Worldwide suicide mortality trends (2000-2019): A joinpoint regression analysis

doi:10.5498/wjp.v12.i8.1044

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World Journal of Psychiatry

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World J Psychiatry. Aug 19, 2022; 12(8): 1044-1060
Published online Aug 19, 2022. doi: 10.5498/wjp.v12.i8.1044

Table 1 Suicide mortality trends, by countries and sex, 2000-2019; a joinpoint analysis: Age-standardized rates (per 100000 population, world standard population)[6,7]

Countries¹	Both sexes			Male			Female
Countries¹	2000	2019	Trend²	2000	2019	Trend²	2000	2019	Trend²
Afghanistan	7.7	6.0	-1.8^a	7.6	6.2	-1.7^a	7.8	5.7	-2.1^a
Albania	5.2	3.7	-2.0	7.6	5.3	-2.0^a	2.9	2.2	-2.0
Algeria	4.7	2.6	-3.4^a	5.9	3.3	-3.3^a	3.5	1.9	-3.4^a
Angola	17.6	12.6	-2.1^a	30.0	21.7	-2.0^a	6.2	4.7	-2.0^a
Antigua	2.0	0.3	-	4.5	0.0	-	0.0	0.6	-
Argentina	9.2	8.1	-0.7^a	16.0	13.5	-0.8^a	3.4	3.3	-0.6
Armenia	3.3	2.7	-0.3	5.5	4.9	-0.2	1.7	1.0	-0.3
Australia	11.8	11.3	+0.6	18.8	17.0	+0.2	5.0	5.6	+1.6^a
Austria	15.8	10.4	-1.8^a	24.9	16.6	-1.9^a	7.9	4.6	-2.1^a
Azerbaijan	3.4	4.0	-0.1	5.8	6.6	-0.1	1.3	1.5	-0.5
Bahamas	2.5	3.4	+1.5^a	4.2	5.8	+1.6^a	1.1	1.2	+0.1
Bahrain	7.0	7.2	-1.9^a	10.2	9.9	-2.1^a	2.5	2.3	-2.4^a
Bangladesh	6.9	3.9	-3.5^a	10.0	6.0	-3.1^a	3.5	1.7	-4.3^a
Barbados	2.6	0.3	-10.0^a	4.9	0.5	-8.7^a	0.5	0.2	-
Belarus	37.3	16.5	-4.7^a	69.3	30.1	-4.8^a	9.5	5.3	-3.5^a
Belgium	18.3	13.9	-1.3^a	27.0	19.6	-1.6^a	10.1	8.4	-0.6^a
Belize	10.0	7.7	-0.9^a	17.2	13.6	-0.7	2.9	1.8	-2.6^a
Benin	14.7	12.7	-0.8^a	23.6	20.3	-0.8^a	7.5	6.1	-1.1^a
Bhutan	6.9	5.1	-1.6^a	8.6	6.8	-1.2^a	5.0	3.1	-2.6^a
Bolivia	8.4	6.8	-0.7^a	11.8	9.6	-0.8^a	5.2	4.2	-0.7^a
Bosnia and Herzegovina	8.1	8.3	-0.3	13.3	13.5	-0.3	3.5	3.4	-0.3^a
Botswana	46.3	20.2	-4.4^a	76.2	35.5	-4.0^a	20.6	7.8	-5.3^a
Brazil	4.5	6.4	+1.6^a	7.4	10.3	+1.5^a	1.8	2.8	+2.0^a
Brunei	1.7	2.5	+2.6^a	3.0	4.2	+1.9	0.4	0.8	-
Bulgaria	14.0	6.5	-3.9^a	21.8	10.6	-3.7^a	7.1	2.9	-4.5^a
Burkina Faso	16.9	14.4	-0.5^a	27.6	24.5	-0.2^a	9.2	6.5	-1.6^a
Burundi	23.4	12.1	-3.3^a	35.5	18.9	-3.0^a	13.6	6.4	-4.1^a
Cabo Verde	18.2	15.2	-0.8^a	33.3	27.4	-1.1^a	6.8	5.1	-1.3^a
