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Suicide

The suicide rate in the general population 14.5 per 100,000.

Globally approximately 800,000 people died by suicide every year, counting to 1.5% of all deaths.

Almost 50,000 deaths by suicide in 2022.

The US suicide rate has increased by more than 30% since 1999.

The tenth leading cause of death in developed countries and kills more than 800,000 people per year worldwide.

Suicide is the second leading cause of death for children and adolescents in the United States.

Associated with depression, substance abuse, loss of family member or friend to suicide, access to firearms and female gender.

Suicide rate for a general hospital about 32 per 100,000.

Suicide accounts for one in every 100 deaths and is the leading cause of adolescent deaths.

In 2020 more than 45,000 people died by suicide in the US, making suicide the second leading cause of death among individuals aged 10 to to 34 years.

The number of suicides increased to 47,646 in 2021, up from 45,979 in 2020, according to researchers at the CDC’s National Center for Health Statistics.

US suicide rates increased by 25.4% between 1999 and 2016.

ED visits for patients who have had suicidal thoughts, harmed themselves or both is up 25.5% in the last two years.

More than half of US suicides involve a firearm.

Non-fatal suicide attempts resulted in an estimated 381,295 ED visits in nearly 200,000 hospitalizations each year from 2015 to 2019.

Has reached a 30-year high across all age groups, not only in completed action, but in ideation.

Highest rates in Europe and the lowest rates in the eastern Mediterranean, including the Middle East.

Estimated 9.2% of the US population will have contemplated suicide at least once in their lifetime, and it’s estimated that 60% of individuals who have contemplated suicide would follow through within the first year of the onset of ideation.

Familial risk is partially explained by parental mood disorders, traits of impulsivity and aggressiveness, or neurocognitive disorders, all of which can be inherited.

Twin studies estimate the genetic contribution to the risk of suicidal behavior ranges from 30-50%

only about 20% of people who die by suicide are being treated for a mental health issue.

Patient recently discharged from the psychiatric hospital have a suicide rate 100 times higher than the rate in the general population.

Suicide attempts are often impulsive, driven by transient life crises.

Most people who attempt suicide do not go on to die in a future suicide.

 

Whether a suicide attempt is fatal depends on the lethality of the method used.

Suicide decedents have significantly more inpatient hospitalizations for mental health and non-mental health related conditions, for ED visits for mental health and non-mental health related issues, and for outpatient visits with mental health related diagnoses, but not for non-mental health related diagnoses.

Total healthcare visits for suicide decedents as compared with control are significantly increased for each quarter of the year, rose over the course of the year while visits for controls were unchanged.

Approximally 1 million people die from suicide worldwide each year.

The lifetime probability of suicide in patients with major affective disorder is 25-30%.

About 50% of people who die by suicide had depression or another mood disorder.

A principal cause of death among individuals with mood disorders.

Most prevalent at nighttime.

Half of suicides in the U.S. occur within weeks of seeing a medical caregiver.

Traumatic brain injury may be associated with increased risk of suicide.

Eighth leading cause of death in the U.S.

Second leading cause of death among 15-24 year olds.

1 suicide occurs, on average, every 13.3 minutes.

Approximately 987,950 suicide attempts in US annually.

Globally estimated 11.4 suicides per 100,000 people occur each year.

Suicide rates vary between various countries, with as much as 10 times difference between regions.

Higher rates of ideation and suicide attempts among women, however rates of suicide deaths generally higher in men: 15 per 100,000 men versus eight per 400,000 women, worldwide.

Suicide rates have been declining over recent deco decades, with the exception of the Americas where in the United States rates have increased one and a half percent annually since 2000.

Causes for increased suicidal rate are: a fragmented mental health care system, the opioid addiction epidemic, unregulated hand gun ownership, posttraumatic stress and other mental illnesses experienced by veterans.

Stressful life events preceded many suicide and suicide attempts: Separation, divorce, death of a partner, death by suicide of someone close, in particular for mothers-death by suicide of adult children, diagnosis of chronic medical condition, particularly in the first week after a diagnosis of cancer, individuals experiencing assault, persons who have been arrested, and prisoners.

