Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ont.
CMAJ. 2012 Jun 12;184(9):1029-34. doi: 10.1503/cmaj.111867. Epub 2012 Apr 2.
Suicide is the second leading cause of death for young Canadians (10-19 years of age)--a disturbing trend that has shown little improvement in recent years. Our objective was to examine suicide trends among Canadian children and adolescents.
We conducted a retrospective analysis of standardized suicide rates using Statistics Canada mortality data for the period spanning from 1980 to 2008. We analyzed the data by sex and by suicide method over time for two age groups: 10-14 year olds (children) and 15-19 year olds (adolescents). We quantified annual trends by calculating the average annual percent change (AAPC).
We found an average annual decrease of 1.0% (95% confidence interval [CI] -1.5 to -0.4) in the suicide rate for children and adolescents, but stratification by age and sex showed significant variation. We saw an increase in suicide by suffocation among female children (AAPC = 8.1%, 95% CI 6.0 to 10.4) and adolescents (AAPC = 8.0%, 95% CI 6.2 to 9.8). In addition, we noted a decrease in suicides involving poisoning and firearms during the study period.
Our results show that suicide rates in Canada are increasing among female children and adolescents and decreasing among male children and adolescents. Limiting access to lethal means has some potential to mitigate risk. However, suffocation, which has become the predominant method for committing suicide for these age groups, is not amenable to this type of primary prevention.
自杀是加拿大年轻人(10-19 岁)的第二大死因——这是一个令人不安的趋势,近年来几乎没有改善。我们的目的是研究加拿大儿童和青少年的自杀趋势。
我们使用加拿大统计局的死亡率数据对 1980 年至 2008 年期间的标准化自杀率进行了回顾性分析。我们按性别和自杀方式对两个年龄组(10-14 岁的儿童和 15-19 岁的青少年)进行了分析。我们通过计算平均年百分比变化(AAPC)来量化年度趋势。
我们发现儿童和青少年的自杀率平均每年下降 1.0%(95%置信区间 [CI] -1.5 至 -0.4),但按年龄和性别分层显示出显著差异。我们发现女性儿童(AAPC = 8.1%,95% CI 6.0 至 10.4)和青少年(AAPC = 8.0%,95% CI 6.2 至 9.8)的窒息自杀率增加。此外,我们注意到在研究期间,涉及中毒和枪支的自杀人数有所减少。
我们的研究结果表明,加拿大的自杀率在女性儿童和青少年中呈上升趋势,在男性儿童和青少年中呈下降趋势。限制获得致命手段有一定潜力降低风险。然而,对于这些年龄组来说,窒息已成为主要的自杀手段,这种方法无法进行这种类型的初级预防。