1Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
2Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3Shiraz University of Medical Sciences, Shiraz, Iran
4Mental Health, Shiraz University of Medical Sciences, Shiraz, Iran
Copyright © 2023 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest associated with the material presented in this paper.
FUNDING
None.
AUTHOR CONTRIBUTIONS
Conceptualization: Mirahmadizadeh A, Azarbakhsh H. Data curation: Azarbakhsh H, Moftakhar L. Formal analysis: Azarbakhsh H, Rezaei F, Moftakhar L. Funding acquisition: None. Methodology: Mirahmadizadeh A, Azarbakhsh H. Project administration: Azarbakhsh H, Amiri S. Visualization: Rezaei F. Writing – original draft: Moftakhar L, Amiri S. Writing – review & editing: Moftakhar L, Mirahmadizadeh A, Amiri S, Rezaei F, Azarbakhsh H.
Variables | Hanging attempts rate | Hanging mortality rate1 | CFR | ||||||
---|---|---|---|---|---|---|---|---|---|
Age (y) | Male | Female | All | Male | Female | All | Male | Female | All |
10-14 | 2.22 | 0.82 | 1.53 | 2.00 | 0.74 | 1.39 | 90.32 | 90.90 | 90.47 |
15-24 | 8.33 | 2.71 | 5.58 | 6.46 | 1.85 | 4.20 | 77.48 | 68.29 | 75.29 |
25-34 | 7.21 | 1.32 | 4.29 | 5.51 | 0.83 | 3.19 | 76.50 | 63.15 | 74.46 |
35-44 | 4.90 | 0.93 | 2.93 | 4.17 | 0.83 | 2.51 | 85.23 | 89.28 | 85.87 |
45-54 | 4.35 | 0.91 | 2.65 | 3.69 | 0.71 | 2.22 | 84.94 | 78.94 | 83.92 |
55-64 | 2.43 | 1.10 | 1.76 | 2.22 | 1.10 | 1.66 | 91.42 | 100.00 | 94.11 |
≥65 | 2.83 | 0.84 | 1.83 | 2.66 | 0.84 | 1.74 | 93.93 | 100.00 | 95.34 |
Total | 5.50 | 1.36 | 3.50 | 4.42 | 1.02 | 2.79 | 80.71 | 75.33 | 79.34 |
Year | Crude | Age-standardized (95% CI) | Crude | Age-standardized (95% CI) | Crude | From standardized rates | |||
2011 | 0.81 | 0.72 (0.43, 1.02) | 0.33 | 0.30 (0.12, 0.48) | 41.37 | 41.23 | |||
2012 | 2.79 | 2.67 (2.12, 3.22) | 2.59 | 2.50 (1.98, 3.02) | 93.00 | 93.64 | |||
2013 | 3.65 | 3.46 (2.84, 4.09) | 3.18 | 2.99 (2.43, 3.56) | 87.12 | 86.41 | |||
2014 | 3.81 | 3.62 (2.99, 4.25) | 3.18 | 3.09 (2.51, 3.66) | 83.45 | 85.36 | |||
2015 | 4.05 | 3.86 (3.22, 4.51) | 3.46 | 3.24 (2.65, 3.83) | 82.55 | 83.94 | |||
2016 | 4.39 | 3.29 (3.55, 4.89) | 3.93 | 3.76 (3.13, 4.40) | 89.57 | 87.65 | |||
2017 | 3.10 | 2.68 (2.15, 3.20) | 2.08 | 1.89 (1.44, 2.35) | 68.10 | 70.52 | |||
2018 | 5.81 | 5.98 (5.22, 6.75) | 4.69 | 4.82 (4.07, 5.56) | 80.82 | 80.60 | |||
2019 | 3.13 | 2.98 (2.42, 3.53) | 1.72 | 1.66 (1.23, 2.09) | 55.08 | 55.70 | |||
Average (9-y period) | 3.50 | 3.25 (2.67, 3.83) | 2.79 | 2.69 (2.06, 3.32) | 79.34 | 76.11 | |||
p-value | <0.001 | 0.257 | <0.001 | 0.314 | 0.141 | <0.001 |
Predictor | OR (95% CI) | p-value |
---|---|---|
Age | 1.00 (0.98, 1.03) | 0.515 |
Sex | ||