The suicide rate is elevated among patients with cancer, especially cancers with lower five-year survival.

The stress-diathesis model to explain the etiology of suicide includes heightened emotional response to stress, a greater propensity for emotion to influence decisions, impaired learning and problem-solving capacity, and several psychiatric disorders.

Most individuals who attempt suicide have a psychiatric disorder, but the majority of those with psychiatric disorders never attempt suicide.

Suicide is associated with head injury, stroke, epilepsy, and multiple sclerosis.

Natural disasters can act as triggers for suicide.

Worldwide, hangings account for approximately 40% of suicidal deaths, and pesticides  account for 14-20%.

Terrorist attacks temporarily protect against suicide in exposed populations.

Small increases in suicide rates occur after the suicide of a celebrity.

Most mental health conditions are linked to an increased risk of suicide.

Veterans have a higher suicide rate than the general population.

Suicide rates partly correlate with economic status and cultural differences.

Risk of attempts is higher in relatives of people who died by suicide, amd the risk of dying by suicide is higher in relatives of people with a history of suicide attempts.

Attempted suicides, drug overdoses, cutting and other types of self-injury have increased substantially in U.S. girls, a 15-year study of emergency room visits found.

Transmission of suicidal behavior is mediated through the transmission of impulsive aggression.

Genetic factors account for part of the familial transmission of suicidal behavior, with estimates of heritability of 30 to 50%.

The specific heritability of suicidality is estimated at about 17% for suicide attempts and 36% for suicide ideation.

 

Men working in construction and minerals, oil and gas extraction are nearly twice as likely to die by suicide than men overall, while their female counterparts were more than three times as likely to die by suicide then all other working women.

There is reduced expression of GABA-synthesizing enzymes in the brain tissue of persons who have died by suicide, also reduced number of GABAergic interneurons in the brain tissue of patients with depression.

Suicide rates of immigrants are more closely correlated with their country of origin than with their adoptive country.

For each suicide death, there are 20 suicide attempts.

Among persons who attempt suicide, 1.6% die by suicide within the next 12 months, and 3.9% die by suicide within the next five years.

Indigenous peoples have high rates of suicide. Which may be caused by disruption of traditional cultural and family supports, lower socioeconomic status, increased prevalence of alcohol and substance abuse.

People and unskilled professions have an increased risk of suicide, partly explained by greater psychosocial stress.

People in professions with access to lethal means for suicide have higher rates of such, and include farmers, nurses, veterinarians, physicians, and police.

Restrictive alcohol policies lower suicide rates.

Individuals with a history of same-sex relationships have a 3-4 time greater risk of dying by suicide, with a disproportionately greater risk for men than for women.

Individuals belonging to a sexual minority is linked with increased rates of suicide attempts .

Suicide correlates with social changes such as forced settlements, assimilation , and disruption of social structure.

A rare phenomenon in homogeneous societies with high social cohesion, common values, and moral objections to suicide.

 

Socially isolated individuals are more vulnerable to suicide than those who have strong social ties with others.

The presence of an economic crisis with unemployment and decreased personal income is correlated with increase in suicide.

Seasonal variation occurs, with peak incidence in spring and summer, suggesting correlation with latitude and exposure to sunshine.

Suicide behaviors run in families.

Media reporting affects suicide rates, particularly within 30 days of public notice.

Adolescents and young adults are susceptible to effects of media reports on suicide.

Rate may be increasing.

Rates increasing in young people, and second leading cause of death in individuals aged 15-29 years.

The mortality rate due to suicide for head and neck cancers survivors was surpassed only by that of pancreatic cancer survivors (63.4 vs 86.4 suicides per 100,000 person-years).

Non–fatal suicide behaviors are more common than suicides: 12 month prevalence of suicidal ideation is approximately 12% in high income countries and slightly less in low income countries, while the prevalence of suicide attempts is about .3-.4.

The worldwide lifetime prevalence of ideation is 9.2% and that of attempts is 2.7%.

