Article

The myth of the birthday blues: A population-based study about the association between birthday and suicide

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Abstract

The problem of time distribution of suicide has aroused the interest of various investigators in the past. A population-based study on the association of the birthday in relation to the time of suicide taking into account sex and the chosen suicide method was conducted. The study included all residents of Bavaria who died between 1998 and 2003 and whose death was classified as suicide by the death certificate. In sum, 11378 deaths from suicide were included. The suicide ratios in various time frames around the individuals' birthdays were compared with expected suicide ratios. The occurrence of suicide did not vary around the birthday. Different time frames (3, 7, 14, 30, and 90 days) before as well as after the individuals' birthdays were taken into account. Even after dichotomization regarding the chosen method as well as sex differences, no significant association between birthdays and dates of suicide could be found. There is no evidence for a "birthday blues" effect on suicide.

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... A significant increase in general population suicides has been observed 3 days prior to one's birthday in those aged 45-64 (Panser et al., 1995); within 30 days of one's birthday in adults aged 75 and over and described by the authors as the "birthday blues" (Barraclough & Shepherd, 1976); and in the 3 months following one's birthday across all age groups (Kunz, 1978). Other authors have found no evidence supporting an association between one's birthday and increased risk of suicide (Chuang & Huang, 1996;Jessen & Jensen, 1999;Reulbach, Biermann, Markovic, Kornhuber, & Bleich, 2007;Wasserman & Stack, 1994). ...
... Comparable age groups have not been used, and in some instances age range is unknown or omitted completely (Kunz, 1978;Reulbach et al., 2007). Previous studies considered only limited psychiatric diagnoses (Greene et al., 1987). ...
... Computational capability has now developed to the extent to enable a more detailed, day-by-day analysis of levels of risk in the lead up to, and following, one's birthday. However few studies have used these approaches with large datasets (Jessen & Jensen, 1999;Reulbach et al., 2007), and none have been carried out using England and Wales data. ...
Article
Socioculturally meaningful events have been shown to influence the timing of suicide, but the influence of psychiatric disorder on these associations has seldom been studied. To investigate the association between birthday and increased risk of suicide in the general population and in a national sample of psychiatric patients. Data on general population suicides and suicide by individuals in recent care of mental health services were examined for day of death in relation to one's birthday using Poisson regression analysis. An increased risk of suicide was observed on day of one's birthday itself for males in both the general population (IRR = 1.39, 95% CI = 1.18-1.64, p < .01) and the clinical population (IRR = 1.48, 95% CI = 1.07-2.07, p = .03), especially for those aged 35 years and older. In the clinical population, risk was restricted to male patients aged 35-54 and risk extended to the 3 days prior to one's birthday. Birthdays are periods of increased risk for men aged 35 and older in the general population and in those receiving mental health care. Raising health-care professionals' awareness of patient groups at greater risk at this personally significant time may benefit care planning and could facilitate suicide prevention in these individuals.
... An anniversary reaction was also found among mothers who had lost a young child on the days surrounding the anniversary of the child's death (Rostila et al. 2015). A number of studies have examined either one of these two hypotheses using a variety of methodological approaches, yet they offered mixed and inconclusive evidence (Chuang and Huang 1996, Jessen and Jensen 1999, Kunz 1978, Lester 1986, Panser et al. 1995, Reulbach et al. 2007, Wasserman and Stack 1994). This was partly due to insufficient sample sizes (Barraclough and Shepherd 1976, Lester 1986). ...
... An anniversary reaction was also found among mothers who had lost a young child on the days surrounding the anniversary of the child's death (Rostila et al., 2015). A number of studies have examined either one of these two hypotheses using a variety of methodological approaches, yet they offered mixed and inconclusive evidence (Chuang and Huang, 1996; Jessen and Jensen, 1999; Kunz, 1978; Lester, 1986; Panser et al., 1995; Reulbach et al., 2007; Wasserman and Stack, 1994). This was partly due to insufficient sample sizes (Barraclough and Shepherd, 1976; Lester, 1986). ...
