What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries

Detalhes bibliográficos
Autor(a) principal: Mergl, Roland
Data de Publicação: 2015
Outros Autores: Koburger, Nicole, Heinrichs, Katherina, Székely, András, Tóth, Mónika Ditta, Coyne, James, Quintão, Sónia, Arensman, Ella, Coffey, Claire, Maxwell, Margaret, Värnik, Airi, Van Audenhove, Chantal, McDaid, David, Sarchiapone, Marco, Schmidtke, Armin, Genz, Axel, Gusmão, Ricardo, Hegerl, Ulrich
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/146472
Resumo: The research leading to these results has received funding from the European Commission (ec.europa.eu) within the Seventh Framework Programme under grant agreement N° 223138. The following authors received the funding: NK KH A. Székely MT RG SQ EA CC MM AV CVA DMcD MS A. Schmidtke AG JC UH. The authors also acknowledge support from the German Research Foundation (DFG) and Universität Leipzig within the program of Open Access Publishing. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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spelling What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countriesGeneralSDG 3 - Good Health and Well-beingThe research leading to these results has received funding from the European Commission (ec.europa.eu) within the Seventh Framework Programme under grant agreement N° 223138. The following authors received the funding: NK KH A. Székely MT RG SQ EA CC MM AV CVA DMcD MS A. Schmidtke AG JC UH. The authors also acknowledge support from the German Research Foundation (DFG) and Universität Leipzig within the program of Open Access Publishing. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Background In Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate of completed suicides, indicating major gender differences in lethality of suicidal behaviour. The aim of this study was to analyse the extent to which these gender differences in lethality can be explained by factors such as choice of more lethal methods or lethality differences within the same suicide method or age. In addition, we explored gender differences in the intentionality of suicide attempts. Methods and Findings Methods. Design: Epidemiological study using a combination of self-report and official data. Setting: Mental health care services in four European countries: Germany, Hungary, Ireland, and Portugal. Data basis: Completed suicides derived from official statistics for each country (767 acts, 74.4%Male) and assessed suicide attempts excluding habitual intentional self-harm (8,175 acts, 43.2%Male). Main Outcome Measures and Data Analysis. We collected data on suicidal acts in eight regions of four European countries participating in the EU-funded "OSPI-Europe"-project (www.ospi-europe.com). We calculated method-specific lethality using the number of completed suicides per method ∗ 100 / (number of completed suicides per method + number of attempted suicides per method). We tested gender differences in the distribution of suicidal acts for significance by using the χ2-test for two-by-two tables. We assessed the effect sizes with phi coefficients (φ). We identified predictors of lethality with a binary logistic regression analysis. Poisson regression analysis examined the contribution of choice of methods and method-specific lethality to gender differences in the lethality of suicidal acts. Findings Main Results Suicidal acts (fatal and non-fatal) were 3.4 times more lethal in men than in women (lethality 13.91% (regarding 4106 suicidal acts) versus 4.05% (regarding 4836 suicidal acts)), the difference being significant for the methods hanging, jumping, moving objects, sharp objects and poisoning by substances other than drugs. Median age at time of suicidal behaviour (35-44 years) did not differ between Males and feMales. The overall gender difference in lethality of suicidal behaviour was explained by Males choosing more lethal suicide methods (odds ratio (OR) = 2.03; 95% CI = 1.65 to 2.50; p < 0.000001) and additionally, but to a lesser degree, by a higher lethality of suicidal acts for Males even within the same method (OR = 1.64; 95% CI = 1.32 to 2.02; p = 0.000005). Results of a regression analysis revealed neither age nor country differences were significant predictors for gender differences in the lethality of suicidal acts. The proportion of serious suicide attempts among all non-fatal suicidal acts with known intentionality (NFSAi) was significantly higher in men (57.1%; 1,207 of 2,115 NFSAi) than in women (48.6%; 1,508 of 3,100 NFSAi) (χ2 = 35.74; p < 0.000001). Main limitations of the study Due to restrictive data security regulations to ensure anonymity in Ireland, specific ages could not be provided because of the relatively low absolute numbers of suicide in the Irish intervention and control region. Therefore, analyses