Suicide epidemiology and demographics: Difference between revisions

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__NOTOC__
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{{Suicide}}
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==Overview==
==Overview==
Studies show a high incidence of [[psychiatric disorder]]s in suicide victims at the time of their death with the total figure ranging from 98%<ref name= "BetoloteJM2004">Bertolote JM, Fleischmann A, De Leo D, Wasserman D.
Suicide is the third leading cause of death among all children and adolescents in the United States. In the United States, the incidence rate of suicide among children aged 5 to 11 years was 1 per 1 million, between 2008 and 2012. Among adolescents, the suicide rate is highest for white males.
(2004) Psychiatric diagnoses and suicide: revisiting the evidence. ''Crisis.'', 25(4):147-55. PMID 15580849</ref>
to 87.3%<ref name= "Arsenault-LapierreG2004"> Arsenault-Lapierre G, Kim C, Turecki G. (2004) Psychiatric diagnoses in 3275 suicides: a meta-analysis. ''BMC Psychiatry'', Nov 4;4:37. PMID 15527502</ref> with [[mood disorder]]s and [[substance abuse]] being the two most common. In [[schizophrenia]] suicide can be triggered by either the depression that is common with this disorder, or in response to command [[hallucination|auditory hallucinations]]. Suicide among people suffering from [[bipolar disorder]] is often an impulse, which is due to the sufferer's extreme mood swings (one of the main symptoms of bipolar disorder), or also possibly an outcome of [[delusions]] occurring during an episode of [[mania]] or [[psychotic depression]]. Severe depression is considered a terminal illness due to the likelihood of suicide when left untreated.<ref> Shuster, JL.(2000) Can depression be a terminal illness? Journal of Palliative Medicine. Winter;3(4):493-5. </ref>


==Epidemiology and Demographics==
==Epidemiology and Demographics==
According to official statistics, about a million people die by suicide annually, more than those murdered or killed in war.<ref>{{cite web
| title=Suicide prevention
| publisher=World Health Organization
| year=February 16, 2006
| work=WHO Sites: Mental Health
| url=http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/
| accessdate=2006-04-11
}}</ref> According to 2005 data, suicides in the U.S. outnumber homicides by nearly 2 to 1 and ranks as the 11th leading cause of death in the country, ahead of liver disease and Parkinson's disease.<ref>{{cite web
| title=2005 Data
| publisher=Suicidology.org
| year=2005
| work=Suicide Prevention
| url=http://www.suicidology.org/associations/1045/files/2005datapgs.pdf
| accessdate=2008-03-24
}}</ref>


