title: Time trends and geographical variations in mortality due to suicide and causes of undetermined intent in Spain, 1991-2008.
abstract: BACKGROUND
  This study analyses the trends, geographical variations, seasonal patterns and methods of mortality due to the combination of suicide and causes of undetermined intent in Spain between 1991 and 2008.
  
  
  METHODS
  Age-adjusted suicide rates were calculated. Poisson models were used to estimate rate ratios and annual percentage changes.
  
  
  RESULTS
  Suicide rates decreased in all age groups with the exception of the 35-44 and 45-54 age groups. There were important geographic variations in suicide rates. Spring and summer were the seasons with the highest suicide rates. Suicide rates for hanging decreased, although the rates increased in the 35-44 age group of males. A significant upward trend in suicide by jumping was observed for males aged 15-54 and for females aged 25-64. There were almost no differences when the deaths of undetermined intent were excluded.
  
  
  CONCLUSIONS
  Suicide rates decreased in both males and females, although the downward trend was not observed in males and females aged 35-44 or in females in the 45-54 age group. A significant upward trend in suicide rates for jumping was observed in some age groups. Substantial geographical variations in suicide rates were observed. The highest rates were observed in the warmest months.
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Salmerón
authors.forename: Lluís
authors.initials: L
authors.lastname: Cirera
authors.forename: Mónica
authors.initials: M
authors.lastname: Ballesta
authors.forename: Fernando
authors.initials: F
authors.lastname: Navarro-Mateu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012621:Seasons; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends
keywords: Spain; mortality; suicide; suicide methods; trend