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What Are Reasons for the Large Gender Differences in the Lethality of Suicidal Acts? An Epidemiological Analysis in Four European Countries

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Listed:
  • Roland Mergl
  • Nicole Koburger
  • Katherina Heinrichs
  • András Székely
  • Mónika Ditta Tóth
  • James Coyne
  • Sónia Quintão
  • Ella Arensman
  • Claire Coffey
  • Margaret Maxwell
  • Airi Värnik
  • Chantal van Audenhove
  • David McDaid
  • Marco Sarchiapone
  • Armin Schmidtke
  • Axel Genz
  • Ricardo Gusmão
  • Ulrich Hegerl

Abstract

Background: In Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate of completed suicides, indicating major gender differences in lethality of suicidal behaviour. The aim of this study was to analyse the extent to which these gender differences in lethality can be explained by factors such as choice of more lethal methods or lethality differences within the same suicide method or age. In addition, we explored gender differences in the intentionality of suicide attempts. Methods and Findings: Methods. Design: Epidemiological study using a combination of self-report and official data. Setting: Mental health care services in four European countries: Germany, Hungary, Ireland, and Portugal. Data basis: Completed suicides derived from official statistics for each country (767 acts, 74.4% male) and assessed suicide attempts excluding habitual intentional self-harm (8,175 acts, 43.2% male). Findings Main Results: Suicidal acts (fatal and non-fatal) were 3.4 times more lethal in men than in women (lethality 13.91% (regarding 4106 suicidal acts) versus 4.05% (regarding 4836 suicidal acts)), the difference being significant for the methods hanging, jumping, moving objects, sharp objects and poisoning by substances other than drugs. Median age at time of suicidal behaviour (35–44 years) did not differ between males and females. The overall gender difference in lethality of suicidal behaviour was explained by males choosing more lethal suicide methods (odds ratio (OR) = 2.03; 95% CI = 1.65 to 2.50; p

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  • Roland Mergl & Nicole Koburger & Katherina Heinrichs & András Székely & Mónika Ditta Tóth & James Coyne & Sónia Quintão & Ella Arensman & Claire Coffey & Margaret Maxwell & Airi Värnik & Chantal van A, 2015. "What Are Reasons for the Large Gender Differences in the Lethality of Suicidal Acts? An Epidemiological Analysis in Four European Countries," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-18, July.
    • Handle: RePEc:plo:pone00:0129062
    DOI: 10.1371/journal.pone.0129062
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    References listed on IDEAS

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    1. Spicer, R.S. & Miller, T.R., 2000. "Suicide acts in 8 states: Incidence and case fatality rates by demographics and method," American Journal of Public Health, American Public Health Association, vol. 90(12), pages 1885-1891.
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    1. Yolanda Mejías-Martín & Juan de Dios Luna del Castillo & Candela Rodríguez-Mejías & Celia Martí-García & Juan Pablo Valencia-Quintero & María Paz García-Caro, 2019. "Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain)," IJERPH, MDPI, vol. 16(22), pages 1-13, November.
    2. Atsushi Kimura & Akitoyo Hishimoto & Ikuo Otsuka & Satoshi Okazaki & Shuken Boku & Tadasu Horai & Takeshi Izumi & Motonori Takahashi & Yasuhiro Ueno & Osamu Shirakawa & Ichiro Sora, 2018. "Loss of chromosome Y in blood, but not in brain, of suicide completers," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-11, January.
    3. Martina Padovano & Mariarosaria Aromatario & Stefano D’Errico & Monica Concato & Federico Manetti & Maria Chiara David & Matteo Scopetti & Paola Frati & Vittorio Fineschi, 2022. "Sodium Nitrite Intoxication and Death: Summarizing Evidence to Facilitate Diagnosis," IJERPH, MDPI, vol. 19(21), pages 1-16, October.
    4. Javzan Badarch & Bayar Chuluunbaatar & Suvd Batbaatar & Edit Paulik, 2022. "Suicide Attempts among School-Attending Adolescents in Mongolia: Associated Factors and Gender Differences," IJERPH, MDPI, vol. 19(5), pages 1-10, March.
    5. Stefan Wiktorsson & Therese Rydberg Sterner & Madeleine Mellqvist Fässberg & Ingmar Skoog & Anne Ingeborg Berg & Paul Duberstein & Kimberly Van Orden & Margda Waern, 2018. "Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above," IJERPH, MDPI, vol. 15(1), pages 1-12, January.

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