Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016

Heather M. Orpana, Laurie B. Marczak, Megha Arora, Nooshin Abbasi, Rizwan Suliankatchi Abdulkader, Zegeye Abebe, Haftom Niguse Abraha, Mohsen Afarideh, Mahdi Afshari, Alireza Ahmadi, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Nadia Akseer, Rajaa M. Al‐raddadi, Fares Alahdab, Ala'a Alkerwi, Peter Allebeck, Nelson Alvis‐guzman, Nahla Hamed AnberMina Anjomshoa, Carl Abelardo T. Antonio, Amit Arora, Krishna K. Aryal, Solomon Weldegebreal Asgedom, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Hamid Badali, Suzanne Lyn Barker‐collo, Till Winfried Bärnighausen, Shahrzad Bazargan‐hejazi, Corina Benjet, Isabela M. Bensenor, Noami Berfeld, Mircea Beuran, Zulfiqar A. Bhutta, Belete Biadgo, Nigus Bililign, Guilherme Borges, Rohan Borschmann, Alexandra Brazinova, Nicholas J.K. Breitborde, Traolach Brugha, Zahid A. Butt, Juan J. Carrero, Félix Carvalho, Deborah Carvalho Malta, Carlos A. Castañeda‐orjuela, Ferrán Catalá‐lópez, Liliana G. Ciobanu, Berihun Assefa Dachew, Lalit Dandona, Rakhi Dandona, Paul I. Dargan, Ahmad Daryani, Dragos Virgil Davitoiu, Kairat Davletov, Louisa Degenhardt, Gebre Teklemariam Demoz, Don C.Des Jarlais, Samath Dhamminda Dharmaratne, Shirin Djalalinia, Linh Doan, David Teye Doku, Manisha Dubey, Ziad El‐khatib, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Andre Faro, Farshad Farzadfar, Wubalem Fekadu, Eduarda Fernandes, Alize J. Ferrari, Irina Filip, Florian Fischer, Kyle J. Foreman, Takeshi Fukumoto, Abadi Kahsu Gebre, Giuseppe Grosso, Rahul Gupta, Juanita A. Haagsma, Hassan Haghparast Bidgoli, Arvin Haj‐mirzaian, Samer Hamidi, Graeme J. Hankey, Josep Maria Haro, Hamid Yimam Hassen, Simon I. Hay, Behnam Heidari, Delia Hendrie, Enayatollah Homaie Rad, Seyed Mostafa Hosseini, Sorin Hostiuc, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Mihajlo Jakovljevic, Spencer James, Achala Upendra Jayatilleke, Ravi Prakash Jha, Jost B. Jonas, Jacek Jerzy Jozwiak, Rajendra Kadel, Amaha Kahsay, Amir Kasaeian, Getachew Mullu Kassa, Norito Kawakami, Adane Teshome Kefale, Grant Rodgers Kemp, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Ibrahim A. Khalil, Ejaz Ahmad Khan, Muhammad Ali Khan, Muhammad Shahzeb Khan, Young Ho Khang, Jagdish Khubchandani, Aliasghar A. Kiadaliri, Christian Kieling, Young Eun Kim, Adnan Kisa, Ann Kristin Skrindo Knudsen, Yoshihiro Kokubo, Ai Koyanagi, Varsha Sarah Krish, Barthelemy Kuate Defo, G. Anil Kumar, Manasi Kumar, Prabhat Lamichhane, Justin J. Lang, Arman Latifi, Paul H. Lee, Janni Leung, Lee Ling Lim, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Rafael Lozano, Raimundas Lunevicius, P. A. Mahesh, Marek Majdan, Reza Majdzadeh, Reza Malekzadeh, Ana Laura Manda, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Joemer C. Maravilla, Jose Martinez‐raga, Manu Raj Mathur, Pallab K. Maulik, John J. McGrath, Ravi Mehrotra, Tesfa Mekonen, Walter Mendoza, Tuomo J. Meretoja, Tomislav Mestrovic, Ted R. Miller, G. K. Mini, Erkin M. Mirrakhimov, Philip