Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Aug 19, 2022; 12(8): 1044-1060
Published online Aug 19, 2022. doi: 10.5498/wjp.v12.i8.1044
Worldwide suicide mortality trends (2000-2019): A joinpoint regression analysis
Milena Ilic, Irena Ilic
Milena Ilic, Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Irena Ilic, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
Author contributions: All authors equally contributed to this paper with conception and design of the study, data acquisition and analysis, and drafting, critical revision, editing, and approval of the final version.
Supported by the Ministry of Education, Science and Technological development, Republic of Serbia, 2011–2020, No. 175042.
Institutional review board statement: This study is approved by the Ethics Committee of the Faculty of Medical Sciences, University of Kragujevac (No. 01-14321).
Informed consent statement: The study was conducted using publicly available data. No patient approvals were sought nor required for this study. The data used for inputs and analysis were derived from public sources (such as websites) and published literature. Our research question for estimating the trends of suicide mortality was based on the number of suicide mortality figures in the world from 2000 to 2019. However, as our model-based analysis used data from published sources such as publications, websites and modelling methods, patients were not involved in the design, or conduct, or reporting or dissemination plans of the research.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the STROBE Statement - checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Milena Ilic, MD, PhD, Professor, Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, S. Markovica 69, Kragujevac 34000, Serbia. drmilenailic@gmail.com
Received: August 22, 2021
Peer-review started: August 22, 2021
First decision: November 8, 2021
Revised: November 16, 2021
Accepted: July 8, 2022
Article in press: July 8, 2022
Published online: August 19, 2022
Processing time: 361 Days and 5.7 Hours
Abstract
BACKGROUND

Studies exploring suicide mortality on a global scale are sparse, and most evaluations were limited to certain populations.

AIM

To assess global, regional and national trends of suicide mortality.

METHODS

Suicide mortality data for the period 2000-2019 were obtained from the mortality database of the World Health Organization and the Global Burden of Disease Study. Age-standardized rates (ASRs; expressed per 100000) were presented. To assess trends of suicide mortality, joinpoint regression analysis was used: The average annual percent change (AAPC) with the corresponding 95% confidence interval (95%CI) was calculated.

RESULTS

A total of 759028 (523883 male and 235145 female) suicide deaths were reported worldwide in 2019. The global ASR of mortality of suicide was 9.0/100000 population in both sexes (12.6 in males vs 5.4 in females). In both sexes, the highest rates were found in the region of Africa (ASR = 11.2), while the lowest rates were reported in Eastern Mediterranean (ASR = 6.4). Globally, from 2000 to 2019, ASRs of mortality of suicide had a decreasing tendency in both sexes together [AAPC = -2.4% per year; 95%CI: (-2.6)-(-2.3)]. The region of the Americas experienced a significant increase in suicide mortality over 2000-2019 unlike other regions that had a declining trend. Out of all 133 countries with a decline in suicide mortality, Barbados (AAPC = -10.0%), Grenada (AAPC = -8.5%), Serbia (AAPC = -7.6%), and Venezuela (AAPC = -6.2%) showed the most marked reduction in mortality rates. Out of all 26 countries with a rise in suicide mortality, Lesotho (AAPC = +6.0%), Cyprus (AAPC = +5.1%), Paraguay (AAPC = +3.0%), Saudi Arabia (AAPC = +2.8%), Brunei (AAPC = +2.6%), Greece (AAPC = +2.6%), Georgia (AAPC = +2.1%), and Mexico (AAPC = +2.0%), are among those with the highest increase in mortality.

CONCLUSION

Decreasing trends in suicide mortality were observed in most countries across the world. Unfortunately, the mortality of suicide showed an increasing trend in a number of populations. Further research should explore the reasons for these unfavorable trends, in order to consider and recommend more efforts for suicide prevention in these countries.

Keywords: Suicide rates; Mortality; Trends; Average annual percent change; Joinpoint analysis

Core Tip: Despite a decline in mortality during the last decades, suicides are one of the main health challenges worldwide. About 750000 suicide deaths were recorded in 2019 across the world. Globally, the rate of suicide mortality in 2019 was 9.0/100000 for both sexes together (12.6 in males vs 5.4 in females). Despite the decreasing trends recorded in both sexes in most countries in the world, the mortality of suicide showed an increasing trend in certain populations. Further research should clarify the reasons for these unfavorable trends, in order to provide more effective measures for suicide prevention.