'''Gender and suicide''': In the Western world, males die much more often by means of suicide than do females, although females attempt suicide more often. This pattern has held for at least a century.<ref>1920 World Book, Volume 9, page 5618</ref> Some medical professionals believe this stems from the fact that males are more likely to end their lives through effective violent means (guns, knives, hanging, etc.), while women primarily use more failure-prone methods such as overdosing on medications; again, this has been the case for at least a century.<ref>1920 World Book, Volume 9, page 5618</ref>  
'''Prevalence'''
*Suicide is the third leading cause of death among all children and adolescents in the United States.<ref name="pmid11551281">{{cite journal |vauthors=Beautrais AL |title=Child and young adolescent suicide in New Zealand |journal=Aust N Z J Psychiatry |volume=35 |issue=5 |pages=647–53 |date=October 2001 |pmid=11551281 |doi=10.1080/0004867010060514 |url=}}</ref><ref name="pmid11331565">{{cite journal |vauthors=McClure GM |title=Suicide in children and adolescents in England and Wales 1970-1998 |journal=Br J Psychiatry |volume=178 |issue= |pages=469–74 |date=May 2001 |pmid=11331565 |doi= |url=}}</ref><ref name="pmid10700371">{{cite journal |vauthors=Hawton K, Fagg J, Simkin S, Bale E, Bond A |title=Deliberate self-harm in adolescents in Oxford, 1985-1995 |journal=J Adolesc |volume=23 |issue=1 |pages=47–55 |date=February 2000 |pmid=10700371 |doi=10.1006/jado.1999.0290 |url=}}</ref><ref name="pmid7708038">{{cite journal |vauthors= |title=Suicide among children, adolescents, and young adults--United States, 1980-1992 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=44 |issue=15 |pages=289–91 |date=April 1995 |pmid=7708038 |doi= |url=}}</ref><ref name="pmid17272625">{{cite journal |vauthors=Hamilton BE, Miniño AM, Martin JA, Kochanek KD, Strobino DM, Guyer B |title=Annual summary of vital statistics: 2005 |journal=Pediatrics |volume=119 |issue=2 |pages=345–60 |date=February 2007 |pmid=17272625 |doi=10.1542/peds.2006-3226 |url=}}</ref><ref name="pmid17766542">{{cite journal |vauthors=Shain BN |title=Suicide and suicide attempts in adolescents |journal=Pediatrics |volume=120 |issue=3 |pages=669–76 |date=September 2007 |pmid=17766542 |doi=10.1542/peds.2007-1908 |url=}}</ref>
*During the time period of 1960s and the 1990s, suicide rates doubled in the 15- to 19-year age group and tripled in the 10- to 14-year age group, in the United States.<ref name="pmid3586265">{{cite journal |vauthors=Brent DA, Perper JA, Allman CJ |title=Alcohol, firearms, and suicide among youth. Temporal trends in Allegheny County, Pennsylvania, 1960 to 1983 |journal=JAMA |volume=257 |issue=24 |pages=3369–72 |date=June 1987 |pmid=3586265 |doi= |url=}}</ref><ref name="pmid1820470">{{cite journal |vauthors=Brent DA, Perper JA, Allman CJ, Moritz GM, Wartella ME, Zelenak JP |title=The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study |journal=JAMA |volume=266 |issue=21 |pages=2989–95 |date=December 1991 |pmid=1820470 |doi= |url=}}</ref>
*Survey data from the United States in 2001, 2003, 2005, and 2007 found that about 7 to 9% of all adolescents attempted suicide in the 12 months before the survey.<ref name="pmid18381544">{{cite journal |vauthors=Martin JA, Kung HC, Mathews TJ, Hoyert DL, Strobino DM, Guyer B, Sutton SR |title=Annual summary of vital statistics: 2006 |journal=Pediatrics |volume=121 |issue=4 |pages=788–801 |date=April 2008 |pmid=18381544 |doi=10.1542/peds.2007-3753 |url=}}</ref><ref name="pmid22291121">{{cite journal |vauthors=Kochanek KD, Kirmeyer SE, Martin JA, Strobino DM, Guyer B |title=Annual summary of vital statistics: 2009 |journal=Pediatrics |volume=129 |issue=2 |pages=338–48 |date=February 2012 |pmid=22291121 |pmc=4079290 |doi=10.1542/peds.2011-3435 |url=}}</ref><ref name="pmid12102329">{{cite journal |vauthors=Grunbaum JA, Kann L, Kinchen SA, Williams B, Ross JG, Lowry R, Kolbe L |title=Youth risk behavior surveillance--United States, 2001 |journal=MMWR Surveill Summ |volume=51 |issue=4 |pages=1–62 |date=June 2002 |pmid=12102329 |doi= |url=}}</ref><ref name="pmid15152182">{{cite journal |vauthors=Grunbaum JA, Kann L, Kinchen S, Ross J, Hawkins J, Lowry R, Harris WA, McManus T, Chyen D, Collins J |title=Youth risk behavior surveillance--United States, 2003 |journal=MMWR Surveill Summ |volume=53 |issue=2 |pages=1–96 |date=May 2004 |pmid=15152182 |doi= |url=}}</ref><ref name="pmid16760893">{{cite journal |vauthors=Eaton DK, Kann L, Kinchen S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Shanklin S, Lim C, Grunbaum JA, Wechsler H |title=Youth risk behavior surveillance--United States, 2005 |journal=MMWR Surveill Summ |volume=55 |issue=5 |pages=1–108 |date=June 2006 |pmid=16760893 |doi= |url=}}</ref><ref name="pmid18528314">{{cite journal |vauthors=Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Lim C, Brener ND, Wechsler H |title=Youth risk behavior surveillance--United States, 2007 |journal=MMWR Surveill Summ |volume=57 |issue=4 |pages=1–131 |date=June 2008 |pmid=18528314 |doi= |url=}}</ref>