Cambodia	6.8	5.5	-1.2^a	9.2	8.4	-0.5^a	5.0	3.1	-2.7^a
Cameroon	19.1	15.9	-1.2^a	29.8	25.2	-1.1^a	9.7	7.6	-1.5^a
Canada	10.7	10.3	+0.1	16.6	15.3	-0.1	5.0	5.4	+0.8^a
Central African Republic	32.5	23.0	-1.2^a	53.7	39.6	-1.0^a	14.6	9.3	-2.1^a
Chad	15.7	13.2	-0.9^a	24.8	20.2	-1.1^a	7.7	6.9	-0.4^a
Chile	10.5	8.0	-1.1^a	19.0	13.4	-1.5^a	2.9	3.0	+0.4
China	14.9	6.7	-4.5^a	15.5	8.6	-3.4^a	14.5	4.8	-6.0^a
Colombia	5.3	3.7	-1.5^a	8.4	6.0	-1.3^a	2.6	1.7	-2.4^a
Comoros	10.9	8.5	-1.1^a	14.5	11.3	-1.0^a	7.6	5.8	-1.3^a
Congo	24.7	11.6	-3.4^a	38.5	18.3	-3.4^a	14.1	6.1	-3.7^a
Costa Rica	6.9	7.6	-0.4	12.3	13.3	-0.6	1.6	1.9	+0.4
Côte d’Ivoire	24.0	15.7	-1.9^a	37.5	25.7	-1.6^a	8.4	5.0	-2.3^a
Croatia	16.3	11.0	-2.0^a	27.1	17.7	-2.1^a	6.9	5.1	-1.7^a
Cuba	15.6	10.2	-1.5^a	22.7	16.7	-1.0^a	8.9	4.1	-3.3^a
Cyprus	1.9	3.2	+5.1^a	2.6	5.3	+6.3^a	1.2	1.1	+0.6
Czechia	13.4	9.5	-1.2^a	22.6	15.4	-1.5^a	5.1	3.8	-0.8^a
DPR Korea	10.3	8.2	-0.7^a	12.3	10.6	-0.2	8.9	6.3	-1.4^a
DR Congo	14.5	12.4	-1.0^a	24.9	20.7	-1.1^a	5.7	5.0	-1.0^a
Denmark	12.5	7.6	-2.3^a	18.9	11.1	-2.3^a	6.4	4.2	-2.3^a
Djibouti	12.1	11.9	+0.1	17.1	16.3	-0.2	7.5	7.6	+0.2
Dominican Republic	4.9	5.1	+1.1^a	8.3	8.5	+1.1^a	1.6	1.9	+1.3^a
Ecuador	6.8	7.7	+0.2	9.6	11.9	+0.8	4.2	3.6	-1.3^a
Egypt	3.6	3.4	-0.3	4.7	4.7	+0.2	2.7	2.2	-1.1^a
El Salvador	6.7	6.1	-0.9	10.6	11.1	-0.4	3.4	2.1	-2.4^a
Equatorial Guinea	19.4	13.5	-0.9^a	31.0	18.5	-1.7^a	7.8	8.8	+1.3^a
Eritrea	23.4	17.3	-1.3^a	38.4	27.2	-1.5^a	9.6	8.3	-0.5^a
Estonia	25.0	12.0	-3.8^a	43.1	20.2	-4.0^a	9.6	4.5	-3.2^a
Eswatini	40.6	40.5	-0.8	65.5	78.7	+0.4	20.9	6.4	-7.5^a
Ethiopia	18.4	9.5	-3.8^a	25.9	14.2	-3.3^a	11.2	5.2	-4.6^a
Fiji	11.7	9.5	-0.6^a	15.3	13.1	-0.2	8.2	6.0	-1.4^a
Finland	21.7	13.4	-2.5^a	33.3	20.1	-2.7^a	10.4	6.8	-2.1^a
France	15.8	9.7	-2.6^a	24.2	15.2	-2.3^a	8.3	4.5	-3.3^a
Gabon	19.4	13.1	-1.5^a	33.2	23.3	-1.2^a	7.5	3.8	-3.4^a
Gambia	11.1	9.6	-0.9^a	15.3	13.3	-1.0^a	7.1	6.2	-0.8^a
Georgia	6.6	7.7	+2.1^a	11.9	14.0	+2.3^a	2.2	2.2	+0.3
Germany	11.2	8.3	-1.4^a	17.6	12.8	-1.6^a	5.3	3.9	-1.3^a
Ghana	9.8	10.5	+0.3	17.2	20.0	+0.7	2.9	1.8	-3.0^a
Greece	2.9	3.6	+2.6^a	4.6	5.9	+2.5^a	1.2	1.5	+3.4^a
Grenada	2.1	0.6	-8.5a	3.8	0.5	-	0.6	0.7	-
