Paul Elise, Mergl Roland, Hegerl Ulrich
Depression Research Centre of the German Depression Foundation, Leipzig, Germany.
Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.
PLoS One. 2017 Dec 28;12(12):e0190136. doi: 10.1371/journal.pone.0190136. eCollection 2017.
Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005-2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of "how-to" information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007-2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for "carbon monoxide poisoning" for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries.
1991年至2006年期间,德国的自杀率持续下降,但这一趋势在2007年发生了逆转。导致这种逆转的原因是女性因吸入毒气自杀以及男性因被车辆碾压自杀的人数大幅增加。在类似的时间段(2005 - 2013年),亚洲和一些西方国家也观察到因某些毒气导致的自杀人数突然增加,并且认为互联网上关于这些无痛自杀方法的“操作指南”信息在这些方法使用增加方面起到了作用。本研究使用德国联邦统计局的数据,按年龄、性别和自杀方式,考察了德国当前(2007 - 2015年)整体自杀死亡率的趋势。还评估了通过新出现的方法自杀是否与使用谷歌趋势数据的相应互联网搜索频率相关。Joinpoint回归分析表明,女性的整体自杀率显著上升(平均年百分比变化(AAPC)= 2.37%),而男性则不然。观察到年度增幅最大的是吸入毒气自杀(AAPC = 13.93%),其中大多数涉及一氧化碳。与男性(164%)相比,女性吸入毒气自杀的增幅更大(500%)。无论男性还是女性亚组,吸入毒气自杀的频率都与互联网上搜索“一氧化碳中毒”的频率显著相关,且与年龄组无关。本研究提供了自杀预防活动所需的最新自杀监测数据。结果与其他国家近期一氧化碳自杀率的突然上升一致。