Explanations for the rise in youth suicides: a European perspective.

Abstract

Background—Suicide rates have doubled in men aged <30 in England and Wales (E&W) since 1970, while in young women rates have declined. With the exception of the former West Germany many other European countries have experienced similar increases in young male suicide and elsewhere in Europe trends in female suicide have generally followed those in men. Methods—Using age and gender specific social and economic data from four countries with different trends in youth suicide—E&W, West Germany, France and Norway —we have investigated whether changes either in social and economic conditions or in the lethality of suicide methods underlie these differing trends. Results—In young men in E&W, France and Norway suicide rates increased by over 70% between 1970–1990, whereas in West Germany, over the same period, rates declined. In young women, rates decreased in E&W and West Germany but increased in both France and Norway. In all four countries there have been reductions in female overdose suicide mortality but in France and Norway these have been offset by increased use of other methods, particularly hanging. Trends in markers of social and economic conditions are broadly similar in the four countries. Between 1970–1990 levels of unemployment rose steeply in each country. In E&W and France the timing of the increase in unemployment coincided with the rise in suicide. While divorce rates have also increased markedly in all four countries, the timing of these rises differs from that for the increases in suicide in all countries except France. Marriage rates declined in all four countries from around 1970. Changes in all these risk factors have been greatest in people aged <30. There are no clear differences between the countries in trends in alcohol consumption or GDP, both of which have increased. Trends in income inequality show no consistent association with suicide trends. Summary—Changes in the social and economic risk factors examined do not seem to explain differing trends in youth suicide. Changes in the lethality of methods used for suicide may have influenced trends in women. Further research is required into reasons for the discordance in suicide trends in Germany compared with other European countries, explanations are relevant to understanding the aetiology of suicide and in developing preventive strategies. Particular features of Germany in the past 50 years are postwar reconstruction, changes in its national borders and reunification in 1989. It is notable that similar reductions in youth suicide occurred in Japan 1970–1990.