Guatemala	13.5	6.2	-5.5^a	24.0	10.3	-6.0^a	4.1	2.5	-3.4^a
Guinea	9.7	12.3	+1.6^a	13.7	18.4	+1.9^a	6.7	8.0	+1.3^a
Guinea-Bissau	17.5	12.4	-1.6^a	28.7	19.8	-1.8^a	8.8	6.7	-1.3^a
Guyana	35.8	40.9	+0.5^a	57.6	65.0	+0.5	14.5	17	+0.4
Haiti	12.7	11.2	-0.4^a	14.7	14.9	+0.5^a	11.1	8.0	-1.5^a
Honduras	3.0	2.6	+0.2	5.1	4.4	+0.3	1.1	1.0	-0.8^a
Hungary	26.6	11.8	-3.7^a	44.7	19.1	-3.9^a	11.0	5.5	-3.1^a
Iceland	12.7	11.2	-0.2	19.3	18.7	+0.6	6.0	3.5	-3.1^a
India	19.1	12.9	-2.3^a	20.9	14.7	-2.2^a	17.4	11.1	-2.4^a
Indonesia	3.8	2.6	-2.2^a	5.5	4.0	-2.0^a	2.1	1.2	-3.1^a
Iran	8.0	5.1	-1.5^a	10.1	7.5	-0.3	5.9	2.8	-3.7^a
Iraq	5.3	4.7	+0.0	7.2	7.3	+0.6^a	3.4	2.4	-1.3^a
Ireland	12.1	8.9	-1.4^a	19.8	14.3	-1.4^a	4.4	3.6	-1.1^a
Israel	6.8	5.2	-1.4^a	11.0	8.3	-1.5^a	2.8	2.1	-1.3^a
Italy	5.5	4.3	-0.8^a	8.7	6.7	-0.9^a	2.7	2.1	-0.9^a
Jamaica	2.1	2.3	+1.1^a	3.3	3.6	+1.0^a	0.9	1.0	+1.3^a
Japan	18.1	12.2	-1.9^a	26.8	17.5	-2.2^a	9.6	6.9	-1.4^a
Jordan	3.5	2.0	-3.4^a	4.5	3.0	-2.5^a	2.4	0.9	-6.0^a
Kazakhstan	39.4	18.1	-4.2^a	71.7	30.9	-4.5^a	11.4	6.9	-2.9^a
Kenya	15.8	11.0	-1.7^a	24.8	18.1	-1.5^a	8.2	5.3	-2.0^a
Kiribati	35.6	30.6	-0.6^a	62.6	53.6	-0.6^a	11.1	9.5	-0.6^a
Kuwait	3.1	2.7	-0.9^a	4.1	3.8	-0.3	1.5	0.7	-4.5^a
Kyrgyzstan	17.6	8.3	-3.5^a	30.7	13.5	-3.8^a	5.5	3.5	-1.9^a
Lao PDR	8.7	6.0	-2.0^a	11.0	8.6	-1.3^a	6.5	3.5	-3.5^a
Latvia	29.6	16.1	-3.0^a	54.3	29.0	-3.0^a	9.4	4.6	-3.9^a
Lebanon	3.0	2.8	-0.2	3.7	3.9	+0.6^a	2.4	1.7	-1.8^a
Lesotho	42.6	87.5	+6.0^a	73.9	146.9	+5.7^a	16.0	34.6	+6.1^a
Liberia	8.8	7.4	-0.7^a	11.0	9.4	-0.6^a	6.7	5.5	-0.7^a
Libya	5.3	4.5	+0.1	7.1	6.1	+0.2	3.3	2.9	+0.3
Lithuania	45.8	20.2	-3.4^a	80.7	36.1	-3.4^a	15.3	6.2	-3.4^a
Luxembourg	13.4	8.6	-2.8^a	20.3	11.8	-3.6^a	7.1	5.4	-1.2
Madagascar	10.8	9.2	-1.0^a	15.5	13.3	-0.9^a	6.1	5.4	-0.8^a
Malawi	19.2	10.6	-2.4^a	31.8	20.0	-1.8^a	8.4	3.3	-4.1^a
Malaysia	6.1	5.8	-0.5^a	9.1	9.0	-0.3	3.1	2.4	-1.3^a
Maldives	5.3	2.8	-3.1^a	8.1	4.1	-3.4^a	2.3	0.9	-4.9^a
Mali	8.8	8.0	-0.4^a	10.6	10.5	+0.0	7.2	5.7	-1.0^a
Malta	6.0	5.3	+0.2	9.8	8.4	+0.5	2.4	2.3	-0.6
Mauritania	6.4	5.5	-0.8^a	8.2	7.4	-0.6^a	4.9	3.9	-1.2^a
Mauritius	11.5	8.8	-0.8	18.4	15.0	-0.5	4.9	2.5	-2.1^a
Mexico	3.9	5.3	+2.0^a	6.9	8.7	+1.7^a	1.1	2.2	+3.6^a
