Time trends in suicide mortality vary in choice of methods: an analysis of 145,865 fatal suicide cases in Germany 1991-2002.
BACKGROUND
Overall, decreasing suicide mortality rates were observed in the last decades in most Western populations. However, it remains unclear, whether these favourable trends occurred uniformly in particular suicide methods. Therefore, the present study evaluated time trends of suicide mortality by method in Germany over the period 1991-2002.


METHODS
A total of 145,865 fatal suicide cases of men and women aged >or=15 years and with available suicide method were recorded by the Federal Statistical Office of Germany (suicides coded "death following a suicide attempt" were excluded). Based on these data, seven different suicide methods were defined. Poisson regression was used to estimate the age-adjusted annual percentage change (AAPC) of the number of each suicide method.


RESULTS
The most frequently used suicide methods in both sexes were hanging, strangling or suffocation (HSS) with 55.8% in men and 39.9% in women, followed by self-poisoning. Statistically significant declines of the number of suicides were observed, in descending order, for self-poisoning, drowning and HSS in both sexes. In contrast, methods using firearm discharges or stab with a sharp object remained in roughly constant level. Modifications of time trends were observed for several methods by age classes.


CONCLUSIONS
The present study demonstrates different time trends for suicide methods. Further examinations are recommended in particular concerning possible reasons for the choice of a suicidal method.
Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany.
Jens
J
Baumert
Natalia
N
Erazo
Esther
E
Ruf
Karl-Heinz
KH
Ladwig
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D005389:Firearms; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D016012:Poisson Distribution; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends*; D014947:Wounds and Injuries / Q000145:classification / Q000401:mortality*; D055815:Young Adult