Epidemiology Completed suicide

In the United States, the age-specific mortality rate from suicide for 10- to 14-year-olds was 1.6 per 100 000 in 1997. (24) This age group accounts for 7 per cent of the population but only 1 per cent of all suicides, and most of these occur in 12- to 14-year-olds.

The comparable figures for 15- to 19-year-olds are about six times higher. The suicide rates at this age in the United States and Canada in 1997 were 9.5 per 100 000 and 12.86 per 100 000 respectively.(7) The proportion of suicides that occur in this age group is about the same as its representation in the general population.

Suicide rates for 15- to 24-year-olds in some other English-speaking countries were 11.0 for males and 2.2 for females in the United Kingdom (1995), 16.0 in Australia (1995), and 26.1 in New Zealand (1997) (all per 100 000 population). (D

Gender

In the United States and most other countries, male suicides outnumber female suicides among 15- to 24-year-olds by a ratio of 4:1. In China and Cuba, the suicide rate is higher in females than in males.(7)

Cultural and ethnic differences

Rates of suicide vary considerably in different cultural and national groups. (7) Possible reasons include variable access to lethal methods, different degrees of social support, integration, or group adherence, or the influence of religious beliefs or spirituality. (2 26 and W In some instances, the differences may be a function of geography rather than culture. Contagion within isolated groups may determine differences in rates.

Secular changes

From 1964 to 1995, the suicide rate in the United States and Canada among 15- to 19-year-old males increased almost threefold, and similar increases were reported in Australia, New Zealand, and the United Kingdom.(7) In most of these countries, there was little change in the female rate or in the rate amongst 10- to 14-year-olds. Fluctuations in the suicide rate appear to be real, rather than due to any methodological artefact (e.g. changes in reporting practices). The most plausible reason for the increase in suicidal behaviour among teenage boys is an increase in alcohol and substance use in the youth population. (3) The reasons offered for the recent decline in suicide rates include lowered substance- and alcohol-use rates among the young and more effective diagnosis and treatment. (28)

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