Micronesia	28.0	29.0	+0.3^a	43.4	44.3	+0.2^a	13.0	13.2	+0.3^a
Mongolia	23.6	18.0	-1.5^a	37.6	31.1	-1.1^a	10.2	5.6	-2.8^a
Montenegro	18.9	16.2	-0.8^a	28.9	25.4	-0.7^a	9.8	7.9	-1.1^a
Morocco	10.8	7.3	-2.3^a	13.9	10.1	-2.0^a	8.0	4.7	-2.8^a
Mozambique	20.9	23.2	+0.9^a	36.2	42.6	+1.2^a	8.8	8.9	+0.6
Myanmar	5.1	3.0	-2.8^a	8.1	5.1	-2.2^a	2.6	1.1	-5.0^a
Namibia	27.5	13.5	-4.1^a	47.5	24.9	-3.9^a	11.4	4.4	-4.8^a
Nepal	10.9	9.8	-0.3	19.4	18.6	+0.2	2.8	2.9	+0.5^a
Netherlands	8.1	9.3	+1.1^a	11.2	12.5	+0.9^a	5.2	6.1	+1.3^a
New Zealand	12.4	10.3	-0.9^a	20.8	15.4	-1.2^a	4.4	5.4	+0.0
Nicaragua	6.3	4.7	-1.7^a	9.3	7.8	-1.5^a	3.6	1.9	-2.4^a
Niger	9.5	10.1	+0.3^a	12.6	14.1	+0.6^a	6.7	6.4	-0.2^a
Nigeria	9.2	6.9	-1.7^a	13.7	10.1	-1.7^a	5.1	3.8	-2.0^a
North Macedonia	8.7	7.2	-1.6^a	12.5	11.0	-1.5^a	4.9	3.5	-1.9^a
Norway	13.0	9.9	-1.0^a	19.9	13.4	-1.5^a	6.1	6.3	+0.1
Oman	6.7	4.5	-2.5^a	10.1	6.4	-2.9^a	2.0	1.1	-3.1^a
Pakistan	11.1	9.8	-0.8^a	16.1	14.6	-0.7^a	5.7	4.8	-1.2^a
Panama	5.9	2.9	-4.4^a	10.4	4.8	-4.5^a	1.5	1.0	-3.6^a
Papua New Guinea	2.8	3.6	+1.1^a	4.4	5.2	+0.9^a	1.4	1.9	+1.4^a
Paraguay	3.6	6.2	+3.0^a	4.8	9.0	+3.5^a	2.5	3.3	+1.5^a
Peru	3.4	2.7	-0.8^a	4.6	4.1	-0.2	2.4	1.4	-2.3^a
Philippines	2.3	2.5	+1.4^a	3.5	3.9	+1.6^a	1.1	1.3	+1.5^a
Poland	15.3	9.3	-1.9^a	26.8	16.5	-1.8^a	4.7	2.4	-2.9^a
Portugal	5.5	7.2	+0.4	9.5	11.6	+0.1	2.1	3.5	+1.3^a
Qatar	7.6	4.7	-2.8^a	10.0	5.7	-3.3^a	2.6	1.7	-2.1^a
Republic of Korea	13.9	21.2	+1.1	20.4	29.7	+1.0	8.2	13.4	+1.0
Moldova	16.3	12.2	-1.9^a	30.7	22.1	-2.0^a	4.2	3.3	-2.0^a
Romania	11.3	7.3	-2.1^a	19.4	12.6	-2.1^a	3.7	2.4	-2.4^a
Russian Federation	48.9	21.6	-4.1^a	88.8	38.2	-4.3^a	13.4	7.2	-3.1^a
Rwanda	25.6	9.5	-4.9^a	38.8	14.8	-4.7^a	14.0	5.0	-5.2^a
Saint Lucia	8.1	6.9	-0.4	14.5	12.5	-0.4	2.1	1.5	-1.1^a
Saint Vincent	6.5	1.0	-	12.6	1.3	-	0.5	0.7	-
Samoa	16.3	14.6	-0.5^a	24.1	20.9	-0.7^a	7.8	7.8	+0.2
Sao Tome and Principe	2.2	2.2	-0.2	3.2	3.3	-0.1	1.4	1.2	-0.8^a
Saudi Arabia	3.8	5.4	+2.8a	5.7	7.8	+2.6^a	1.4	1.9	+3.2^a
Senegal	14.4	11.0	-1.3^a	23.5	18.5	-1.1^a	6.8	5.2	-1.2^a
Serbia	18.9	7.9	-7.6^a	29.0	12.2	-8.1^a	10.1	3.9	-6.9^a
Seychelles	9.8	7.7	-1.2^a	18.4	14.0	-1.5^a	1.7	1.3	-1.4^a
