BMJ. 2019 Feb 6;364:l94. doi: 10.1136/bmj.l94.
To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016.
Systematic analysis.
Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education).
The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%).
Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.
利用 2016 年全球疾病负担研究的估计数,描述全球、各区域以及 195 个国家和地区按年龄、性别和社会人口指数划分的自杀死亡率模式,并描述 1990 年至 2016 年期间的时间趋势。
系统分析。
比较各区域和国家、各年龄、性别和社会人口指数(生育率、收入和教育的综合衡量标准)的自杀死亡率的粗死亡率和年龄标准化率以及生命年损失。
在 27 年的研究期间,全球自杀死亡人数增加了 6.7%(95%不确定区间为 0.4%至 15.6%),2016 年达到 817000 人(762000 人至 884000 人)。然而,1990 年至 2016 年期间,全球自杀的年龄标准化死亡率下降了 32.7%(27.2%至 36.6%),与全球年龄标准化死亡率下降 30.6%的降幅相似。在高收入亚太地区的全球疾病负担区域,自杀是年龄标准化生命年损失的主要原因,也是东欧、中欧、西欧、中亚、澳大拉西亚、南拉丁美洲和北美高收入地区前 10 大死因之一。除了 15 至 19 岁年龄组外,各区域、国家和年龄组的男性自杀率均高于女性。在女性与男性的比例方面存在差异,社会人口指数较低的地区比例较高。女性的死亡率下降幅度更大(49.0%,95%不确定区间为 42.6%至 54.6%),而男性下降幅度较小(23.8%,15.6%至 32.7%)。
自 1990 年以来,自杀的年龄标准化死亡率大幅下降,但自杀仍是全球范围内死亡的一个重要原因。自杀死亡率因地点、性别和年龄组而异。如果根据死亡率的变化为自杀预防策略提供信息,则可以针对脆弱人群实施这些策略。