Article
This study examined whether people have a higher risk of death on and around their birthday using a large national mortality data. We examined 2,073,656 death records of individuals who died in Japan from major external causes between 1974 and 2014. Poisson regression analysis showed that people were more likely to die on their birthday than on any other calendar day by means of suicide, traffic accidents, accidental falls, drowning, and choking. For suicide cases in particular, people are 50% more likely to die on their birthday compared to any other dates. Excess deaths on birthdays were observed regardless of gender, marital status, and age-at-death subgroups. For suicide deaths, our results provided strong support for the “birthday blues” hypothesis that predicts excess deaths on birthdays. With regards to traffic accidents and other unintentional accidents, however, our results suggest that excess deaths on birthdays may be related to birthday celebrations. For the elderly population, our analysis indicates that special activities associated with birthday celebrations, which often involves going out to consume festive food and drinks, may be contributors to a sudden increase in the number of accidental deaths on their birthday. In contrast, a notably sharp increase in the number of motor vehicle accidents was observed for individuals in the 20s on their birthday, which may be attributable to birthday celebrations that involved both driving and drinking.
... Beneath this established high risk period it has never been investigated if there are certain other time patterns of inpatient suicides like these explored by population-based samples in terms of season of suicide [6,7,10], week day of suicide [12,14,17,18], month of birth [30], public holidays [18,20-22] or birthdays [28]. ...
... Regarding birthday, only two inpatients committed suicide around their birthday which makes a pronounced 'birthday blues' effect unlikely. Also in the general population a 'birthday blues' effect could not be confirmed [28], whereas certain time patterns of suicides around public holidays have been identified [17][18][19][20][21][22][23]. Nearly 40% of our inpatient suicides occurred around public holidays. ...
Article
Full-text available
Objective. Time patterns of suicides have been investigated in many population-based studies, but there are no studies exploring time patterns of suicides during psychiatric inpatient stay up to now. Methods. All inpatient suicides (1998–2007) of a psychiatric university hospital were identified by the German psychiatric basic documentation system (DGPPN-BADO). Descriptive and univariate analyses were performed to analyse time patterns of inpatient suicides. Results. No significant differences could be found for the occurrence of the 37 inpatient suicides due to season (c 2 1.595, P0.696), month (χ 2 4.838, P0.958) or weekday (c 2 5.189, P0.550) of suicide. Furthermore, we could not find an unequal distribution of suicides due to month of birth (c 2 12.622, P0.337). 78.4% of inpatient suicides occurred within 50 days after admission. Fourteen inpatients committed suicide around public holidays, two around their birthday. Conclusions. Apart from a notably enhanced risk of suicide in the period after admission, we could not find any time patterns to be of high relevance to inpatient suicides. There may be more relevant risk factors than cyclic or temporal variations.
... Beneath this established high risk period it has never been investigated if there are certain other time patterns of inpatient suicides like these explored by population-based samples in terms of season of suicide [6,7,10], week day of suicide [12,14,17,18], month of birth [30], public holidays [18,20-22] or birthdays [28]. ...
... Regarding birthday, only two inpatients committed suicide around their birthday which makes a pronounced 'birthday blues' effect unlikely. Also in the general population a 'birthday blues' effect could not be confirmed [28], whereas certain time patterns of suicides around public holidays have been identified [17][18][19][20][21][22][23]. Nearly 40% of our inpatient suicides occurred around public holidays. ...
... Barraclough and Shepherd (1976) studied 247 completed suicides and found that the suicides more often had been committed within a period of 30 days around their birthday than chance would predict, but this phenomenon was statistically significant only for people over the age of 75. Other researchers have also reported that suicide is more frequent in the period around birthdays than in other months of the year (Kunz, 1978;Lester, 2005;Shaffer, 1974), while some (Bradshow, 1981;Chuang & Huang, 1996;Danneel, 1975Danneel, , 1977Lester, 1986Lester, , 1997Reulbach, Biermann, Markovic, Kornhuber, & Bleich, 2007;Wasserman & Stack, 1994) have not been able to replicate this result. ...
... The myth of birthday blues is well known, but there is conflicting evidence on whether suicides are higher around birthdays or not. A German study [9] looking at 11,378 deaths from suicide found no evidence to suggest their association with birthdays. However, the UK study [10] observed that in men aged 35 and above, receiving mental health care, there was an increased risk for suicide around their birthday compared to the general population. ...