Sierra Leone	10.1	11.3	+0.2	14.4	14.8	-0.2	6.5	8.2	+0.9^a
Singapore	11.4	9.7	-2.0^a	15.2	12.7	-1.9^a	7.8	6.4	-2.7^a
Slovakia	12.6	9.3	-1.8^a	21.9	16.7	-1.7^a	4.3	2.6	-2.2^a
Slovenia	25.6	14.0	-3.4^a	40.4	22.7	-3.3^a	12.6	5.5	-4.2^a
Solomon Islands	17.4	17.4	+0.3	32.0	32.2	+0.3^a	2.1	2.4	+1.3^a
Somalia	16.8	14.7	-0.8^a	26.0	22.8	-0.8^a	7.9	7.1	-0.5^a
South Africa	26.6	23.5	-0.8^a	42.7	37.9	-0.6^a	11.6	9.8	-1.5^a
South Sudan	7.9	6.7	-0.9^a	12.4	10.4	-1.0^a	3.9	3.4	-0.8^a
Spain	6.6	5.3	-0.8^a	10.5	7.9	-1.1^a	3.0	2.8	+0.0
Sri Lanka	27.4	12.9	-3.7^a	41.5	20.9	-3.3^a	14	6.1	-3.9^a
Sudan	5.6	4.8	-0.8^a	7.2	6.3	-0.7^a	4.0	3.3	-0.9^a
Suriname	25.0	25.9	-0.3^a	38.8	41.3	-0.2	11.8	11.8	-0.1
Sweden	12.2	12.4	+0.1	17.1	16.9	-0.1	7.5	7.7	+0.4
Switzerland	15.9	9.8	-2.8^a	23.7	14.2	-2.7^a	8.6	5.7	-3.0^a
Syria	2.0	2.1	+0.5^a	3.2	3.5	+0.7^a	0.9	0.8	+0.1
Tajikistan	5.1	5.3	+0.7^a	7.3	7.4	+0.4^a	2.9	3.4	+1.5^a
Thailand	11.6	8.0	-2.1^a	16.4	13.9	-1.2^a	7.1	2.3	-5.4^a
Timor-Leste	4.9	4.5	-0.2	6.5	6.7	+0.4	3.3	2.4	-1.7^a
Togo	17.3	14.8	-1.0^a	27.0	24.0	-0.8^a	8.6	6.5	-1.7^a
Tonga	5.1	4.4	-0.2	6.7	5.9	-0.1	3.6	2.9	-0.5^a
Trinidad and Tobago	16.2	8.3	-3.2^a	26.4	13.1	-3.5^a	6.3	3.7	-1.8^a
Tunisia	3.9	3.2	-1.6^a	5.2	4.6	-1.1^a	2.6	1.8	-2.3^a
Turkey	4.2	2.3	-2.9^a	6.7	3.6	-3.2^a	1.9	1.2	-2.2^a
Turkmenistan	13.8	6.1	-5.9^a	23.7	9.4	-6.5^a	4.6	2.9	-3.6^a
Uganda	21.7	10.4	-4.5^a	38.6	19.4	-4.2^a	8.6	3.7	-5.4^a
Ukraine	33.5	17.7	-3.7^a	62.7	32.7	-3.8^a	8.5	4.7	-3.2^a
United Arab Emirates	8.0	5.2	-2.4^a	9.3	6.3	-2.3^a	4.7	2.6	-3.1^a
United Kingdom	7.7	6.9	+0.0	12.0	10.4	-0.1	3.6	3.4	+0.2
Tanzania	15.6	8.2	-3.1^a	24.5	13.5	-2.8^a	8.1	3.7	-3.7^a
United States of America	10.0	14.5	+1.9^a	16.4	22.4	+1.6^a	4.0	6.8	+2.7^a
Uruguay	14.5	18.8	+1.5^a	25.7	31.1	+1.4^a	5.1	7.7	+1.3^a
Uzbekistan	12.0	8.3	-1.5^a	19.6	11.8	-2.2^a	4.8	4.9	+0.7^a
Vanuatu	23.2	21.0	-0.4^a	36.0	33.1	-0.3^a	10.1	9.0	-0.6^a
Venezuela	6.4	2.1	-6.2^a	11.3	3.7	-6.2^a	1.7	0.7	-5.6^a
Viet Nam	7.2	7.2	+0.4^a	9.4	10.6	+1.1^a	5.2	4.2	-1.0^a
Yemen	8.5	7.1	-1.1^a	10.5	9.0	-1.0^a	6.5	5.3	-1.3^a
Zambia	24.0	14.4	-2.2^a	35.9	25.7	-1.4^a	14.5	5.3	-4.4^a
Zimbabwe	20.0	23.6	+1.9^a	28.2	37.8	+2.7^a	14.2	13.5	+0.8