Others ascribe the difference to inherent differences in male/female psychology. Greater social stigma against male depression and a lack of social networks of support and help with depression are often identified as key reasons for men's disproportionately higher level of suicides, since suicide as a "cry for help" is not seen by men as an equally viable option. Typically males die from suicide three to four times more often as females, and not unusually five or more times as often.
'''Age'''
*In the United States, the incidence rate of suicide among children aged 5 to 11 years was 1 per 1 million, between 2008 and 2012.<ref name="pmid17726127">{{cite journal |vauthors=Tishler CL, Reiss NS, Rhodes AR |title=Suicidal behavior in children younger than twelve: a diagnostic challenge for emergency department personnel |journal=Acad Emerg Med |volume=14 |issue=9 |pages=810–8 |date=September 2007 |pmid=17726127 |doi=10.1197/j.aem.2007.05.014 |url=}}</ref><ref name="pmid16183394">{{cite journal |vauthors=Doshi A, Boudreaux ED, Wang N, Pelletier AJ, Camargo CA |title=National study of US emergency department visits for attempted suicide and self-inflicted injury, 1997-2001 |journal=Ann Emerg Med |volume=46 |issue=4 |pages=369–75 |date=October 2005 |pmid=16183394 |doi=10.1016/j.annemergmed.2005.04.018 |url=}}</ref><ref name="pmid25984947">{{cite journal |vauthors=Bridge JA, Asti L, Horowitz LM, Greenhouse JB, Fontanella CA, Sheftall AH, Kelleher KJ, Campo JV |title=Suicide Trends Among Elementary School-Aged Children in the United States From 1993 to 2012 |journal=JAMA Pediatr |volume=169 |issue=7 |pages=673–7 |date=July 2015 |pmid=25984947 |doi=10.1001/jamapediatrics.2015.0465 |url=}}</ref><ref name="pmid8634012">{{cite journal |vauthors=Shaffer D, Gould MS, Fisher P, Trautman P, Moreau D, Kleinman M, Flory M |title=Psychiatric diagnosis in child and adolescent suicide |journal=Arch. Gen. Psychiatry |volume=53 |issue=4 |pages=339–48 |date=April 1996 |pmid=8634012 |doi= |url=}}</ref><ref name="pmid9585647">{{cite journal |vauthors=Grøholt B, Ekeberg O, Wichstrøm L, Haldorsen T |title=Suicide among children and younger and older adolescents in Norway: a comparative study |journal=J Am Acad Child Adolesc Psychiatry |volume=37 |issue=5 |pages=473–81 |date=May 1998 |pmid=9585647 |doi=10.1097/00004583-199805000-00008 |url=}}</ref>