of the interaction between gender and age could only be conducted for three of the four countries. Attempted suicides were assessed for patients presenting to emergency departments or treated in hospitals. An unknown rate of attempted suicides remained undetected. This may have caused an overestimation of the lethality of certain methods. Moreover, the detection of attempted suicides and the registration of completed suicides might have differed across the four countries. Some suicides might be hidden and misclassified as undetermined deaths. Conclusions Men more often used highly lethal methods in suicidal behaviour, but there was also a higher method-specific lethality which together explained the large gender differences in the lethality of suicidal acts. Gender differences in the lethality of suicidal acts were fairly consistent across all four European countries examined. Males and feMales did not differ in age at time of suicidal behaviour. Suicide attempts by Males were rated as being more serious independent of the method used, with the exceptions of attempted hanging, suggesting gender differences in intentionality associated with suicidal behaviour. These findings contribute to understanding of the spectrum of reasons for gender differences in the lethality of suicidal behaviour and should inform the development of gender specific strategies for suicide prevention.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNMergl, RolandKoburger, NicoleHeinrichs, KatherinaSzékely, AndrásTóth, Mónika DittaCoyne, JamesQuintão, SóniaArensman, EllaCoffey, ClaireMaxwell, MargaretVärnik, AiriVan Audenhove, ChantalMcDaid, DavidSarchiapone, MarcoSchmidtke, ArminGenz, AxelGusmão, RicardoHegerl, Ulrich2022-12-20T22:15:50Z2015-07-062015-07-06T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/146472eng1932-6203PURE: 48422937https://doi.org/10.1371/journal.pone.0129062info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:27:34Zoai:run.unl.pt:10362/146472Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:52:39.066423Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
title What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
spellingShingle What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
Mergl, Roland
General
SDG 3 - Good Health and Well-being
title_short What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
title_full What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
title_fullStr What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
title_full_unstemmed What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
title_sort What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries
author Mergl, Roland
author_facet Mergl, Roland
Koburger, Nicole
Heinrichs, Katherina
Székely, András
Tóth, Mónika Ditta
Coyne, James
Quintão, Sónia
Arensman, Ella
Coffey, Claire
Maxwell, Margaret
Värnik, Airi
Van Audenhove, Chantal
McDaid, David
Sarchiapone, Marco
Schmidtke, Armin
Genz, Axel
Gusmão, Ricardo
Hegerl, Ulrich
author_role author
author2 Koburger, Nicole
Heinrichs, Katherina
Székely, András
Tóth, Mónika Ditta
Coyne, James
Quintão, Sónia
Arensman, Ella
Coffey, Claire
Maxwell, Margaret
Värnik, Airi
Van Audenhove, Chantal
McDaid, David
Sarchiapone, Marco
Schmidtke, Armin
Genz, Axel
Gusmão, Ricardo
Hegerl, Ulrich
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
Centro de Estudos de Doenças Crónicas (CEDOC)
RUN
dc.contributor.author.fl_str_mv Mergl, Roland
Koburger, Nicole
Heinrichs, Katherina
Székely, András
Tóth, Mónika Ditta
Coyne, James
Quintão, Sónia
Arensman, Ella
Coffey, Claire
Maxwell, Margaret
Värnik, Airi
Van Audenhove, Chantal
McDaid, David
Sarchiapone, Marco
Schmidtke, Armin
Genz, Axel
Gusmão, Ricardo
Hegerl, Ulrich
dc.subject.por.fl_str_mv General
SDG 3 - Good Health and Well-being
topic General
SDG 3 - Good Health and Well-being
description The research leading to these results has received funding from the European Commission (ec.europa.eu) within the Seventh Framework Programme under grant agreement N° 223138. The following authors received the funding: NK KH A. Székely MT RG SQ EA CC MM AV CVA DMcD MS A. Schmidtke AG JC UH. The authors also acknowledge support from the German Research Foundation (DFG) and Universität Leipzig within the program of Open Access Publishing. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
publishDate 2015
dc.date.none.fl_str_mv 2015-07-06
2015-07-06T00:00:00Z
2022-12-20T22:15:50Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/146472
url http://hdl.handle.net/10362/146472
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1932-6203
PURE: 48422937
https://doi.org/10.1371/journal.pone.0129062
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eu_rights_str_mv openAccess
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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