27. Epidemiology and prevention of suicide

  • Epidemiology
    • 1 million worldwide every year
    • 3rd leading cause of death in 15 – 24 age group
    • 80% occur in low and middle income countries
    • Peak incidence: 45 – 65
    • 25 attempts for each success
      • 3:1 in older
      • 100:1 in younger
    • Male > female
    • Suicide attempts more common in women
    • >90% have psychiatric illness or substance abuse disorder
    • 20 – 50% have alcohol or drug use problems
  • Countries
    • Korea
    • Hungary
    • Russia
    • Japan
    • China
  • Individual risk factors
    • Mood disorders
      • Depression
    • Alcoholism
    • Previous attempt
    • Schizophrenia
    • Life crisis
    • Partner problems
    • Chronic pain or illness
    • Impulsivity
    • Isolation
    • Trauma or abuse
  • Socio-cultural risk factors
    • Lack of social support
    • Stigma associated with seeking help
    • Decreased access to health care
    • The belief that suicide is noble
    • Copycat effect
  • Protective factors
    • Easy access to mental health care
    • Strong connection to friends and family
    • Restricted access to means of suicide
    • Problem-solving skills
    • Sense of belonging
    • Positive self-esteem
  • Prevention
    • Restrict access to means of suicide
    • Low-threshold access to help
    • Hotlines
    • Improve social circumstances
    • Programmes in school
    • Screening for mental well-being at GP