Excess male mortality from suicide is also evident from data from non-western countries. In 1979–81, 74 territories reported one or more cases of suicides. Two of these reported equal rates for both sexes: Seychelles and Kenya. Three territories reported female rates exceeding male rates: Papua New Guinea, Macau, French Guiana. The remaining 69 territories had male suicide rates greater than female suicide rates.<ref>Lester, Patterns, Table 3.3, pp. 31-33</ref>
'''Sex'''
*The rate of suicidal ideation is greater in high school girls than boys (21 to 31% versus 13 to 20%)<ref name="pmid12102329">{{cite journal |vauthors=Grunbaum JA, Kann L, Kinchen SA, Williams B, Ross JG, Lowry R, Kolbe L |title=Youth risk behavior surveillance--United States, 2001 |journal=MMWR Surveill Summ |volume=51 |issue=4 |pages=1–62 |date=June 2002 |pmid=12102329 |doi= |url=}}</ref>
*Suicide attempts are also more common in adolescent girls than boys<ref name="pmid15152182">{{cite journal |vauthors=Grunbaum JA, Kann L, Kinchen S, Ross J, Hawkins J, Lowry R, Harris WA, McManus T, Chyen D, Collins J |title=Youth risk behavior surveillance--United States, 2003 |journal=MMWR Surveill Summ |volume=53 |issue=2 |pages=1–96 |date=May 2004 |pmid=15152182 |doi= |url=}}</ref>
*Adolescent boys are more likely to complete suicide than girls<ref name="pmid10697808">{{cite journal |vauthors=Grunbaum JA, Kann L, Kinchen SA, Ross JG, Gowda VR, Collins JL, Kolbe LJ |title=Youth risk behavior surveillance. National Alternative High School Youth Risk Behavior Survey, United States, 1998 |journal=J Sch Health |volume=70 |issue=1 |pages=5–17 |date=January 2000 |pmid=10697808 |doi= |url=}}</ref><ref name="pmid9393659">{{cite journal |vauthors= |title=Youth Risk Behavior Surveillance: National College Health Risk Behavior Survey--United States, 1995 |journal=MMWR CDC Surveill Summ |volume=46 |issue=6 |pages=1–56 |date=November 1997 |pmid=9393659 |doi= |url=}}</ref>


Barraclough found that the female rates of those aged 5–14 equaled or exceeded the male rates only in 14 countries, mainly in South America and Asia.<ref>Barraclough,B M. Sex ratio of juvenile suicide. Journal of the American Academy of Child & Adolescent Psychiatry, 1987, 26, 434-435.</ref>
'''Race/ethnicity'''
*The suicide rates are variable among different ethnic groups<ref name="pmid9531022">{{cite journal |vauthors= |title=Suicide among black youths--United States, 1980-1995 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=47 |issue=10 |pages=193–6 |date=March 1998 |pmid=9531022 |doi= |url=}}</ref>
*Among adolescents, the suicide rate is highest for white males<ref name="pmid18528314">{{cite journal |vauthors=Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Lim C, Brener ND, Wechsler H |title=Youth risk behavior surveillance--United States, 2007 |journal=MMWR Surveill Summ |volume=57 |issue=4 |pages=1–131 |date=June 2008 |pmid=18528314 |doi= |url=}}</ref>
*During 1980 and 1996, the suicide rate increased most rapidly among black males ages 15 to 19 years (from 3.6 to 8.1 per 100,000)


'''National suicide rates''' sometimes tend to remain stable. For example, the 1975 rates for Australia, Denmark, England, France, Norway, and Switzerland  were within 3.0 per 100,000 of population from the 1875 rates.<ref>Australian Bureau of Statistics, 1983; Lester, Patterns, 1996, p. 21</ref> The rates in 1910–14 and in 1960 differed less than 2.5 per 100,000 of the population in Australia, Belgium, Denmark, England and Wales, Ireland, Japan, New Zealand, Norway, Scotland, South Africa, Spain, Sweden, and the Netherlands.<ref>Lester, Patterns, 1996, p. 22</ref>
'''National suicide rates''' sometimes tend to remain stable. For example, the 1975 rates for Australia, Denmark, England, France, Norway, and Switzerland  were within 3.0 per 100,000 of population from the 1875 rates.<ref>Australian Bureau of Statistics, 1983; Lester, Patterns, 1996, p. 21</ref> The rates in 1910–14 and in 1960 differed less than 2.5 per 100,000 of the population in Australia, Belgium, Denmark, England and Wales, Ireland, Japan, New Zealand, Norway, Scotland, South Africa, Spain, Sweden, and the Netherlands.<ref>Lester, Patterns, 1996, p. 22</ref>
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'''Ethnic groups and suicide''': In the USA, Asian-Americans are more likely to die by suicide than any other ethnic group. [[White American|Caucasians]] die by suicide more often than [[African American]]s do. This is true for both genders. Non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or [[Hispanic]]s.<ref>{{PDFlink|[http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_13.pdf]|3.72&nbsp;[[Mebibyte|MiB]]<!-- application/pdf, 3901433 bytes -->}}</ref>  
'''Ethnic groups and suicide''': In the USA, Asian-Americans are more likely to die by suicide than any other ethnic group. [[White American|Caucasians]] die by suicide more often than [[African American]]s do. This is true for both genders. Non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or [[Hispanic]]s.<ref>{{PDFlink|[http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_13.pdf]|3.72&nbsp;[[Mebibyte|MiB]]<!-- application/pdf, 3901433 bytes -->}}</ref>  


