Spittal Matthew J, Mitchell Rachel, Clapperton Angela, Laughlin Adrian, Sinyor Mark, Page Andrew
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.
Lancet Reg Health West Pac. 2024 Aug 13;51:101171. doi: 10.1016/j.lanwpc.2024.101171. eCollection 2024 Oct.
Suicide rates have been increasing in Australia since the mid-2000s, especially for women aged ≤25 years. We conducted an age-period-cohort study to investigate these recent trends in the context of historical Australian suicide rates.
Data on annual suicides in Australia from 1907 to 2020 were extracted from the General Record of Incidence of Mortality. We modelled age-specific effects for a reference cohort, after adjustment for period effects.
We found evidence of age, cohort and period effects. For males, compared to the cohort born in 1946-1950, rates were higher for all cohorts born after this year. The period effect showed peaks in the risk of male suicide in the mid 1960s and the early 1990s, followed by a decline in risk until early 2010, after which the risk began to rise again. For females, compared to the cohort born in 1946-1950, the risk of suicide was higher for all cohorts born after this, with the highest risk for those born in 2006-2010. The period effect for females showed an elevated risk of suicide in the mid 1960s followed by a sharp decline, and an increase in risk after 2009.
Suicide rates in Australia have fluctuated substantially over time and appear to be related to age trends as well as period and cohort trends. Advocacy and policy making tends to focus on contemporaneous changes in suicide rates. However, this study shows that focusing only on year-on-year changes in suicide rates ignores underlying trends for specific population birth-cohorts.
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自21世纪中叶以来,澳大利亚的自杀率一直在上升,尤其是25岁及以下的女性。我们开展了一项年龄-时期-队列研究,以在澳大利亚自杀率历史背景下调查这些近期趋势。
从死亡率发病总记录中提取了1907年至2020年澳大利亚年度自杀数据。在调整时期效应后,我们对一个参考队列建立了年龄特异性效应模型。
我们发现了年龄、队列和时期效应的证据。对于男性,与1946 - 1950年出生的队列相比,此后出生的所有队列的自杀率都更高。时期效应显示,男性自杀风险在20世纪60年代中期和90年代初出现峰值,随后风险下降直至2010年初,此后风险又开始上升。对于女性,与1946 - 1950年出生的队列相比,此后出生的所有队列的自杀风险都更高,2006 - 2010年出生的队列风险最高。女性的时期效应显示,20世纪60年代中期自杀风险升高,随后急剧下降,2009年后风险增加。
澳大利亚的自杀率随时间大幅波动,似乎与年龄趋势以及时期和队列趋势有关。宣传和政策制定往往侧重于自杀率的同期变化。然而,这项研究表明,仅关注自杀率的逐年变化会忽略特定人口出生队列的潜在趋势。
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