Article
Background: Not many studies have examined the risk of emergency medical attendance during stressful life events or special days such as birthdays. This study looked at whether patients had a higher than normal chance of attending the emergency departments around their birthdays compared to the rest of the year. Methods: Patient attendance data were collected from our accident and emergency department from April 2013 to March 2014. The birthday of individual patients was matched with their date of attendance to find out the number of patients attending emergency department on and around their birthdays. Chi-square test and binominal distribution test were used to compare birthday attendances with those occurring at other times of the year. Results: A total of 1028 patients attended within the 7 days starting from their birthday (expected number 49, 211/52 = 946). This was found to be statistically significant (P = 0.0071). Road traffic accidents were more frequent on both the birthday week and the week after birthday. Medical emergencies, injury in a public place, 19-35 years age group and male patients showed similarly significant association but for the week after birthday only. Conclusions: People are more likely to present to emergency departments in the week starting from their birthday than any other week of the year. There is scope for public health initiatives such as sending health education information in the form of a birthday card to raise awareness of this risk.
... This birthday blues phenomenon was found for urban and rural suicides, for those of all marital statuses, and for both violent and nonviolent methods for suicide. In contrast, Reulbach, et al. (2007) found no birthday blues effect in 11,378 suicides in Bavaria, Germany. ...
Article
Full-text available
Data from 10,884 suicides, whose dates of birth and death were posted on a suicide memorial wall, were examined for whether they were more likely to die by suicide on their birthdays than expected. Sixty-three suicides died on their birthdays as compared to an expected number of 29.8, significantly more than would be expected by chance.
... A recent review of the literature on suicide and seasonality confirmed that the evidence for a seasonal suicide effect remains inconclusive (Christodoulou et al., 2011). The evidence showing an elevated risk around birthdays and the impact of other temporal factors also remains ambiguous (Williams et al., 2011;Reulbach et al., 2007). ...
Chapter
Suicide is the 15th leading cause of death worldwide (in 2012) and accounts for 1.4% of all deaths. This chapter provides an overview of the current international literature on the rates and risk factors for suicide and self-harm. The most common methods of suicide in high-income countries are hanging and firearms, accounting for 50% and 18% of all suicides, respectively. Across the globe, suicide rates are generally higher among males than females, with an average male-to-female ratio of 2.8:1 but with wide variations across countries. The chapter discusses some issues in a cross-national context: marital status and children; ethnicity, culture, and religion; migration and social integration; and socioeconomic and wider societal factors. It considers the term 'self-harm' to describe intentional acts irrespective of the intent, including self-poisoning and self-injury. There are international differences in the nomenclature used, with some distinguishing between nonsuicidal self-injury and suicide attempt.
... Barraclough and Shepherd (1976) studied 247 completed suicides and found that the suicides more often had been committed within a period of 30 days around their birthday than chance would predict, but this phenomenon was statistically significant only for people over the age of 75. Other researchers have also reported that suicide is more frequent in the period around birthdays than in other months of the year (Kunz, 1978;Lester, 2005;Shaffer, 1974), while some (Bradshow, 1981;Chuang & Huang, 1996;Danneel, 1975Danneel, , 1977Lester, 1986Lester, , 1997Reulbach, Biermann, Markovic, Kornhuber, & Bleich, 2007;Wasserman & Stack, 1994) have not been able to replicate this result. ...
Article
The present study analyzed a large sample of 133,421 suicides in Hungary (for the period 1970–2002) for the birthday blues phenomenon. The number of suicides taking place on the individuals’ birthdays was compared with the number expected using chi-square tests. More suicides occurred on birthdays for men of all ages and for women over the age of 60. The birthday blues phenomenon was found for urban and rural suicides, for all marital statuses and for both violent and nonviolent methods for suicide. Possible explanations for these results were discussed.
... Several empirical studies have searched for evidence of deviations from expected mortalitydnamely spikes or dipsdon or around holidays and birthdays, and they have found mixed evidence (Phillips and Smith, 1990;Young and Hade, 2004;Williams et al., 2011;Skala and Freedland, 2004;Reulbach et al., 2007;Abel and Kruger, 2009;Phillips et al., 2010;Ajdacic-Gross et al., 2012). Some studies have found mortality dips before holidays and birthdays and spikes on and after those days, while others have found either the opposite or no dips or spikes at all. ...
