From 2006 to 2015, suicide attempts in the United States became more common and more lethal in certain subgroups of the population, new data from the Centers for Disease Control and Prevention show.
Investigators found the incidence of suicidal acts increased in females, adolescents, and older adults aged 65-74 years, whereas suicidal acts became more lethal in both sexes and in those between the ages of 20 and 64 years.
“Effective suicide prevention efforts must be informed by an understanding of whether increased suicide rates are associated with more suicidal acts, greater lethality of suicidal acts, or a combination of both,” wrote Jing Wang, MD, MPH, and colleagues at the CDC’s National Center for Injury Prevention and Control.
The study was published online April 22 in JAMA Psychiatry.
Prior U.S. studies show a greater incidence of suicide attempts among some adult subgroups and young people, as well as changing patterns in suicide methods over time.
Between 2000 and 2010, for example, the rate of suicide by suffocation jumped 52% compared with a 19% increase in suicide by poisoning and a 3% increase in firearm-related suicides.
However, until now, there’s been no research examining the trends in both incidence and lethality of suicidal acts.
Medically treated nonfatal suicide attempts were identified via the Nationwide Inpatient Sample and Nationwide Emergency Department Sample databases, and suicide deaths were identified via the National Vital Statistics System.
The incidence rate of total suicidal acts rose 10% during the study period (annual percentage change [APC] 0.8%; 95% confidence interval [CI], 0.3%-1.3%). The case fatality rate (CFR) increased 13% (APC, 2.3%; 95% CI, 1.3%-3.3%).
In subgroup analyses, the incidence rate of suicidal acts increased 1.1% (95% CI, 0.6%-1.6%) per year for women but held stable for men. The CFR increased for women and men, with APCs of 5% (95% CI, 3.1%-6.9%) since 2010 for women and 1.6% (95% CI, 0.6%-2.5%) since 2009 for men.
The data show an increase in incidence rate of suicidal acts among adults aged 65-74 years throughout the study period, and among adolescents from 2011 to 2015. The CFR increased since 2009 among those aged 20-44 years (APC, 3.7%; 95% CI, 2.5%-5.0%) and since 2012 for individuals 45-64 years (APC, 2.7%; 95% CI, 0%-5.4%).
Among males and females aged 20-64 years, suicidal acts involving guns and suffocation (methods of greater lethality) increased, but suicidal acts by poisoning (a method of lesser lethality) decreased or flattened, “which may explain the observed increases in lethality,” the CDC researchers said.
“Adolescents and older adults aged 65-74 years experienced general increases in suicide attempts by all means, including poisoning, which was associated with stable or declining lethality for these subgroups,” they reported.
Dr. Wang and colleagues said their findings on population-level epidemiologic patterns may help with efforts to develop comprehensive suicide prevention strategies.
In particular, they said, reducing access to lethal means of suicide among those at risk, “which include not only firearms but also medications and other potentially dangerous household products, may be a helpful approach for reducing suicide rates.
“Ultimately, upstream prevention approaches, including teaching coping and problem-solving skills early in life, promoting connectedness, and developing and implementing policies that strengthen economic supports, may mitigate the risk of suicidal behavior for all age groups,” they concluded.
The study had no specific funding. The authors have disclosed no relevant financial relationships.
A version of this article originally appeared on Medscape.com.