'''Age and suicide''': In the USA, males over the age of seventy die by suicide more often than younger males. There is no such trend for females. Older non-Hispanic Caucasian men are much more likely to kill themselves than older men or women of any other group, which contributes to the relatively high suicide rate among Caucasians.
.


'''Season and suicide''': People die by suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception.<ref name="Christmas">{{cite news
'''Season and suicide''': People die by suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception.<ref name="Christmas">{{cite news
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Primary care]]
[[Category:Psychiatry]]
[[Category:Psychiatry]]
{{WH}}
{{WS}}

Latest revision as of 00:20, 30 July 2020

Suicide Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

Overview

Suicide is the third leading cause of death among all children and adolescents in the United States. In the United States, the incidence rate of suicide among children aged 5 to 11 years was 1 per 1 million, between 2008 and 2012. Among adolescents, the suicide rate is highest for white males.

Epidemiology and Demographics

Prevalence

  • Suicide is the third leading cause of death among all children and adolescents in the United States.[1][2][3][4][5][6]
  • During the time period of 1960s and the 1990s, suicide rates doubled in the 15- to 19-year age group and tripled in the 10- to 14-year age group, in the United States.[7][8]
  • Survey data from the United States in 2001, 2003, 2005, and 2007 found that about 7 to 9% of all adolescents attempted suicide in the 12 months before the survey.[9][10][11][12][13][14]

Age

  • In the United States, the incidence rate of suicide among children aged 5 to 11 years was 1 per 1 million, between 2008 and 2012.[15][16][17][18][19]

Sex

  • The rate of suicidal ideation is greater in high school girls than boys (21 to 31% versus 13 to 20%)[11]
  • Suicide attempts are also more common in adolescent girls than boys[12]
  • Adolescent boys are more likely to complete suicide than girls[20][21]

Race/ethnicity

  • The suicide rates are variable among different ethnic groups[22]
  • Among adolescents, the suicide rate is highest for white males[14]
  • During 1980 and 1996, the suicide rate increased most rapidly among black males ages 15 to 19 years (from 3.6 to 8.1 per 100,000)

National suicide rates sometimes tend to remain stable. For example, the 1975 rates for Australia, Denmark, England, France, Norway, and Switzerland were within 3.0 per 100,000 of population from the 1875 rates.[23] The rates in 1910–14 and in 1960 differed less than 2.5 per 100,000 of the population in Australia, Belgium, Denmark, England and Wales, Ireland, Japan, New Zealand, Norway, Scotland, South Africa, Spain, Sweden, and the Netherlands.[24]

Suicides per 100,000 people per year[25]
Rank Country Males Females Total Year
1 Lithuania 70.1 14.0 40.2 2004
2 Belarus 63.3 10.3 35.1 2003
3 Russia 61.6 10.7 34.3 2004
4 Kazakhstan 51.0 8.9 29.2 2003
5 Hungary 44.9 12.0 27.7 2003
6 Guyana 42.5 12.1 27.2 2003
7 South Korea[26][27] N/A N/A 26.1 2005
8 Slovenia 37.9 13.9 25.6 2004
9 Latvia 42.9 8.5 24.3 2004
10 Japan 35.6 12.8 24.0 2004

There are considerable differences in national suicide rates among various countries. Findings from two studies showed a range from 0 to more than 40 suicides per 100,000 of population.[28]

National suicide rates, apparently universally, show a long-term upward trend. This trend has been well-documented in European countries.[29] The trend for national suicide rates to rise slowly over time might be an indirect result of the gradual reduction in deaths from other causes, i.e. falling death rates from causes other than suicide uncover a previously hidden predisposition towards suicide.[30][31] There may also be an explanation in the reduced stigma attached to survivors as suicide is no longer considered a crime or a sin. This may allow coroners to record more suicides as such and so increase stats.

