AN and BN share many risk factors for suicide: the factors causing lower suicide rates per person-year in BN compared to AN should be investigated.

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To verify if attempted suicides follow different seasonal distributions according to the method chosen, we studied the Italian monthly distribution of admissions for attempted suicide in the period 1984–1995 according to gender and age, distinguishing between non-violent (ICD 950–952) and violent (ICD 953–958) attempted suicides. The effect of temperature was also taken into account. A clear asymmetry in seasonal distribution of events can be observed in the oldest age groups in both genders, with a peak in warmer months. Only male attempted suicides by violent methods show a clear asymmetry in seasonal distribution, with a peak in spring months and a trough in autumn months. Spectral analysis, more accurate in detecting seasonal rhythms than analyses that only compare monthly seasonal means, identifies a circannual rhythm for violent suicides in both genders. The seasonal components of total variance in attempted suicides account for 16.5 and 12.4%, respectively, of violent male and female attempted suicides. Among males, a significant (p < 0.05) 4 cycles/year pattern is seen alongside the more relevant (89.4%, p < 0.01) 1 cycle/year distribution. Among females, aside from the 1 cycle/year distribution (63.3%, p < 0.01) noted, a 6 cycles/year pattern is found to contribute significantly (16.9%, p < 0.05) to the seasonal component of variance. A clear relationship with temperature indicators is noted among males: higher temperatures positively correlate with attempted suicides, whereas cooler temperatures seem to exert a protective action. Female attempts show a less evident correlation with indicators of temperature. Sample composition by age and gender and the lack of distinction between methods of attempted suicide may have obscured the seasonal component of some classes of attempted suicide in previous studies. The circannual rhythm found in this study of violent attempted suicide in relation to climate seasonal change confirms the importance of taking chronobiological variables into account in the evaluation of patients at risk of suicide.

Results-Suicide rates among the unemployed are clearly and constantly higher than those among the employed: up to three times higher among men, and twice as high among women. Among the unemployed a clear and significant rise in suicide rates in both sexes took place over the study period; suicide rates among the employed showed a less marked increase. The rise in suicide rates was accompanied by a concurrent rise in unemployment rate percentage. Men seem to be aVected most by this change in unemployment rate percentage; women are subject to less evident influences and variations. Conclusion-DiVerent suicidal behaviour trends among unemployed compared with employed people indicate that unemployment (and above all the prospect of not having access to a working role) acts as a contributing factor for suicide. Unemployment, even if symptomatic of a mental disorder, should therefore always be taken into consideration as a risk factor for suicide: the potentially lethal consequences of its negative influence on both self esteem and the ability to use supportive networks in a eYcient way is an element to which great attention should be paid. (J Epidemiol Community Health 1999;53:694-701) In Italy and in other Western countries there has been a progressive rise in suicide rates for both sexes over the past 20 years, especially among young people.

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In a mixed male-female sample of 1000 adolescents age 15 to 19 years in a northeastern area of Italy, we investigated the links between eating disorders and suicidal tendencies by means of self-compiled measures, including the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Test (BAT), and the SCL-90-R. More females than males reported abnormal eating patterns suggesting eating disorders: we found that 100 females (15.8%) and 8 males (2.8%) achieved scores above the suggested cutoff on EAT (cutoff = 30), 26 females (4.1%) and 1 male (.3%) achieved scores above the suggested cutoff on BITE (cutoff = 20), and 287 females (45.5%) and 24 males (8.6%) achieved scores above the suggested cutoff on BAT (cutoff = 36). More females than males also reported symptoms of hopelessness (44.3% vs. 30.5%) and suicidal ideation (30.8% vs. 25.3%). Both males and females reporting suicidal ideation achieved significantly higher scores on the eating disorders inventories, with no independent contribution by age, socioeconomic status, or body mass index. Although caution is required when drawing conclusions from self-reported measures, studies on mood disorders and suicidality in youth clearly need to include measures of eating disorders.