Investigation of suicide deaths in Turkey between 2015 and 2019
1Department of Forensic Medicine, Ankara University, School of Medicine, 06620 Ankara, Turkey
2Cankaya District Health Directorate, 06230 Ankara, Turkey
3Department of Criminalistics, Ankara University Institute of Forensic Sciences, 06620 Ankara, Turkey
Submitted: 08 June 2021 Accepted: 09 August 2021
Online publish date: 26 August 2021
Background and objectives: Although suicide is the act of an individual, it is an important public health problem that affects the individual's environment and also society. Approximately 800,000 people die by suicide each year. In this study, we aimed to evaluate the socio-demographic characteristics of fatal suicides in Turkey between 2015 and 2019.
Materials and methods: This observational-analytical study was conducted by examining retrospec-tive records in the period 2015–2019. The study was conducted by secondary analysis based on data from the Turkish Statistical Institute.
Results: During the study period, the suicide rate (per 100,000) varied in the range 3.94–4.15 and the mean (standard deviation, SD) was 4.07 (0.09). The mean (SD) suicide rate was 6.14 (0.13) in males and 1.99 (0.18) in females; it was higher in males (z = 2.611; p = 0.008). Considering age groups, there was no difference between sex in terms of suicide rate among those aged <19 years (z = 1.617; p = 0.446), whereas the suicide rate was higher in males and in those aged ≥20 years (p < 0.05 for each). During the study period, the most common suicide mean in both men and women was "by hanging". The incidence of suicide using chemical substances and by jumping from a height was higher in women than in men, whereas the rate of suicide using firearms was high in men (p = 0.000). When the female/male suicide rate was compared according to marital status, the suicide rate was observed to be higher in men regardless of marital status, and this difference was more striking in men who were divorced or whose spouse had died.
Conclusion: Between 2015 and 2019, the suicide rate was higher especially in older men and in those who had lost a spouse. Therefore, socio-demographic characteristics should be considered in planning interventions to prevent suicides and guiding rehabilitation programs following a suicide attempt.
Suicide; Sex; Turkey; TURKSTAT; Marital status; Education; Economic problems
Emrah Emiral,Gulsum Ozturk Emiral,Zehra Arslan Cevik,Nergis Canturk,Gurol Canturk. Investigation of suicide deaths in Turkey between 2015 and 2019. Journal of Men's Health. 2022.doi:10.31083/jomh.2021.100.
 World Health Organization. Preventing Suicide: A Global Imperative. Geneva: WHO. 2014.
 Naghavi M. Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. British Medical Journal. 2019; 364: 1–11.
 Asirdizer M, Kartal E, Etli Y, Tatlisumak E, Gumus O, Hekimoglu Y, et al. The effect of altitude and climate on the suicide rates in Turkey. Journal of Forensic and Legal Medicine. 2018; 54: 91–95.
 Asirdizer M, Yavuz MS, Aydin SD, Dizdar MG. Suicides in Turkey between 1996 and 2005: General perspective. American Journal of Forensic Medicine and Pathology. 2010; 31: 138–145.
 Chen Y-Y, Chien-Chang Wu K, Yousuf S, Yip PS. Suicide in Asia: Opportunities and challenges. Epidemiologic Reviews. 2012; 34: 129–144.
 Devrimci-Ozguven H, Sayıl I. Suicide attempts in Turkey: Results of the WHO-EURO multicentre study on suicidal behaviour. Canadian Journal of Psychiatry. 2003; 48: 324–329.
 Hawton K, Van Heeringen K. International Handbook of Suicide and Attempted Suicide. Hoboken, NJ: John Wiley & Sons. 2000.
 Kaplan J, Sadock M. Comprehensive textbook of psychiatry on CD-ROM. Tijdschrift voor Psychiatrie. 2003; 45: 12–22.
 Vijayakumar L. Suicide in women. Indian Journal of Psychiatry. 2015; 57: S233.
 Göktaş S, Metintaş S. Suicide mortality trends by age, gender and method in Turkey, 2002–2015. Turkish Journal of Public Health. 2019; 17: 195–206.
 Karbeyaz K, Çelikel A, Emiral E, Emiral GÖ. Elderly suicide in Eskisehir, Turkey. Journal of Forensic and Legal Medicine. 2017; 52: 12–15.
 Naghavi M, Marczak LB, Kutz M, Shackelford KA, Arora M, Miller–Petrie M, et al. Global mortality from firearms, 1990–2016. Journal of the American Medical Association. 2018; 320: 792–814.
 Wu Y, Schwebel DC, Huang Y, Ning P, Cheng P, Hu G. Sex-specific and age-specific suicide mortality by method in 58 countries between 2000 and 2015. Injury Prevention. 2021; 27: 61–70.
