What Are Reasons for the Large Gender Differences in the Lethality of Suicidal Acts? An Epidemiological Analysis in Four European Countries

• DOI: 10.1371/journal.pone.0129062
• Publication Date: 2015-07-06T18:38:29Z
• Authors: Roland Mergl; Nicole Koburger; Katherina Heinrichs; András Székely; Mónika Ditta Tóth; James Coyne; Sónia Quintão; Ella Arensman; Claire Coffey; Margaret Maxwell; Airi Värnik; Chantal van Auden...; David McDaid; Marco Sarchiapone; Armin Schmidtke; Axel Genz; Ricardo Gusmão; Ulrich Hegerl
• Keywords: Lethality

Background In Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate completed suicides, indicating major gender differences in lethality suicidal behaviour. The aim this study was analyse extent which these can be explained by factors such as choice more lethal methods or within method age. addition, we explored intentionality attempts. Methods Findings Methods. Design: Epidemiological using combination self-report official data. Setting: Mental health care services four European countries: Germany, Hungary, Ireland, Portugal. Data basis: Completed suicides derived from statistics for each country (767 acts, 74.4% male) assessed attempts excluding habitual intentional self-harm (8,175 43.2% male). Main Outcome Measures Analysis. We collected data on acts eight regions countries participating EU-funded "OSPI-Europe"-project (www.ospi-europe.com). calculated method-specific number per * 100 / (number + method). tested distribution significance χ2-test two-by-two tables. effect sizes with phi coefficients (φ). identified predictors binary logistic regression analysis. Poisson analysis examined contribution acts. Results Suicidal (fatal non-fatal) were 3.4 times than (lethality 13.91% (regarding 4106 acts) versus 4.05% 4836 acts)), difference being significant hanging, jumping, moving objects, sharp objects poisoning substances other drugs. Median age behaviour (35–44 years) did not differ between males females. overall choosing (odds ratio (OR) = 2.03; 95% CI 1.65 2.50; p < 0.000001) additionally, but lesser degree, even (OR 1.64; 1.32 2.02; 0.000005). revealed neither nor proportion serious among all non-fatal known (NFSAi) significantly (57.1%; 1,207 2,115 NFSAi) (48.6%; 1,508 3,100 (χ2 35.74; 0.000001). limitations Due restrictive security regulations ensure anonymity specific ages could provided because relatively low absolute numbers Irish intervention control region. Therefore, analyses interaction only conducted three countries. Attempted patients presenting emergency departments treated hospitals. An unknown remained undetected. This may caused an overestimation certain methods. Moreover, detection registration might differed across Some hidden misclassified undetermined deaths. Conclusions Men often used highly behaviour, there also together large Gender fairly consistent examined. Males females Suicide rated independent used, exceptions suggesting associated These findings contribute understanding spectrum reasons should inform development strategies prevention.