A community-based study of case fatality proportion among those who carry out suicide acts

Chen, Vincent Chin‐Hung; Cheng, Andrew T. A.; Tan, Happy Kuy‐Lok; Chen, Chung-Ying; Chen, Tony H. H.; Stewart, Robert; Prince, Martin

doi:10.1007/s00127-009-0021-9

Cited by 32 publications

(28 citation statements)

References 17 publications

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“…In most studies, male sex has been associated with higher mortality rates due to suicide,3,36 while female sex has been linked to a higher incidence of repeat suicide attempts 18. A discrepancy regarding the rate of repeat suicide attempts between sexes exists among previous international studies 22,37. Social environment and cultural differences might be important factors accounting for the conflicting results 38,39.…”

Section: Discussionmentioning

confidence: 99%

“…Following previous epidemiology research,20,22,26 individuals who attempted suicide were classified into two groups based on the lethality of their suicide method. The first, the low-lethal group, consisted of those who attempted suicide through poisoning by solid or liquid substances (E950) or used cutting and piercing instruments (E956).…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the method used during the first suicide attempt has been demonstrated to serve as an important predictor of completed subsequent attempts 20,21. Methods of suicide have been classified as low-lethal and high-lethal 22. Higher rates of suicide death are related to high-lethal suicide attempts, such as firearms and hanging, in Western countries, and charcoal burning or pesticides ingestion in Eastern countries 23,24.…”

Section: Introductionmentioning

confidence: 99%

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Methods of suicide predict the risks and method-switching of subsequent suicide attempts: a community cohort study in Taiwan

Huang¹,

Wu²,

Chen³

et al. 2014

NDT

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ObjectiveSuicide is a major public health concern. This study aimed to determine the predictors of repeated suicide attempts, focusing on whether lethality level of the suicidal method predicts the risk of subsequent suicide attempts.MethodsAll consecutive individuals (N=2,070) with an episode of nonfatal self-harm registered in a surveillance database provided by the Department of Health of Keelung City Government in Taiwan from January 1, 2006 to December 31, 2010 were enrolled and followed up until the end of 2011. The earliest attempt recorded in the database was defined as the index attempt. Subjects were classified according to suicide method into low-lethal and high-lethal groups. Data on time of and methods chosen for subsequent suicide attempts during the follow-up period were analyzed.ResultsOf the total people screened for the study, 18.1% made a repeated suicide attempt. Subjects in the high-lethal group were more likely to be male; aged 35–64 years; and single, divorced, or widowed. Compared to other time intervals, most subsequent suicide attempts occurred within 6 months from the index attempt. The independent predictors for repeated suicide attempts were the use of low-lethal methods in the index attempt and being 35–49 years old. Using high-lethal methods and being older than 50 years were associated with changing suicide method for the second attempt.ConclusionLethality level of former suicidal method could predict repeated suicide attempts and changing of suicide methods. Further clarification is needed on whether a higher risk of repeat attempts is associated with higher rates of suicide mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Methods of suicide predict the risks and method-switching of subsequent suicide attempts: a community cohort study in Taiwan

Huang¹,

Wu²,

Chen³

et al. 2014

NDT

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“…For geographic and demographic subgroups, the CFR is determined largely by the distribution of methods used in suicidal acts, rather than by marked variation in method-specific case fatality across subgroups (28,40,56,87,113). For example, compared with females, males are less likely to engage in suicidal behavior (and only slightly more likely to die by suicide when they use a given method), but three to four times more likely to die in a suicidal act because the methods that men use are far more lethal (56,87,113).…”

Section: Determinants Of the Case Fatality Ratiomentioning

confidence: 99%

Suicide Mortality in the United States: The Importance of Attending to Method in Understanding Population-Level Disparities in the Burden of Suicide

Miller

Azrael

Barber

2012

Annu. Rev. Public Health

239

153

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Suicide mortality varies widely across age, sex, race, and geography, far more than does mortality from the leading causes of natural death. Unlike the tight correlation between cancer mortality and the incidence of cancer, suicide mortality is only modestly correlated with the incidence of suicidal acts and other established risk factors for suicidal behavior, such as major psychiatric disorders. An implication of this modest correlation is that the proportion of all suicidal acts that prove fatal (the case fatality ratio) must account for a substantial portion of the (nonrandom) variation observed in suicide mortality. In the United States, the case fatality ratio is strongly related to the availability of household firearms. Findings from ecologic and individual-level studies conducted over the past two decades illustrate the importance of accounting for the availability of highly lethal suicide methods in efforts to understand (and ultimately reduce) disparities in suicide mortality across populations.

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“…For methods of high lethality, such as hanging and jumping, men and women did not differ significantly in case fatality. One prior study from rural Taiwan has demonstrated no gender differences in case fatality when variables such as age and suicide method were considered 23. Pesticide, an agent of high lethality, is the most commonly used substance in solid/liquid poisoning in rural Taiwan; conversely, medication overdose, a method of low lethality, is the most common agent used for solid/liquid poisoning suicide in metropolitan Taipei.…”

Section: Discussionmentioning

confidence: 97%

A decompositional analysis of the relative contribution of age, sex and methods of suicide to the changing patterns of suicide in Taipei City, 2004–2006

et al. 2011

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The rise in suicide rate reflected an increase in attempts and an influx of working-age men joining the pool of people attempting suicide. The much larger size of the attempter pool had the effect of reducing the case fatality even as the suicide rate climbed. The increase in the number of suicide attempts and the rise in the suicide rate were age-, sex-, and method-specific. These results strongly support the concept that reducing the total number of attempts is a central element to curbing suicides.

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A community-based study of case fatality proportion among those who carry out suicide acts

Cited by 32 publications

References 17 publications

Methods of suicide predict the risks and method-switching of subsequent suicide attempts: a community cohort study in Taiwan

Methods of suicide predict the risks and method-switching of subsequent suicide attempts: a community cohort study in Taiwan

Suicide Mortality in the United States: The Importance of Attending to Method in Understanding Population-Level Disparities in the Burden of Suicide

A decompositional analysis of the relative contribution of age, sex and methods of suicide to the changing patterns of suicide in Taipei City, 2004–2006

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