Ethnic groups and suicide: In the USA, Asian-Americans are more likely to die by suicide than any other ethnic group. Caucasians die by suicide more often than African Americans do. This is true for both genders. Non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or Hispanics.[32]

.

Season and suicide: People die by suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception.[33] There is also potential risk of suicide in some people experiencing Seasonal affective disorder.

References

  1. Beautrais AL (October 2001). "Child and young adolescent suicide in New Zealand". Aust N Z J Psychiatry. 35 (5): 647–53. doi:10.1080/0004867010060514. PMID 11551281.
  2. McClure GM (May 2001). "Suicide in children and adolescents in England and Wales 1970-1998". Br J Psychiatry. 178: 469–74. PMID 11331565.
  3. Hawton K, Fagg J, Simkin S, Bale E, Bond A (February 2000). "Deliberate self-harm in adolescents in Oxford, 1985-1995". J Adolesc. 23 (1): 47–55. doi:10.1006/jado.1999.0290. PMID 10700371.
  4. "Suicide among children, adolescents, and young adults--United States, 1980-1992". MMWR Morb. Mortal. Wkly. Rep. 44 (15): 289–91. April 1995. PMID 7708038.
  5. Hamilton BE, Miniño AM, Martin JA, Kochanek KD, Strobino DM, Guyer B (February 2007). "Annual summary of vital statistics: 2005". Pediatrics. 119 (2): 345–60. doi:10.1542/peds.2006-3226. PMID 17272625.
  6. Shain BN (September 2007). "Suicide and suicide attempts in adolescents". Pediatrics. 120 (3): 669–76. doi:10.1542/peds.2007-1908. PMID 17766542.
  7. Brent DA, Perper JA, Allman CJ (June 1987). "Alcohol, firearms, and suicide among youth. Temporal trends in Allegheny County, Pennsylvania, 1960 to 1983". JAMA. 257 (24): 3369–72. PMID 3586265.
  8. Brent DA, Perper JA, Allman CJ, Moritz GM, Wartella ME, Zelenak JP (December 1991). "The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study". JAMA. 266 (21): 2989–95. PMID 1820470.
  9. Martin JA, Kung HC, Mathews TJ, Hoyert DL, Strobino DM, Guyer B, Sutton SR (April 2008). "Annual summary of vital statistics: 2006". Pediatrics. 121 (4): 788–801. doi:10.1542/peds.2007-3753. PMID 18381544.
  10. Kochanek KD, Kirmeyer SE, Martin JA, Strobino DM, Guyer B (February 2012). "Annual summary of vital statistics: 2009". Pediatrics. 129 (2): 338–48. doi:10.1542/peds.2011-3435. PMC 4079290. PMID 22291121.
  11. 11.0 11.1 Grunbaum JA, Kann L, Kinchen SA, Williams B, Ross JG, Lowry R, Kolbe L (June 2002). "Youth risk behavior surveillance--United States, 2001". MMWR Surveill Summ. 51 (4): 1–62. PMID 12102329.
  12. 12.0 12.1 Grunbaum JA, Kann L, Kinchen S, Ross J, Hawkins J, Lowry R, Harris WA, McManus T, Chyen D, Collins J (May 2004). "Youth risk behavior surveillance--United States, 2003". MMWR Surveill Summ. 53 (2): 1–96. PMID 15152182.
  13. Eaton DK, Kann L, Kinchen S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Shanklin S, Lim C, Grunbaum JA, Wechsler H (June 2006). "Youth risk behavior surveillance--United States, 2005". MMWR Surveill Summ. 55 (5): 1–108. PMID 16760893.
