title: Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study.
abstract: OBJECTIVE
  To investigate the trends and correlations of gross domestic product (GDP) adjusted for purchasing power parity (PPP) per capita on suicide rates in 10 WHO regions during the past 30 years.
  
  
  METHODS
  Analyses of databases of PPP-adjusted GDP per capita and suicide rates. Countries were grouped according to the Global Burden of Disease regional classification system.
  
  
  METHODS
  World Bank's official website and WHO's mortality database.
  
  
  METHODS
  After graphically displaying PPP-adjusted GDP per capita and suicide rates, mixed effect models were used for representing and analysing clustered data.
  
  
  RESULTS
  Three different groups of countries, based on the correlation between the PPP-adjusted GDP per capita and suicide rates, are reported: (1) positive correlation: developing (lower middle and upper middle income) Latin-American and Caribbean countries, developing countries in the South East Asian Region including India, some countries in the Western Pacific Region (such as China and South Korea) and high-income Asian countries, including Japan; (2) negative correlation: high-income and developing European countries, Canada, Australia and New Zealand and (3) no correlation was found in an African country.
  
  
  CONCLUSIONS
  PPP-adjusted GDP per capita may offer a simple measure for designing the type of preventive interventions aimed at lowering suicide rates that can be used across countries. Public health interventions might be more suitable for developing countries. In high-income countries, however, preventive measures based on the medical model might prove more useful.
authors.affiliation: Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain.
authors.forename: Hilario
authors.initials: H
authors.lastname: Blasco-Fontecilla
authors.forename: M Mercedes
authors.initials: MM
authors.lastname: Perez-Rodriguez
authors.forename: Rebeca
authors.initials: R
authors.lastname: Garcia-Nieto
authors.forename: Pablo
authors.initials: P
authors.lastname: Fernandez-Navarro
authors.forename: Hanga
authors.initials: H
authors.lastname: Galfalvy
authors.forename: Jose
authors.initials: J
authors.lastname: de Leon
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-Garcia