 per million (43 deaths) during 1943 before falling to 66 per million (23 deaths) by 1946. This was accompanied by an increase in male suicides attributable to firearms and explosives during the War years which decreased following its conclusion.


CONCLUSIONS
All age male and female suicide rates decreased in Scotland during World War II. However, once the general background decrease in suicide rates over the whole period is accounted for, the likelihood of suicide among the entire Scottish population during the Second World War was elevated. The overall decrease in suicide rates concealed large increases in younger male age groups during the War years, and an increase in male suicides recorded as due to the use of firearms. We conclude that the effects of war on younger people, reported in recent conflicts in Central Europe, were also seen in Scotland during the Second World War. The results support the findings of studies of recent conflicts which have found a heterogeneous picture with respect to age specific suicide rates during wartime.
Henderson
Rob
R
NHS Highland, Department of Public Health, Assynt House, Beechwood Park, Inverness, IV2 3HG, Scotland, UK. robert.henderson@hhb.scot.nhs.uk
Stark
Cameron
C
Humphry
Roger W
RW
Selvaraj
Sivasubramaniam
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002423:Cause of Death / Q000639:trends; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data / Q000639:trends*; D047789:World War II