Article
This study estimates average excess death rates on and around birthdays, and explores differences between birthdays falling on weekends and birthdays falling on weekdays. Using records from the U.S. Social Security Administration for 25 million people who died during the period from 1998 to 2011, average excess death rates are estimated controlling for seasonality of births and deaths. The average excess death rate on birthdays is 6.7% (p < 0.0001). No evidence is found of dips in average excess death rates in a ±10 day neighborhood around birthdays that could offset the spikes on birthdays. Significant differences are found between age groups and between weekend and weekday birthdays. Younger people have greater average excess death rates on birthdays, reaching up to 25.4% (p < 0.0001) for ages 20–29. Younger people also show the largest differences between average excess death rates on weekend birthdays and weekday birthdays, reaching up to 64.5 percentage points (p = 0.0063) for ages 1–9. Over the 13-year period analyzed, the estimated excess deaths on birthdays are 4590.KeywordsTiming of deathDeath on birthdaysDeath on weekends
... A recent communication that studied quite a large sample has not found significant relationship between birthday and the day of suicide. In the authors' opinion there is no evidence of the so-called "Birthday Blues" effect (Reulbach et al. 2007). ...
Article
Full-text available
Authors review the literature related to the suicide and the victims' birthday, but they have not found study, which have shown a strong connection. They investigated a large Hungarian sample using the well-known methods, but they have applied also a new one supposing they will found some connection. All the three methods have shown a strong relationship between the date of birthday and the date of suicide among man in all age-groups: namely, much more man committed suicide on his birthday than on other days of the year. Only a slight significant connection they found among the female aged 60 and more. Authors did search the conceivable causes (sociologic, cultural etc.) but they have not found any explanation. The cause is presumably is the special sensibility of the Hungarian man.
Article
Background: Suicides are generally the consequence of overchallenged coping strategies of individual for psychological, social or internal and external biological strain factors. Timing of the suicide, too, may be influenced by external factors. Studies so far have yielded in part inconsistent results concerning the association of suicides with particular days or periods of the year. Even less is known regarding a potential effect of the time of birth on suicide risk. Methods: The Tyrol Suicide Register (TSR) provides data on suicides occurring in the Austrian State of Tyrol including birthday of the suicide victim and day of the suicide. In the present study the frequency of suicides was analyzed with regard to birthday, day of the week, major holidays and season over a period of 17 years. Further, a potential association with month of birth and zodiac signs was studied. Results: We found a significant variation in suicide frequency concerning day of the week with a peak on Mondays and Tuesdays and seasonality with increased numbers in spring and summer months. Conclusions: The increase of suicide numbers at the beginning of the week may be explained by the "broken-promise effect" which has been described as the consequence of frustrated expectations concerning the weekend. Possible explanations for the suicide peaks in spring and summer may be biological, specifically serotonergic alterations as well as the experience of depressed patients perceiving the social and emotional contrast to people who are able to enjoy these periods of pleasure and outdoor activities.
Article
Background: Previous research has produced conflicting findings concerning whether birthdays are associated with an increased risk of suicide. This study examined the association in Tokyo, Japan. Methods: Suicide data (ICD-10 codes X60-X84) for the period 2001-2010 were obtained from the Japanese Ministry of Health, Labour and Welfare. A time-stratified case-crossover design was used with conditional logistic regression analysis being performed to estimate within-subject 'birthday exposures' while controlling for meteorological conditions and public holidays. Results: There were 27,007 suicides in the study period. For males the 5 days before the birthday and the week after the birthday were associated with significantly higher odds for suicide with the odds ratio being highest on the actual birthday (OR =1.677, 95% CI: 1.294, 2.172). For females, significantly higher odds for completed suicide were observed 7-11 days before the birthday. Stratified analyses showed different at risk time patterns among men from different age groups, and that married men had higher odds for suicide on, and for the 4 days before and in the 2 weeks after their birthday. Limitations: We lacked detailed information on suicides which would have enabled a better understanding of the observed associations. Conclusions: Birthdays are associated with an increased risk for suicide in Tokyo, Japan. Health professionals who work with individuals at risk of suicide should be made aware that birthdays are associated with an elevated suicide risk. This information should also be communicated in wider suicide prevention campaigns.
