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.
Bibliographical noteFunding Information:
Research reported in this publication was supported by the Bill and Melinda Gates Foundation (OPP1152504). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to the study data and had final responsibility for the decision to submit for publication. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: CAA Antonio reports personal fees from Johnson and Johnson (Philippines), Inc, outside the submitted work. LD reports grants from Seqirus, Indivior, and Mundipharma, outside the submitted work. JMH reports personal fees from Lundbeck, Eli Lilly and Co, and Otsuka, outside the submitted work. JJ reports a grant from VALEANT; personal fees from VALEANT, ALAB Laboratoria, and AMGEN; and non-financial support from MICROLIFE and SERVIER, from outside the submitted work. CK has received authorship royalties from Brazilian publishers Artmed and Manole. SL reports personal fees from Akcea Therapeutics, AMGEN, Berlin-Chemie, MSD Sharp and Dohme, Novo Nordisk, Sanofi-Aventis, Synlab, Unilever, and non-financial support from Preventicus outside the submitted work. WM is currently Program Analyst, Population and Development, in the Peru Country Office of the United Nations Population Fund (UNFPA), the institution does not necessarily endorse this study. CP reports other support from South African National Department of Health during the conduct of the study. MP reports grants and personal fees from various pharmaceutical industries, all outside the submitted work. MP holds stocks in Ingress Health and Pharmacoeconomics Advice Groningen (PAG Ltd) and is advisor to Asc Academics. JS reports consulting activities with Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta/Horizon, Allergan, Fidia, UBM LLC, WebMD, and the American College of Rheumatology; grants from Takeda and Savient; stocks from Amarin Pharmaceuticals; serves as the principal investigator for an investigator-initiated study funded by Horizon Pharmaceuticals through a grant to DINORA, Inc; and is on the steering committee of OMERACT, which receives funding from 36 pharmaceutical companies. MS reports personal fees from Janssen Pharmaceuticals, Bionomics, Aptinyx, and Neurocrine outside the submitted work.
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