Female | 1.00 (reference) | |
Male | 2.28 (0.95, 5.46) | 0.062 |
Residence | ||
Rural | 1.00 (reference) | |
Urban | 1.15 (0.55, 1.44) | 0.654 |
History of suicide attempts | ||
No | 1.00 (reference) | |
Yes1 | 2.28 (1.21, 4.27) | 0.010 |
Psychological disorder | ||
No | 1.00 (reference) | |
Yes | 1.85 (1.09, 3.12) | 0.021 |
Education | ||
Illiterate | 1.00 (reference) | |
No diploma | 0.99 (0.96, 1.05) | 0.998 |
Diploma and higher | 0.97 (0.95, 1.03) | 0.980 |
Occupation | ||
Unemployment | 1.00 (reference) | |
Housewife | 0.37 (0.10, 1.03) | 0.058 |
Student | 0.35 (0.14, 0.85) | 0.021 |
Governmental | 0.54 (0.10, 2.80) | 0.474 |
Non-governmental | 0.99 (0.98, 1.02) | 0.980 |
Other | 0.51 (0.27, 0.93) | 0.030 |
Characteristics | Attempted suicide |
Completed suicide |
|||
---|---|---|---|---|---|
n (%) | Valid % | n (%) | Valid % | ||
Total | 1167 (100) | 100 | 926 (100) | 100 | |
Sex | |||||
Female | 227 (19.5) | 19.46 | 173 (18.7) | 18.68 | |
Male | 940 (80.5) | 80.54 | 753 (81.3) | 81.32 | |
Age (y) | |||||
10-14 | 42 (3.6) | 3.67 | 38 (4.1) | 4.15 | |
15-24 | 344 (29.5) | 30.12 | 259 (28.0) | 28.33 | |
25-34 | 371 (31.8) | 32.48 | 277 (29.9) | 30.30 | |
35-44 | 177 (15.2) | 15.49 | 152 (16.4) | 16.63 | |
45-54 | 112 (9.6) | 9.80 | 94 (10.1) | 10.28 | |
55-64 | 52 (4.4) | 4.53 | 48 (5.2) | 5.25 | |
≥65 | 44 (3.8) | 3.85 | 45 (4.8) | 4.92 | |
Missing or unknown | 25 (2.1) | - | 12 (1.3) | - | |
Marital status | |||||
Married | 373 (32.0) | 37.41 | 287 (31.0) | 37.27 | |
Single | 517 (44.3) | 52.27 | 398 (43.0) | 51.68 | |
Divorce and widow | 99 (8.5) | 10.01 | 85 (9.2) | 11.03 | |
Missing or unknown | 178 (15.2) | - | 156 (16.8) | - | |
Residence | |||||
Urban | 496 (42.5) | 50.00 | 361 (39.0) | 47.06 | |
Rural | 496 (42.5) | 50.00 | 406 (43.8) | 52.94 | |
Missing or unknown | 175 (15.0) | - | 159 (17.2) | - | |
Education | |||||
Illiterate | 65 (5.6) | 6.93 | 63 (6.8) | 8.52 | |
Primary school | 152 (13.0) | 16.22 | 126 (13.6) | 17.05 | |
Middle school | 267 (22.9) | 28.49 | 207 (22.3) | 28.01 | |
High school | 171 (14.6) | 18.24 | 143 (15.4) | 19.35 | |
Diploma | 196 (16.8) | 20.91 | 125 (13.5) | 16.91 | |
Academic/University | 86 (7.4) | 9.17 | 75 (8.1) | 10.14 | |
Missing or unknown | 230 (19.7) | - | 187 (20.2) | - | |
Job | |||||
Housewife | 133 (11.4) | 13.50 | 104 (11.2) | 13.54 | |
Student: School | 120 (10.3) | 12.18 | 98 (10.6) | 12.76 | |
Student: University | 16 (1.4) | 1.62 | 15 (1.6) | 1.95 | |
Governmental | 15 (1.3) | 1.52 | 11 (1.2) | 1.43 | |
Non-governmental | 449 (38.5) | 45.58 | 373 (40.3) | 48.56 | |
Soldier and military | 6 (0.5) | 0.60 | 4 (0.4) | 0.52 | |
Unemployment | 166 (14.2) | 16.85 | 109 (11.8) | 14.19 | |
Other | 80 (6.8) | 8.12 | 54 (5.8) | 7.03 | |