Article
I grew up believing that birthdays were special, almost like a personal Christmas. My birthday often fell during the Easter school holidays. I have never quite got used to having to go to work on my birthday and, indeed, try to avoid it. I would never choose to arrange disagreeable activities — for example, visiting the dentist — on my birthday. It seems I am not alone in this: a receptionist at my surgery told me that patients booking appointments sometimes declare that a date offered is their birthday and ask for a different one (D Pearce, personal communication, 2009) Therefore it interested me to discover that patients sometimes came to see me, as their GP, on their birthdays. I decided to investigate why they did so. Cases were ascertained opportunistically. For 10 years from 2001 to 2010 I made notes about patients who were seen on their birthdays. Some patients drew my attention to the fact; others I noticed for myself, by looking at their records, particularly when writing a prescription. I wished them ‘many happy returns’, commiserated with those who were poorly and, if their condition allowed for such levity, asked them why they had come on this of all days. I subsequently examined their practice records and compared their consultation pattern with that of the practice population in general. I identified 30 patients who consulted on their birthdays, 16 male and 14 female, aged 1-90 years. The modal age was 50-59 years, which accounted for six consultations. The second …
Article
Previous studies have provided somewhat inconsistent results about the effects of season of birth on the risk of suicidal behavior. Therefore, we decided to investigate this question in a large sample of suicide completers. We determined the season of birth-associated risk of completed suicide between the years 1970 and 2008 among all individuals who were born in the area of today's Hungary between 1930 and 1939, 1941 and 1942, and 1944 and 1969. The final sample of participants included around six and a half million people. About 80,000 completed suicides occurred among participants during the period investigated (the number of suicide completers in our study greatly exceeds the number of suicide completers in any previous studies). A significantly (p < .05) elevated risk of completed suicide was found among those individuals who were born in the high-risk period (spring and summer). Quantitatively, the biggest increase (7.6% [95% confidence interval: 5.4-9.9]) in suicide risk was detected among those who were born in July compared with the average risk of suicide in the population investigated. The associations between season of birth and the risk of completed suicide were stronger among male subjects than among female subjects and among those who committed suicide using violent methods than among those who chose nonviolent methods. Our results from a large sample of suicide completers from Hungary--a country with one of the highest suicide rates in the world over the last century--strongly support the concept that the season of birth is significantly associated with the risk of completed suicide.
Article
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The present results fail to find an excess of deaths from suicide (and natural deaths and homicides) around the birthday. Thus there is no evidence for a "birthday blues" effect.
Article
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Suicide and premature death due to coronary heart disease, violence, accidents, drug or alcohol abuse are strikingly male phenomena, particularly in the young and middle-aged groups. Rates of offending behaviour, conduct disorders, suicide and depression are even rising, and give evidence to a high gender-related vulnerability of young men. In explaining this vulnerability, the gender perspective offers an analytical tool to integrate structural and cultural factors. It is shown that traditional masculinity is a key risk factor for male vulnerability promoting maladaptive coping strategies such as emotional unexpressiveness, reluctance to seek help, or alcohol abuse. This basic male disposition is shown to increase psychosocial stress due to different societal conditions: to changes in male gender-role, to postmodern individualism and to rapid social change in Eastern Europe and Russia. Relying on empirical data and theoretical explanations, a gender model of male vulnerability is proposed. It is concluded that the gender gap in suicide and premature death can most likely be explained by perceived reduction in social role opportunities leading to social exclusion.
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Analysis of 25,987 suicides occurring in Italy during the years 1974-1983 demonstrated a clear diurnal variation, death by suicide being most prevalent between 6 a.m. and 4 p.m. Reasons and implications are discussed with reference to earlier work on this topic.