The incidence of suicidal ideation and behavior peaks in adolescents and young adults with a lifetime prevalence of suicidal ideation at 12-33 percent of suicidal behavior 4-9.3%.

People with suicide ideation within the previous 12 months have a significantly higher twelve-month prevalence rate of suicide attempts: 15 to 20%, and suicidal planning further increases risk.

Approximately one third of adolescents with suicide ideation will go on to attempt suicide with in one year.

People who attempt suicide presenting to an emergency department have a 12 month risk of suicide of 1.6% and repeated suicide attempt of 16.3%, with a five-year risk of suicide of 3.9%

Suicide rates are high in the elderly, particularly among those with physical disorders, depression, and anxiety.

Up to 60% of people who die by suicide have a mood disorder such as major depression, and the risk is especially high if a person has a marked sense of hopelessness or has both depression and borderline personality disorder.

The lifetime risk of suicide associated with a diagnosis of major depression in the US is estimated at 3.4%, which averages two highly disparate figures of almost 7% for men and 1% for women.

Claims more US lives than vehicular crashes.

In high income countries suicide is most common among middle-aged and elderly men..

Annually in the US 300-400 physicians commit suicide.

US Centers for Disease Control and Prevention found a 28.4% increase in suicides between 1999 and 2010 among people aged 35-64 years.

During that time suicide rates for men aged 50-59 years increased by about 50% and the rate for women aged 60-64 grew by nearly 60%.

Suicide rates fluctuate and are linked to level of alcohol consumption per capita, and to access and quality of psychiatric care.

Short – sleep is more common in old age, with an increased likelihood of suicide ideation and suicide attempts.

The suicide rate among male physicians is 40% higher than among men in general, and the rate among female physicians is 130% higher than women in general.

The suicide rate of medical people Is higher than that of the general population.

Related to mental illness as people who have chronic mood disorders or psychosis or 10-20 times more likely to commit suicide than people without those disorders.

Psychiatric disorders have the strongest effect on suicide rates.

Depression, bipolar disorder, schizophrenia, substance use disorders, epilepsy, and traumatic brain injury each increases the odds of completed suicide by a factor of more than three.

Serious mental illness affects 5% of the US population but accounts for 47-74% of the population attributable risk of suicide.

70% of elderly patients who die by suicide have seen their primary care physician with the month before death.

Accounts for more than 1% of all US deaths annually.

In 2007 34,598 deaths by suicide occurred in the US, more than half involved firearms.

Firearms is the most modifiable risk factor in suicide, as guns were used in 51% of completed suicide in 2013.

In 2018 24,432 suicides by firearms occurred in the US.

In states with stricter firearm laws there are much lower firearm suicide related death rates, than in states with looser regulations.

Case fatality rate for intentional self injury with a gun is 84% while the average case fatality for self intentional self injury using other means is 4%.

Guns result in suicidal deaths over 90% of the time, whereas ingestion of pills or wrist cutting will be unsuccessful more than 90% of the time.

The majority of people who try to commit suicide but survive the attempt will not go on to die from suicide, however if the attempt is with a gun there will be no second chance at life.

The second most lethal means of suicide are suffocation/hanging (69% fatality) and falls 31%, but together acount for fewer than half the number of suicides thst guns claim each year.

Fourth leading cause of death in the U.S. for persons aged 10-60 years of age.

33364 Americans committed suicide in 2010,

Among adults age 35-64 suicide rate has increased by 28% from 13.7-17.6 to 100,000 population during a 12 analysis 1999 2010 (Morbidity and Mortality Weekly Report).

Native Americans and Alaskans, followed by white people have the highest suicide rates.

The effects of divorce on men, in terms of suicide, is greater than the effect seen in women.

Mainly white men over the age of 85 years, have the highest suicide rate at 51.6/year per 100,000 population.

Risk of dying from suicide in the year 2003 for whites 13 per 100,000 compared to blacks 5.3 per 100,000, more than 2:1.

Rates among blacks have climbed since the 1980s.

Risk 10 times higher in patients with mood disorders.

Risks 26 times higher in men admitted to a psychiatric unit with bipolar disorder.

