Reduced completed suicide rate in Hungary from 1990 to 2001: Relation to suicide methods

Gender differences in antidepressant use-related seasonality change in suicide mortality in Hungary, 1998–2006

“…In agreement with international (Isacsson 2000;Grunebaum et al 2004;Ludwig and Marcotte 2005;Sondergard et al 2006;Bramness et al 2007;Nakagawa et al 2007) and with previously published Hungarian studies covering different time periods between 1980 and 2005 (Rihmer 2004;Berecz et al 2005;Kalmar et al 2008) we also found, as expected, a signifi cant negative correlation between AD prescription and declining national suicide rate in Hungary between 1998 and 2006. However, in spite of the facts that this negative association was highly signifi cant in both genders ( P Ͻ 0.001) and the changes in AD utilization and in suicide rates were very similar in females and males (ϩ 112 and -21% in females and ϩ117 and -23% in males, respectively) the effect of increasing AD consump tion was about 8-fold stronger in males (Table I).…”

“…In agreement with the prior study of us ) and Oravecz et al (2006) these fi ndings also indicate that decreasing seasonality of suicides could be a good marker of lowering rate of depression-related suicides in the population, particularly in males who use much more frequently violent suicide methods (Maes et al 1993;Kim et al 2004;Lin et al 2008). As gender distribution, method preference, psychiatric morbidity and seasonality of suicides in Hungary (Murphy 2000;Voracek et al 2004;Berecz et al 2005;Kalmar et al 2008) is the same as in other European and North American countries (Murphy 2000;Maes et al 1993;Voracek et al 2004;Oravecz et al accompanied by a sharp increase of suicide mortality in that age-groups while suicide rates further de creased in older people where the utilization of ADs further increased or declined only slightly. Studying all the suicides, natural deaths and accidental deaths, which had been investigated by forensic toxicological survey between 1995 and 2005 and looking at the blood levels of all ADs and some control medica tions (including tramadole), Isacsson et al (2009) clearly demonstrated that the increased use of ADs had been a substantially contributing cause of the decrease in suicide mortality in Sweden, but it was not the case for the control medication (tramadole) that also showed sharply increasing utilization dur ing the study period.…”

“…However, in spite of the facts that this negative association was highly signifi cant in both genders ( P Ͻ 0.001) and the changes in AD utilization and in suicide rates were very similar in females and males (ϩ 112 and -21% in females and ϩ117 and -23% in males, respectively) the effect of increasing AD consump tion was about 8-fold stronger in males (Table I). The explanation of this could be that although the current and 1-year prevalence ofmajor depression in Hungary is twotimes more frequent in females (Szadoczky et al 1998) about 80% of suicide victims are males (Berecz et al 2005;Kalmar et al 2008). This indicates that depressed males are particularly vulnerable for suicide and therefore the same in crease in AD pharmacotherapy could show greater anti-suicidal effect in males.…”

“…A statistically signifi cant correlation between in creasing antidepressant (AD) utilization and de creasing national suicide rates have been reported recently from several countries (Ludwig and Marcotte 2005), including Sweden, Denmark, Finland, Norway (Isacsson 2000;Sondergard et al 2006;Bramness et al 2007), the United States (Grunebaum et al 2004) Japan (Nakagawa et al 2007) and from Hungary (Rihmer 2004;Berecz et al 2005;Kalmar et al 2008). Although ecological association does not mean causality considering that (1) there is a strong relationship between untreated major depression and suicide (Moller 2006;Rihmer 2007);…”

Substâncias tóxicas e tentativas e suicídios: considerações sobre acesso e medidas restritivas

“…Existem evidências de que medidas restritivas de acesso ao meio têm conduzido à redução da frequência de determinados tipos de suicídio [16][17][18] . Raros estudos nacionais ampliaram a discussão sobre medidas restritivas e acesso aos meios utilizados na tentativa/suicídio.…”