title: Suicide among children and adolescents in Canada: trends and sex differences, 1980-2008.
abstract: BACKGROUND
  Suicide is the second leading cause of death for young Canadians (10-19 years of age)--a disturbing trend that has shown little improvement in recent years. Our objective was to examine suicide trends among Canadian children and adolescents.
  
  
  METHODS
  We conducted a retrospective analysis of standardized suicide rates using Statistics Canada mortality data for the period spanning from 1980 to 2008. We analyzed the data by sex and by suicide method over time for two age groups: 10-14 year olds (children) and 15-19 year olds (adolescents). We quantified annual trends by calculating the average annual percent change (AAPC).
  
  
  RESULTS
  We found an average annual decrease of 1.0% (95% confidence interval [CI] -1.5 to -0.4) in the suicide rate for children and adolescents, but stratification by age and sex showed significant variation. We saw an increase in suicide by suffocation among female children (AAPC = 8.1%, 95% CI 6.0 to 10.4) and adolescents (AAPC = 8.0%, 95% CI 6.2 to 9.8). In addition, we noted a decrease in suicides involving poisoning and firearms during the study period.
  
  
  CONCLUSIONS
  Our results show that suicide rates in Canada are increasing among female children and adolescents and decreasing among male children and adolescents. Limiting access to lethal means has some potential to mitigate risk. However, suffocation, which has become the predominant method for committing suicide for these age groups, is not amenable to this type of primary prevention.
authors.affiliation: Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ont. robin.skinner@phac-aspc.gc.ca
authors.forename: Robin
authors.initials: R
authors.lastname: Skinner
authors.forename: Steven
authors.initials: S
authors.lastname: McFaull
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002170:Canada / Q000453:epidemiology; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D013405:Suicide / Q000639:trends*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult