Trends in suicide methods in Switzerland from 1969 to 2018: an observational study

BACKGROUND: Suicide is a serious societal and health problem. We examined changes in rates of completed suicides in Switzerland between 1969–2018 with particular regard to different methods of suicide used in different subgroups of the resident population. METHODS: We used data of the Swiss cause...

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Main Authors: Niklaus Stulz, Urs Hepp, Stephan Kupferschmid, Nesrin Raible-Destan, Marcel Zwahlen
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2022-12-01
Series:Swiss Medical Weekly
Online Access:https://smw.ch/index.php/smw/article/view/3271
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author Niklaus Stulz
Urs Hepp
Stephan Kupferschmid
Nesrin Raible-Destan
Marcel Zwahlen
author_facet Niklaus Stulz
Urs Hepp
Stephan Kupferschmid
Nesrin Raible-Destan
Marcel Zwahlen
author_sort Niklaus Stulz
collection DOAJ
description BACKGROUND: Suicide is a serious societal and health problem. We examined changes in rates of completed suicides in Switzerland between 1969–2018 with particular regard to different methods of suicide used in different subgroups of the resident population. METHODS: We used data of the Swiss cause of death statistics and Poisson regression models to analyse annual incidence rates and calendar time trends of specific suicide methods used in population subgroups by sex (men vs women), age (10–29, 30–64, >64 years), and nationality (Swiss vs other citizenship). RESULTS: There were 64,996 registered suicides between 1969 and 2018. Across these 5 decades, the overall suicide rate was higher in men than in women (incidence rate ratio [IRR] 2.62, 95% confidence interval [CI] 2.58–2.67), in Swiss citizens than in foreigners (IRR 2.02; 95% CI 1.97–2.07), and in older residents (>64 years) than in the age groups 30–64 years (IRR 1.35, 95% CI 1.32–1.37) and 10–29 years (IRR 2.37, 95% CI 2.32–2.43). After peaking in the 1980s, the overall suicide rate had declined in all of these population subgroups, with flattening trends over most recent years. The most common specific methods of suicide were hanging (accounting for 26.7% of all suicides) and firearms (23.6%). The rates of the specific suicide methods were usually higher in men, in Swiss citizens and in older residents, and they had typically declined over most recent decades in the population subgroups examined. However, some methods diverged from this general pattern, at least in some population subgroups. For instance, railway suicides most recently increased in younger and in male residents whereas suicides by gas and by drowning were only at a low level after rapid declines in the last millennium. CONCLUSIONS: Restricting access to lethal means (e.g., detoxification of domestic gas), improvements in health care and media guidelines for responsible reporting of suicides are possible explanations for the generally declining suicide rates in Switzerland. Whereas some methods (e.g., poisoning by gases or drowning) had become rare, others continue to account for many suicides every year, at least in some population subgroups (e.g., firearms in older Swiss men or railway suicides in younger and in male residents). As different methods of suicide are chosen by different people or subgroups of the population, preventive efforts should include differentiated strategies and targeted measures to further reduce suicides in Switzerland and elsewhere.
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spelling doaj.art-0e60979fe70841d5952e951bec67bf102023-01-02T10:54:50ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972022-12-01152495010.57187/smw.2022.40007Trends in suicide methods in Switzerland from 1969 to 2018: an observational studyNiklaus StulzUrs HeppStephan KupferschmidNesrin Raible-DestanMarcel Zwahlen BACKGROUND: Suicide is a serious societal and health problem. We examined changes in rates of completed suicides in Switzerland between 1969–2018 with particular regard to different methods of suicide used in different subgroups of the resident population. METHODS: We used data of the Swiss cause of death statistics and Poisson regression models to analyse annual incidence rates and calendar time trends of specific suicide methods used in population subgroups by sex (men vs women), age (10–29, 30–64, >64 years), and nationality (Swiss vs other citizenship). RESULTS: There were 64,996 registered suicides between 1969 and 2018. Across these 5 decades, the overall suicide rate was higher in men than in women (incidence rate ratio [IRR] 2.62, 95% confidence interval [CI] 2.58–2.67), in Swiss citizens than in foreigners (IRR 2.02; 95% CI 1.97–2.07), and in older residents (>64 years) than in the age groups 30–64 years (IRR 1.35, 95% CI 1.32–1.37) and 10–29 years (IRR 2.37, 95% CI 2.32–2.43). After peaking in the 1980s, the overall suicide rate had declined in all of these population subgroups, with flattening trends over most recent years. The most common specific methods of suicide were hanging (accounting for 26.7% of all suicides) and firearms (23.6%). The rates of the specific suicide methods were usually higher in men, in Swiss citizens and in older residents, and they had typically declined over most recent decades in the population subgroups examined. However, some methods diverged from this general pattern, at least in some population subgroups. For instance, railway suicides most recently increased in younger and in male residents whereas suicides by gas and by drowning were only at a low level after rapid declines in the last millennium. CONCLUSIONS: Restricting access to lethal means (e.g., detoxification of domestic gas), improvements in health care and media guidelines for responsible reporting of suicides are possible explanations for the generally declining suicide rates in Switzerland. Whereas some methods (e.g., poisoning by gases or drowning) had become rare, others continue to account for many suicides every year, at least in some population subgroups (e.g., firearms in older Swiss men or railway suicides in younger and in male residents). As different methods of suicide are chosen by different people or subgroups of the population, preventive efforts should include differentiated strategies and targeted measures to further reduce suicides in Switzerland and elsewhere. https://smw.ch/index.php/smw/article/view/3271
spellingShingle Niklaus Stulz
Urs Hepp
Stephan Kupferschmid
Nesrin Raible-Destan
Marcel Zwahlen
Trends in suicide methods in Switzerland from 1969 to 2018: an observational study
Swiss Medical Weekly
title Trends in suicide methods in Switzerland from 1969 to 2018: an observational study
title_full Trends in suicide methods in Switzerland from 1969 to 2018: an observational study
title_fullStr Trends in suicide methods in Switzerland from 1969 to 2018: an observational study
title_full_unstemmed Trends in suicide methods in Switzerland from 1969 to 2018: an observational study
title_short Trends in suicide methods in Switzerland from 1969 to 2018: an observational study
title_sort trends in suicide methods in switzerland from 1969 to 2018 an observational study
url https://smw.ch/index.php/smw/article/view/3271
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AT urshepp trendsinsuicidemethodsinswitzerlandfrom1969to2018anobservationalstudy
AT stephankupferschmid trendsinsuicidemethodsinswitzerlandfrom1969to2018anobservationalstudy
AT nesrinraibledestan trendsinsuicidemethodsinswitzerlandfrom1969to2018anobservationalstudy
AT marcelzwahlen trendsinsuicidemethodsinswitzerlandfrom1969to2018anobservationalstudy