^aStatistically significant trend (P < 0.05).

¹Joinpoint results are not shown for mortality in some countries, because no case of suicide occurred in at least 1 year in the observed period.

²For full period presented average annual percent change.

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Table 2 Joinpoint regression analysis: global trends in age-specific suicide mortality rates (per 100000), by sex, 2000-2019

Age¹	Males			Females
Age¹	Age-specific rates²(2000)	Age-specific rates²(2019)	AAPC (95%CI)	Age-specific rates²(2000)	Age-specific rates²(2019)	AAPC (95%CI)
10-19	6.7	4.5	-2.0^a [(-2.2)-(-1.8)]	6.7	3.8	-3.0^a [(-3.2)-(-2.7)]
20-29	21.4	15.7	-1.8^a [(-1.9)-(-1.6)]	14.9	7.9	-3.3^a [(-3.8)-(-2.8)]
30-39	23.4	17.6	-1.6^a [(-1.7)-(-1.5)]	12.6	6.3	-3.6^a [(-4.0)-(-3.2)]
40-49	27.6	17.8	-2.6^a [(-2.8)-(-2.4)]	11.0	6.4	-2.7^a [(-2.9)-(-2.5)]
50-59	31.0	19.6	-2.5^a [(-2.6)-(-2.4)]	11.6	7.8	-2.3^a [(-2.7)-(-2.0)]
60-69	33.7	21.8	-2.5^a [(-2.6)-(-2.3)]	13.7	9.2	-2.3^a [(-2.6)-(-2.0)]
70-79	46.0	31.1	-2.3^a [(-2.5)-(-2.1)]	21.4	13.6	-2.8^a [(-3.2)-(-2.4)]
80 +	71.5	52.3	-1.7^a [(-1.9)-(-1.6)]	29.4	19.1	-2.7^a [(-3.1)-(-2.3)]

^aStatistically significant trend.

¹Joinpoint results are not shown for the subgroups aged < 10 years for mortality, because fewer than 5 cases of suicide cases occurred in each of the decennium in any year.

²Average annual, per 100000 people. AAPC: Average annual percent change; CI: Confidence interval.

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Citation: Ilic M, Ilic I. Worldwide suicide mortality trends (2000-2019): A joinpoint regression analysis. World J Psychiatry 2022; 12(8): 1044-1060
URL: https://www.wjgnet.com/2220-3206/full/v12/i8/1044.htm
DOI: https://dx.doi.org/10.5498/wjp.v12.i8.1044