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Previous studies suggest that suicide occurrence varies by month and day of the week, but not by lunar phase. Variation by time of day has never before been adequately examined; to our knowledge, all previous studies have failed to obtain time-of-death information for a large percentage of cases. We examined suicide occurrence among residents of Sacramento County, CA, during the period from 1925 to 1983. Data were abstracted from coroner's autopsy and investigative reports. In contrast to previous studies, data on time of death were available for a large percentage of cases. 4,190 suicide deaths were identified during the study period. Suicide occurrence varied substantially by time of day; for both sexes and for ages under 65 years, the fewest suicide deaths occurred during the early morning hours, from 0401 to 0800. For recent years of the study, suicides occurred most frequently on Monday for both males and females and for most age groups. Variation by month followed no consistent pattern by gender, age, years of the study, or combinations of these factors. Contrary to popular belief, suicide occurrence did not vary by lunar phase.
Article
Lack of bias in the estimation of relative effect in epidemiologic studies depends on the internal validity of the study. This paper conveys in graphic and tabular form the direction and magnitude of bias due to misclassification of study subjects. A series of computer-generated graphs shows that the departure of the estimate of effect (relative risk or odds ratio) from its true value is a function of sensitivity and specificity (measures of classification validity), disease frequency, and exposure frequency. The discussion of bias emphasizes misclassification of the "outcome" variable; i.e., disease occurrence in a cohort study and exposure rate in a case-control study. Examples are used to illustrate that the magnitude of the bias can be large under circumstances which occur readily in epidemiologic research. When misclassification is equal for the two compared groups, the estimate is biased toward the null value, and in some instances beyond; when differential misclassification occurs (as in selective recall in case-control studies) the bias can be in either direction, and may be great. Formulas are derived to estimate the underlying true value of the relative risk or odds ratio using the investigator's observations together with the estimated sensitivity and specificity of the classification procedure.
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An excess of deaths was observed in the 30 days before and after a birthday for a sample of self-inflicted deaths aged 75 and over.
Article
Synopsis An unsuccessful attempt to discover the variation in the time of day chosen for the suicide of 100 consecutive cases is described. The reasons for the failure are discussed.
Article
A special analysis of mortality data for England and Wales fof 1972 has been used to examine the relationship between month of birth and month of death. For persons 75 and over in eight subgroups (by sex and marital status) there was a consistent trend in deaths with an excess in the birth month and the following three months. This excess was of the order of only 1% of all deaths in the year but statistically significant for each subgroup. The method of analysis was adjusted for the nonsynchronous monthly variation in births and deaths, but a systematic error in recording the month of birth could not be excluded. A wide range of studies on the relationship between stress, morbidity, and mortality are briefly reviewed; it is suggested that in the elderly a birthday may in some subtle way influence the general morale of an individual. Further studies have been planned to test whether 'birthday stress' is a realistic explanation, or if a number of other hypotheses need to be invoked.
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Circadian variations in suicide attempts in Tokyo from 1978 to 1985 were analyzed on the basis of records of the Ambulance Service of Tokyo. A significant circadian variation in suicide attempts was demonstrated by the cosinor method, power spectrum analysis (by the maximum-entropy method), and analysis of variance. The peak time for suicide attempts was established by cosinor analysis as about 1800 hours (6:00 P.M.). The circadian variation in suicide attempts seemed to be associated with endogenous rhythms such as mood, as well as with daily variation in social activities.
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Four hundred and twenty-two consecutive hospitalized suicide attempts made by 15-19 year old girls and boys in Helsinki area were investigated. One hundred and twenty suicide attempts were made by 115 boys and 302 by 247 girls. Differences between sex were analyzed. Boys had more severe adaptive problems. Their overall level of functioning was poorer than was that of the girls. Their physical health was not as good as that of the girls. Boys did not carry out more severe suicide attempts as concerns the estimated lethality and intent of the attempt, but their suicide attempts seemed to be connected with more severe physical, mental and social problems. Boys were more susceptible to alcohol provoked suicidal behaviour than girls, and they presented less appealing motives. The outcome of the boys was much worse than the outcome of the girls. Risk ratio for suicide during the 5-year follow-up was 2.0 for boys and 0.55 for girls. Risk ratio concerning violent death was 2.43 for boys and 0.33 for girls. Young male adolescents attempting suicide should be taken very seriously as a risk group for subsequent suicide.