Unknown or missing | 182 (15.6) | - | 158 (17.1) | - | |
Cause of suicide | |||||
Familial conflicts | 151 (12.9) | 45.61 | 81 (8.7) | 50.62 | |
Addiction | 27 (2.3) | 8.15 | 17 (1.8) | 10.62 | |
Economic problems | 13 (1.1) | 3.92 | 10 (1.1) | 6.25 | |
Falling in love or romance | 5 (0.4) | 1.51 | 3 (0.3) | 1.87 | |
Mental disorders | 73 (6.2) | 22.05 | 25 (2.7) | 15.62 | |
Unemployment | 3 (0.2) | 0.90 | 3 (0.3) | 1.87 | |
Mourning | 5 (0.4) | 1.51 | 1 (0.1) | 0.62 | |
Others | 49 (4.2) | 14.80 | 18 (1.9) | 11.25 | |
Rather not say | 3 (0.2) | 0.90 | 2 (0.2) | 1.25 | |
Unknown or missing | 836 (71.6) | - | 766 (82.7) | - | |
History of somatic disorder | |||||
Yes | 25 (2.1) | 5.07 | 16 (1.7) | 5.81 | |
No | 468 (40.1) | 94.93 | 259 (28.0) | 94.19 | |
Missing or unknown | 674 (57.8) | - | 651 (70.3) | - | |
Suicide outcome | |||||
Recovered | 149 (12.8) | 13.17 | - | - | |
Hospitalized or under medication | 56 (4.8) | 4.95 | - | - | |
Death | 926 (79.3) | 81.87 | - | - | |
Unknown or missing | 36 (3.1) | - | - | - |
Variables | Hanging attempts rate | Hanging mortality rate |
CFR | ||||||
---|---|---|---|---|---|---|---|---|---|
Age (y) | Male | Female | All | Male | Female | All | Male | Female | All |
10-14 | 2.22 | 0.82 | 1.53 | 2.00 | 0.74 | 1.39 | 90.32 | 90.90 | 90.47 |
15-24 | 8.33 | 2.71 | 5.58 | 6.46 | 1.85 | 4.20 | 77.48 | 68.29 | 75.29 |
25-34 | 7.21 | 1.32 | 4.29 | 5.51 | 0.83 | 3.19 | 76.50 | 63.15 | 74.46 |
35-44 | 4.90 | 0.93 | 2.93 | 4.17 | 0.83 | 2.51 | 85.23 | 89.28 | 85.87 |
45-54 | 4.35 | 0.91 | 2.65 | 3.69 | 0.71 | 2.22 | 84.94 | 78.94 | 83.92 |
55-64 | 2.43 | 1.10 | 1.76 | 2.22 | 1.10 | 1.66 | 91.42 | 100.00 | 94.11 |
≥65 | 2.83 | 0.84 | 1.83 | 2.66 | 0.84 | 1.74 | 93.93 | 100.00 | 95.34 |
Total | 5.50 | 1.36 | 3.50 | 4.42 | 1.02 | 2.79 | 80.71 | 75.33 | 79.34 |
Year | Crude | Age-standardized (95% CI) | Crude | Age-standardized (95% CI) | Crude | From standardized rates | |||
2011 | 0.81 | 0.72 (0.43, 1.02) | 0.33 | 0.30 (0.12, 0.48) | 41.37 | 41.23 | |||
2012 | 2.79 | 2.67 (2.12, 3.22) | 2.59 | 2.50 (1.98, 3.02) | 93.00 | 93.64 | |||
2013 | 3.65 | 3.46 (2.84, 4.09) | 3.18 | 2.99 (2.43, 3.56) | 87.12 | 86.41 | |||
2014 | 3.81 | 3.62 (2.99, 4.25) | 3.18 | 3.09 (2.51, 3.66) | 83.45 | 85.36 | |||
2015 | 4.05 | 3.86 (3.22, 4.51) | 3.46 | 3.24 (2.65, 3.83) | 82.55 | 83.94 | |||
2016 | 4.39 | 3.29 (3.55, 4.89) | 3.93 | 3.76 (3.13, 4.40) | 89.57 | 87.65 | |||
2017 | 3.10 | 2.68 (2.15, 3.20) | 2.08 | 1.89 (1.44, 2.35) | 68.10 | 70.52 | |||
2018 | 5.81 | 5.98 (5.22, 6.75) | 4.69 | 4.82 (4.07, 5.56) | 80.82 | 80.60 | |||
2019 | 3.13 | 2.98 (2.42, 3.53) | 1.72 | 1.66 (1.23, 2.09) | 55.08 | 55.70 | |||
