title: Increased use of lethal methods and annual increase of suicide rates in Korean adolescents: comparison with adolescents in the United States.
abstract: BACKGROUND
  The lethality of the suicide method is a strong risk factor for completed suicide. We examined whether the annual change in the pattern of suicide methods was related to the annual change in suicide rates among adolescents in South Korea and the United States.
  
  
  METHODS
  We analyzed annual data for the 2000-2009 period for South Korea and the 2000-2008 period for the United States to examine time trends in the suicide rates and suicide methods of adolescents aged 10-19 years in two countries. Data on suicide methods were obtained from the World Health Organization (WHO) mortality database.
  
  
  RESULTS
  Suicide rates among adolescents in the United States have remained relatively steady since 2000, whereas the suicide among Korean adolescents has increased. Between 2000 and 2009, the most common suicide method among Korean adolescents was jumping for boys and girls, whereas it was hanging for girls and firearms for boys in the United States. Along with the annual increase in suicide rates in South Korea, the incidences of jumping among males and hanging (and recently jumping) among females have increased steadily, whereas suicide by self-poisoning steadily decreased. In the United States, between 2000 and 2008, the proportion of suicides committed by hanging increased, whereas those committed using firearms steadily decreased, particularly among adolescent females.
  
  
  CONCLUSIONS
  These findings suggest that the increased use of lethal suicide methods is reflected in the increase in suicide rates in Korean adolescents. The most fruitful approach to addressing the rises in jumping suicides among Korean adolescents and hanging suicides among adolescents in the United States may be through population-based initiatives to reduce the physical availability (e.g., limiting access to or fencing off tall structures) and the social acceptability (e.g., effective and responsible regulations for reporting suicide) of these methods.
authors.affiliation: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Subin
authors.initials: S
authors.lastname: Park
authors.forename: Soo-Churl
authors.initials: SC
authors.lastname: Cho
authors.forename: Bung-Nyun
authors.initials: BN
authors.lastname: Kim
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Jin Pyo
authors.initials: JP
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D000328:Adult; D002423:Cause of Death / Q000639:trends*; D002648:Child; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D008297:Male; D056910:Republic of Korea / Q000208:ethnology; D013405:Suicide / Q000208:ethnology* / Q000639:trends; D013997:Time Factors; D014481:United States / Q000208:ethnology; D055815:Young Adult
keywords: Adolescence; suicide