B. Mitchell, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Shafiu Mohammed, Ali H. Mokdad, Lorenzo Monasta, Mahmood Moosazadeh, Ghobad Moradi, Maziar Moradi‐lakeh, Mehdi Moradinazar, Ilais Moreno Velásquez, Naho Morisaki, Shane Douglas Morrison, Marilita M. Moschos, Seyyed Meysam Mousavi, Ghulam Mustafa, Gabriele Nagel, Aliya Naheed, Gurudatta Naik, Farid Najafi, Ionut Negoi, Ruxandra Irina Negoi, Huong Lan Thi Nguyen, Long Hoang Nguyen, Molly R. Nixon, Richard Ofori‐asenso, Felix Akpojene Ogbo, In Hwan Oh, Andrew T. Olagunju, Tinuke O. Olagunju, Simon Øverland, Mayowa Ojo Owolabi, Songhomitra Panda‐jonas, Charles D.H. Parry, Sanghamitra Pati, Scott B. Patten, George C. Patton, Max Petzold, Michael R. Phillips, Oleguer Plana‐ripoll, Maarten J. Postma, Akram Pourshams, Hossein Poustchi, Mostafa Qorbani, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Afarin Rahimi‐movaghar, Vafa Rahimi‐movaghar, Muhammad Aziz Rahman, Rajesh Kumar Rai, Shahab Rezaeian, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Perminder S. Sachdev, Hosein Safari, Saeid Safiri, Payman Salamati, Yahya Salimi, Joshua A. Salomon, Abdallah M. Samy, Itamar S. Santos, Milena M. Santric‐milicevic, Benn Sartorius, Shahabeddin Sarvi, Maheswar Satpathy, Monika Sawhney, David C. Schwebel, Sadaf G. Sepanlou, Masood Ali Shaikh, Mehdi Sharif, Kenji Shibuya, Mika Shigematsu, Rahman Shiri, Ivy Shiue, Soraya Siabani, Tariq J. Siddiqi, Inga Dora Sigfusdottir, João Pedro Silva, Jasvinder A. Singh, Adauto Martins Soares Filho, Soheila Sobhani, Dan J. Stein, Murray B. Stein, Mu'awiyyah Babale Sufiyan, Bruno F. Sunguya, Rafael Tabarés‐seisdedos, Karen M. Tabb, Mohammad Tavakkoli, Arash Tehrani‐banihashemi, Mohamad Hani Temsah, Roman Topor‐madry, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Jurgen Unutzer, Muhammad Shariq Usman, Olalekan A. Uthman, Pascual R. Valdez, Tommi Juhani Vasankari, Cintia Vasconcelos, Vasily Vlassov, Theo Vos, Isidora S. Vujcic, Yasir Waheed, Yuan Pang Wang, Elisabete Weiderpass, Andrea Werdecker, Ronny Westerman, Harvey A. Whiteford, Grant M.A. Wyper, Mehdi Yaseri, Ebrahim M. Yimer, Engida Yisma, Naohiro Yonemoto, Seok Jun Yoon, Marcel Yotebieng, Mahmoud Yousefifard, Chuanhua Yu, Zoubida Zaidi, Mohammad Zamani, Christopher J.L. Murray, Mohsen Naghavi

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    179 Citations (Scopus)

    Abstract

    Objectives To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Design Systematic analysis. Main outcome measures Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). Results The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%). Conclusions Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.

    Original languageEnglish
    Article number94
    JournalBMJ (Online)
    Volume364
    DOIs
    Publication statusPublished - 2019 Jan 1

    Bibliographical note

    Publisher Copyright:
    © Published by the BMJ Publishing Group Limited.

    ASJC Scopus subject areas

    • General Medicine

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