 Oner S, Yenilmez C, Ozdamar K. Sex-related differences in methods of and reasons for suicide in Turkey between 1990 and 2010. Journal of International Medical Research. 2015; 43: 483–493.
 Turkish Statistical Institute. Address Based Population Registration System Results. 2020. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayali-Nufus-Kayit-Sistemi-Sonuclari-2020-37210 (Accessed: 1 June 2021).
 Turkish Statistical Institute. Statistics Data Portal. 2020. Avail-able at: https://data.tuik.gov.tr/Search/Search?text= intihar (Accessed: 1 June 2021).
 Turkish Statistical Institute. What job is to do? Available at: https: //www.tuik.gov.tr/Kurumsal/Sikca_Sorulan_Sorular
(Accessed: 1 June 2021).
 World Health Organization. Mental Health and Substance Use: Sui-cide Data. Available at: https://www.who.int/teams/mental-health-and-substance-use/suicide-data (Accessed: 12 Au-gust 2021).
 World Health Organization. Suicide Rates. 2019. Available at: https://apps.who.int/gho/data/node.sdg.3–4–data?lang=en (Accessed: 1 June 2021).
 Lester D. Suicide and Islam. Archives of Suicide Research. 2006; 10: 77–97.
 Gearing RE, Lizardi D. Religion and suicide. Journal of Religion and Health. 2009; 48: 332–341.
 Gal G, Goldberger N, Kabaha A, Haklai Z, Geraisy N, Gross R, et al. Suicidal behavior among muslim Arabs in Israel. Social Psychiatry and Psychiatric Epidemiology. 2012; 47: 11–17.
 Eskin M. Suicidal behavior in the mediterranean countries. Clinical Practice and Epidemiology in Mental Health. 2020; 16: 93.
 Qin P, Agerbo E, Westergård–Nielsen N, Eriksson T, Mortensen PB. Gender differences in risk factors for suicide in Denmark. British Journal of Psychiatry. 2000; 177: 546–550.
 Clarke CS, Bannon F, Denihan A. Suicide and religiosity: Masaryk’s theory revisited. Social Psychiatry and Psychiatric Epidemiology. 2003; 38: 502–506.
 Rossow I. Suicide, alcohol, and divorce: Aspects of gender and family integration. Addiction. 1993; 88: 1659–1665.
 Schrijvers DL, Bollen J, Sabbe BG. The gender paradox in suicidal behavior and its impact on the suicidal process. Journal of Affective Disorders. 2012; 138: 19–26.
 Denning DG, Conwell Y, King D, Cox C. Method choice, intent, and gender in completed suicide. Suicide and Life-Threatening Behavior. 2000; 30: 282–288.
 Arsenault–Lapierre G, Kim C, Turecki G. Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry. 2004; 4: 1–11.
 Beautrais AL. Gender issues in youth suicidal behaviour. Emergency Medicine. 2002; 14: 35–42.
 Centers for Disease Control and Prevention. Suicide Prevention. 2021. Available at: https://www.cdc.gov/suicide/facts/index. html (Accessed: 1 June 2021).
 Moneim WMA, Yassa HA, George SM. Suicide rate: Trends and implications in upper Egypt. Egyptian Journal of Forensic Sciences. 2011; 1: 48–52.
 ElHak SAG, El–Ghazali AM, Salama MM, Aboelyazeed AY. Fatal suicide cases in Port Said city. Egyptian Journal of Forensic and Legal Medicine. 2009; 16: 266–268.
 Manders B, Kaur J. Suicides in the UK: 2018 Registrations. 2019. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2018registrations (Accessed: 1 June 2021).
 Varin M, Orpana HM, Palladino E, Pollock NJ, Baker MM. Trends in Suicide Mortality in Canada by Sex and Age Group, 1981 to 2017: A Population-Based Time Series Analysis: Tendances de la mortalité par suicide au Canada selon le sexe et le groupe d’âge, 1981–2017: Une analyse de séries chronologiques dans la population. Canadian Journal of Psychiatry. 2021; 66: 170–178.
 Martini M, da Fonseca RC, de Sousa MH, de Azambuja Farias C, de Azevedo Cardoso T, Kunz M, et al. Age and sex trends for suicide in Brazil between 2000 and 2016. Social Psychiatry and Psychiatric Epidemiology. 2019; 54: 857–860.
 Dyvesether SM, Nordentoft M, Forman JL, Erlangsen A. Joinpoint re-gression analysis of suicides in Denmark during 1980–2015. Methods. 2018; 65: A5477.
 Snowdon J, Saberi SM, Moazen–Zadeh E. A comparison between the age patterns and rates of suicide in the Islamic Republic of Iran and Australia. Eastern Mediterranean Health Journal. 2020; 26: 748–754.