  14. 14.0 14.1 Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Lim C, Brener ND, Wechsler H (June 2008). "Youth risk behavior surveillance--United States, 2007". MMWR Surveill Summ. 57 (4): 1–131. PMID 18528314.
  15. Tishler CL, Reiss NS, Rhodes AR (September 2007). "Suicidal behavior in children younger than twelve: a diagnostic challenge for emergency department personnel". Acad Emerg Med. 14 (9): 810–8. doi:10.1197/j.aem.2007.05.014. PMID 17726127.
  16. Doshi A, Boudreaux ED, Wang N, Pelletier AJ, Camargo CA (October 2005). "National study of US emergency department visits for attempted suicide and self-inflicted injury, 1997-2001". Ann Emerg Med. 46 (4): 369–75. doi:10.1016/j.annemergmed.2005.04.018. PMID 16183394.
  17. Bridge JA, Asti L, Horowitz LM, Greenhouse JB, Fontanella CA, Sheftall AH, Kelleher KJ, Campo JV (July 2015). "Suicide Trends Among Elementary School-Aged Children in the United States From 1993 to 2012". JAMA Pediatr. 169 (7): 673–7. doi:10.1001/jamapediatrics.2015.0465. PMID 25984947.
  18. Shaffer D, Gould MS, Fisher P, Trautman P, Moreau D, Kleinman M, Flory M (April 1996). "Psychiatric diagnosis in child and adolescent suicide". Arch. Gen. Psychiatry. 53 (4): 339–48. PMID 8634012.
  19. Grøholt B, Ekeberg O, Wichstrøm L, Haldorsen T (May 1998). "Suicide among children and younger and older adolescents in Norway: a comparative study". J Am Acad Child Adolesc Psychiatry. 37 (5): 473–81. doi:10.1097/00004583-199805000-00008. PMID 9585647.
  20. Grunbaum JA, Kann L, Kinchen SA, Ross JG, Gowda VR, Collins JL, Kolbe LJ (January 2000). "Youth risk behavior surveillance. National Alternative High School Youth Risk Behavior Survey, United States, 1998". J Sch Health. 70 (1): 5–17. PMID 10697808.
  21. "Youth Risk Behavior Surveillance: National College Health Risk Behavior Survey--United States, 1995". MMWR CDC Surveill Summ. 46 (6): 1–56. November 1997. PMID 9393659.
  22. "Suicide among black youths--United States, 1980-1995". MMWR Morb. Mortal. Wkly. Rep. 47 (10): 193–6. March 1998. PMID 9531022.
  23. Australian Bureau of Statistics, 1983; Lester, Patterns, 1996, p. 21
  24. Lester, Patterns, 1996, p. 22
  25. Country reports and charts available, World Health Organization, accessed on March 16 2008.
  26. Suicide in South Korea Case of Too Little, Too Late, OhmyNews KOREA
  27. S. Korea has top suicide rate among OECD countries, Seoul, September 18, 2006 Yonhap News
  28. La Vecchia, C., Lucchini, F., & Levi, F. (1994) Worldwide trends in suicide mortality, 1955-1989. Acta Psychiatrica Scandinavica, 90, 53-64.; Lester, Patterns, 1996, pp. 28-30.
  29. Lester, Patterns, 1996, p. 2.
  30. Baldessarini, R. J., & Jamison, K. R. (1999) Effects of medical interventions on suicidal behavior. Journal of Clinical Psychiatry, 60 (Suppl. 2), 117-122.
  31. Khan, A., Warner, H. A., & Brown, W. A. (2000) Symptom reduction and suicide risk in patients treated with placebo in antidepressant clinical trials. Archives of General Psychiatry, 57, 311-317.
  32. Template:PDFlink
  33. "Questions About Suicide". Centre For Suicide Prevention. 2006.

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