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SUMMARYA survey, using contemporary medical and educational data, was carried out on all childhood suicides in England and Wales over a 7 yr period. No deaths were reported before the age of 12. All the cases studied were aged 12–14, there were more than twice as many boys as girls and the group included more tall children and more children of superior intelligence than would be expected in the general population. Antisocial behaviour had been reported in most of the children before death. Suicide was most often precipitated by a disciplinary crisis and often took place after a period away from school. Previous suicidal behaviour was noted in 40 per cent of the cases, but this may be an underestimate. There was a high incidence of depression and suicidal behaviour amongst the children's parents and siblings.
Article
Psychoanalytic literature has a number of references to suicidal acts taking place on the anniversary of the death of a loved person. Anniversaries of significant bereavements have been seen as likely to reactivate a depressive syndrome and as possible precipitants of suicide. Zilboorg (7) suggested that suicides might take their lives on the anniversary of a parent's death as though to expiate the death which they unconsciously perceived as the result of their own wishes. Others have seen the meaning of the suicide's act as a fantasied rebirth or new beginning with a lost love object, and the supposed occurrence of suicides on the anniversary of a death has again been instanced as support (Jackson (3)).
Article
Recent life events as reported by the next of kin were explored in male and female suicide victims to see how these factors varied across age groups by decade of age. The study population comprised all 1022 suicide victims aged 20 years and older in Finland during a 12-month period who had life event data assessed as reliable by the interviewing mental health professionals. Age-related patterns of variation of life events were found: separation, serious family arguments, financial trouble, job problems, unemployment, and residence change were more common among younger victims, whereas somatic illness and retirement were more common among older victims. Mean number of life events, greater among men than women, tended to decline gradually across the age range. In terms of sex differences, somatic illness was more common among elderly men, while separation, financial trouble, and unemployment were more common among younger men. Most life events among younger age groups were possibly dependent upon the victims' own behavior. Logistic regression indicated association between specific life events and alcohol misuse: separation, serious family arguments, financial trouble and unemployment were especially related to alcohol misuse. Violent suicide method lacked association with life events, being commoner only among males and those not having misused alcohol. Age- and sex-specific control groups and multidimensional life event interview schedules are needed to further investigate the relative risk of life events in suicide.
Article
Caracciolo S, Manfredini R, Gallerani M, Tugnoli S. Circadian rhythm of parasuicide in relation to violence of method and concomitant mental disorder. Scand 1996: 93: 352–256. © Munksgaard 1996. Circadian occurrence of parasuicide was evaluated in relation to sex, violence of parasuicide method and psychiatric diagnosis. In all, 457 consecutive episodes of parasuicide were recruited during a 5-year period. Complete data for time of parasuicide, parasuicide method, parasuicide recurrency and psychiatric diagnosis (ICD-9) were available for 304 subjects. Parasuicide methods were classified into two groups depending on the violence of the method. Parasuicide occurred significantly more often in the afternoon and evening hours for both men and women, for both violent and non-violent methods, both in first-event cases and repeaters, and in the following diagnostic groups: organic mental and psychoactive substance disorders, neurotic disorders and personality disorders. The data support the hypothesis of a circadian rhythmicity of parasuicide, showing an area of chronobiological risk in the afternoon and early evening hours.
Article
Synopsis To evaluate whether a time pattern exists in the occurrence of suicide, 223 cases observed in Ferrara, Italy, over a 10-year period were considered. The determination of the hour of suicide was precise in 99 cases, presumptive (within a range of 1 hour) in 53, while for another 44 cases it was possible to define a probable time of suicide, grouping into four 6-hour periods (night, morning, afternoon, and evening). The remaining 27 cases were excluded as it was impossible to determine the time reliably. The data were analysed both by means of χ ² test for goodness-of-fit and by single cosinor. A specific pattern, characterized by a significant peak in the late morning – early afternoon hours was found for the entire sample and sex subgroups.
Suicide in childhood and early adolescence
  • Shaffer
Shaffer D. Suicide in childhood and early adolescence. J Child Psycho! Psychiatry 1974;15:275-91.
Agerelated variation in recent life events preceding suicide
  • M Heikkinen
  • E T Ismnetsa
  • H M Aro
  • S J Sarna
  • Li Jk
Heikkinen M, Ismnetsa ET, Aro HM, Sarna SJ, Li.innqvist JK. Agerelated variation in recent life events preceding suicide. J Nerv Mcnt Dis 1995; 183:325-6.
The birthday blues revisited
  • Lester