Lifetime prevalence in the general population for attempted suicide is 4.6% and for blacks it has increased to 4.1%.

One in five adults who suffer from chronic pain have suicidal ideation, and 8 – 41% of those adults attempt suicide at least once.

People who are widowed or divorced, particularly if they live alone, commit suicide more often than those in other sociological groups.

Western states have higher rates of suicides than other states.

Suicide attempts are a significant predictor of completed suicide rates and an indicator of psychologic distress.

Has a lifelong and profound effect on families, friends and physicians of the person committing suicide.

Among individuals who made near lethal suicide attempts, 24% took less than 5 minutes between the decision to kill themselves and the attempt, and 70% took less than 1 hour (Simon).

More than 90% of people who survive a suicide attempt do not go on to die by suicide.

Persons who attempt suicide are 38-40 times more likely to commit suicide than are persons without previous attempts.

National Comorbidity Survey Replication study conducted in 2001-2003 revealed 3.3% of U.S. residents aged 18-54 years had seriously considered killing themselves in the previous 12 months. Of this group 28.6% had made a plan to kill themselves and 32.8% of those that made a plan to kill themselves carried out an attempt to commit suicide.

Most persons who committed suicide after being discharged from the hospital had diagnosable psychiatric disorders, particularly depression and substance use disorders.

Patients dying by suicide visit primary care physicians more than twice as often as mental health clinicians.

7% of older primary care patients have suicidal ideation.

30% of older patients with major depression have suicidal ideation.

Many older adults who commit suicide have visited their primary care physician very close to the time of the suicide: 20 percent on the same day, 40 percent within one week, and 70 percent within one month of the suicide.

45% of those dying by suicide visited their primary care physician in the month before their death, and only 20% saw a mental health professional in the preceding month.

Patients with recent diagnosis of cancer have increased risk of having suicide and death from cardiovascular disease (Fang F et al).

The risk of suicide is increased by early-life adversity.

Older persons account for 20 percent of all suicide deaths, with white males particularly vulnerable.

Highest rate of suicide is for white males aged 85 and older: 65 deaths per 100,000 about 6 times the national U.S. rate.

White men commit 70% of the suicides in the U.S.

While females more often have suicidal thoughts, males die by suicide more frequently.

This discrepancy is also known as the gender paradox in suicide.

Mood disorders, particularly depression and bipolar disorder, commonly contribute to suicide in all age-groups.

Substance abuse couples with a mood disorder dramatically increases risk of suicide.

Other predisposing factors include a previous suicide attempts, childhood sexual abuse, family history of suicidal behavior, and a loss of parent to suicide in early childhood.

 

Muslims in the U.S. are more likely to have attempted suicide than members of other religions.

 

Survey responses from a weighted sample of 2,836 Americans revealed that self-identified Muslims were 2.18 times as likely as Protestant respondents to report a lifetime suicide attempt, while Catholics 1.20, other Christians 1.18 and Jews were at lower risk. 

 

A family history of suicide is a risk factor and there is evidence suggesting a mother’s suicidal behavior has a greater influence than a father’s suicidal behavior.

Parental suicide has a greater effect on younger children than on adolescents in terms of their lifetime risk of suicide.

About 8 percent of children report any past or current suicidal ideation, according to a study in The Lancet Psychiatry.

Antidepressant agents have no significant acute effect on risk but may have a weak effect by reducing the number of depressive episodes.

The long time risk is reduced for those with mood disorders by the use of lithium.

Patients taking anticonvulsants have approximately twice the risk of suicidal ideation or behavior compared with placebo (FDA).

The use of gabapentin, lamotrigine, oxcarbazine, and tiagabine compared with topiramate may be associated with increased risk of suicidal acts or violent deaths (Patorno E).

Randomized control studies that lithium compared to placebo reduces number of suicides by 13% and deaths from any cause by 38%

Lithium reduces suicide risk and total mortality in patients with depressive episodes or bipolar disorders.

Electroconvulsive therapy reduces the acute risk of suicide in those with mood disorders with (CORE) reduction in suicidal thought or suicidal acts.

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