Average (9-y period) | 3.50 | 3.25 (2.67, 3.83) | 2.79 | 2.69 (2.06, 3.32) | 79.34 | 76.11 | |||
p-value | <0.001 | 0.257 | <0.001 | 0.314 | 0.141 | <0.001 |
Variables | Class | Outcome |
p-value | |
---|---|---|---|---|
Death | Survived | |||
Age (y) | 10-14 | 38 (86.4) | 6 (13.6) | 0.001 |
15-24 | 259 (78.7) | 70 (21.3) | ||
25-34 | 278 (77.0) | 83 (23.0) | ||
35-44 | 152 (86.4) | 24 (13.6) | ||
45-54 | 94 (85.5) | 16 (14.5) | ||
55-64 | 48 (94.1) | 3 (5.9) | ||
≥65 | 41 (97.6) | 1 (2.4) | ||
Sex | Male | 753 (82.9) | 155 (17.1) | 0.023 |
Female | 173 (77.9) | 49 (22.1) | ||
Marital status | Single | 398 (78.8) | 107 (21.2) | 0.607 |
All statuses | 372 (81.0) | 87 (19.0) | ||
Residence | Rural | 406 (83.4) | 81 (16.6) | 0.020 |
Urban | 361 (76.3) | 112 (23.7) | ||
History of suicide attempts | No | 639 (81.9) | 141 (18.1) | <0.001 |
Yes | 94 (62.7) | 56 (37.3) | ||
Psychological disorder | No | 211 (64.1) | 118 (35.9) | 0.001 |
Yes | 75 (48.7) | 79 (51.3) | ||
Education | Illiterate | 63 (98.4) | 1 (1.6) | <0.001 |
No diploma | 476 (82.6) | 100 (17.4) | ||
Diploma and higher | 200 (73.0) | 74 (27.0) | ||
Season | Spring | 238 (78.0) | 67 (22.0) | 0.446 |
Summer | 236 (82.2) | 51 (17.8) | ||
Fall | 207 (82.8) | 43 (17.2) | ||
Winter | 201 (82.0) | 44 (18.0) | ||
Occupation | Housewife | 104 (80.0) | 26 (20.0) | 0.001 |
Student | 113 (85.0) | 20 (15.0) | ||
Governmental | 11 (78.6) | 3 (21.4) | ||
Non-governmental | 373 (85.0) | 66 (15.0) | ||
Unemployment | 109 (68.6) | 50 (31.4) | ||
Other | 55 (70.5) | 23 (29.5) |
Predictor | OR (95% CI) | p-value |
---|---|---|
Age | 1.00 (0.98, 1.03) | 0.515 |
Sex | ||
Female | 1.00 (reference) | |
Male | 2.28 (0.95, 5.46) | 0.062 |
Residence | ||
Rural | 1.00 (reference) | |
Urban | 1.15 (0.55, 1.44) | 0.654 |
History of suicide attempts | ||
No | 1.00 (reference) | |
Yes |
2.28 (1.21, 4.27) | 0.010 |
Psychological disorder | ||
No | 1.00 (reference) | |
Yes | 1.85 (1.09, 3.12) | 0.021 |
Education | ||
Illiterate | 1.00 (reference) | |
No diploma | 0.99 (0.96, 1.05) | 0.998 |
Diploma and higher | 0.97 (0.95, 1.03) | 0.980 |
Occupation | ||
Unemployment | 1.00 (reference) | |
Housewife | 0.37 (0.10, 1.03) | 0.058 |
Student | 0.35 (0.14, 0.85) | 0.021 |
Governmental | 0.54 (0.10, 2.80) | 0.474 |
Non-governmental | 0.99 (0.98, 1.02) | 0.980 |
Other | 0.51 (0.27, 0.93) | 0.030 |
CFR, case-fatality rate; CI, confidence interval. Direct standardization method and using the 2013 standard populations of low- and middle-income countries.
Values are presented as number (%).
0.030OR, odds ratio; CI, confidence interval. Attempt to suicide by any of the suicide methods such as overdose or self-immolation or suicide with a cold weapon or other suicide methods.