 Ajilore OA, Kumar A. Suicide in late life. The Neurobiological Basis of Suicide (pp. 347). Boca Raton, FL: CRC Press. 2012.
 Van Orden K, Conwell Y. Suicides in late life. Current Psychiatry Reports. 2011; 13: 234–241.
 Yoshioka E, Hanley S, Kawanishi Y, Saijo Y. Time trends in method-specific suicide rates in Japan, 1990–2011. Epidemiology and Psychiatric Sciences. 2016; 25: 58.
 World Health Organization. Suicide. 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/suicide (Accessed: 1 August 2021).
 Presidential Legislation Information System of the Republic of Turkey. Biocidal Products Regulation. Available at: https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=13672& MevzuatTur=7&MevzuatTertip=5 (Accessed: 1 June 2021).
 Yip PS, Caine E, Yousuf S, Chang S-S, Wu KC-C, Chen Y-Y. Means restriction for suicide prevention. Lancet. 2012; 379: 2393–2399.
 Griffiths C, Ladva G, Brock A, Baker A. Trends in suicide by marital status in England and Wales, 1982–2005. Health Statistics Quarterly. 2008; 8–14.
 Kyung–Sook W, SangSoo S, Sangjin S, Young-Jeon S. Marital status integration and suicide: A meta-analysis and meta–regression. Social Science & Medicine. 2018; 197: 116–126.
 Masocco M, Pompili M, Vanacore N, Innamorati M, Lester D, Girardi P, et al. Completed suicide and marital status according to the Italian region of origin. Psychiatric Quarterly. 2010; 81: 57–71.
 Duberstein PR, Conwell Y, Conner KR, Eberly S, Evinger JS, Caine ED. Poor social integration and suicide: fact or artifact? A case–control study. Psychological Medicine. 2004; 34: 1331.
 Zhang J, Li N, Tu X-M, Xiao S, Jia C. Risk factors for rural young suicide in China: A case-control study. Journal of Affective Disorders. 2011; 129: 244–251.
 Martiello MA, Boncompagni G, Lacangellera D, Corlito G. Risk factors for suicide in rural Italy: A case-control study. Social Psychiatry and Psychiatric Epidemiology. 2019; 54: 607–616.
 Alaräisänen A, Miettunen J, Lauronen E, Räsänen P, Isohanni M. Good school performance is a risk factor of suicide in psychoses: A 35‐year follow up of the Northern Finland 1966 Birth Cohort. Acta Psychiatrica Scandinavica. 2006; 114: 357–362.
 Lorant V, Kunst AE, Huisman M, Costa G, Mackenbach J. Socio-economic inequalities in suicide: A European comparative study. British Journal of Psychiatry. 2005; 187: 49–54.
 Rezaie L, Khazaie H, Soleimani A, Schwebel DC. Is self-immolation a distinct method for suicide? A comparison of Iranian patients attempting suicide by self-immolation and by poisoning. Burns. 2011; 37: 159–163.
 Shojaei A, Moradi S, Alaeddini F, Khodadoost M, Barzegar A, Khademi A. Association between suicide method, and gender, age, and education level in Iran over 2006–2010. Asia‐Pacific Psychiatry. 2014; 6: 18–22.
 Rocchi MB, Sisti D, Miotto P, Preti A. Seasonality of suicide: Relationship with the reason for suicide. Neuropsychobiology. 2007; 56: 86–92.
 Amiri B, Pourreza A, Rahimi Foroushani A, Hosseini SM, Poorolajal J. Suicide and associated risk factors in Hamadan province, west of Iran, in 2008 and 2009. Journal of Research in Health Sciences. 2012; 12: 88–92.
 Kim SH, Kim HJ, Oh SH, Cha K. Analysis of attempted suicide episodes presenting to the emergency department: Comparison of young, middle aged and older people. International Journal of Mental Health Systems. 2020; 14: 1–8.
Science Citation Index Expanded Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Social Sciences Citation Index Social Sciences Citation Index contains over 3,400 journals across 58 social sciences disciplines, as well as selected items from 3,500 of the world’s leading scientific and technical journals. More than 9.37 million records and 122 million cited references date back from 1900 to present.
Current Contents - Social & Behavioral Sciences Current Contents - Social & Behavioral Sciences provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in the social and behavioral sciences.
Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.
SCOPUS Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
DOAJ DOAJ is a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals.
CrossRef Crossref makes research outputs easy to find, cite, link, assess, and reuse. Crossref committed to open scholarly infrastructure and collaboration, this is now announcing a very deliberate path.
Portico Portico is a community-supported preservation archive that safeguards access to e-journals, e-books, and digital collections. Our unique, trusted process ensures that the content we preserve will remain accessible and usable for researchers, scholars, and students in the future.