School of Public Health, Xuzhou Medical University, Xuzhou, China.
Research Center for Mental Crisis Prevention and Intervention of College Students in Jiangsu Province, Xuzhou Medical University, Xuzhou, China.
Epidemiol Psychiatr Sci. 2024 Oct 21;33:e52. doi: 10.1017/S2045796024000532.
We aimed to report an overview of trends in suicide mortality and years of life lost (YLLs) among adolescents and young adults aged 10-24 years by sex, age group, Socio-demographic Index (SDI), region and country from 1990 to 2021 as well as the suicide mortality with age, period and birth cohort effects.
Estimates and 95% uncertainty intervals for suicide mortality and YLLs were extracted from the Global Burden of Diseases Study 2021. Joinpoint analysis was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to describe the mortality and rate of YLLs trends. Age, period and cohort model was utilized to disentangle age, period and birth cohort effects on suicide mortality trends.
Globally, suicide mortality and the rate of YLLs among adolescents and young adults both declined from 1990 to 2021 (AAPC: -1.6 [-2.1 to -1.2]). In 2021, the global number of suicide death cases was 112.9 thousand [103.9-122.2 thousand] and led to 7.9 million [7.2-8.6 million] YLLs. A significant reduction in suicide mortality was observed in all sexes and age groups. By SDI quintiles, the high SDI region (AAPC: -0.3 [-0.6 to 0.0]) had the slowest decline trend, and low-middle SDI region remained the highest suicide mortality till 2021 (7.8 per 100,000 population [6.9-8.6]). Most SDI regions showed generally lower period and cohort effects during the study period, whereas high SDI region showed more unfavourable risks, especially period and cohort effects in females. Regionally, Central Latin America (AAPC: 1.7 [1.1-2.3]), Tropical Latin America (AAPC: 1.5 [0.9-2.0]), High-income Asia Pacific (AAPC: 1.2 [0.7-1.7]) and Southern sub-Saharan Africa (AAPC: 0.8 [0.4-1.2]) had the significance increase in suicide mortality. In 2021, Southern sub-Saharan Africa had the highest mortality (10.5 per 100,000 population [8.6-12.5]). Nationally, a total of 29 countries had a significant upward trend in suicide mortality and rate of YLLs over the past three decades, and certain countries in low-middle and middle regions exhibited an extremely higher burden of suicide.
Global suicide mortality and the rate of YLLs among adolescents and young adults both declined from 1990 to 2021, but obvious variability was observed across regions and countries. Earlier mental health education and targeted management are urgently required for adolescents and young adults in certain areas.
本研究旨在报告 1990 年至 2021 年期间，10-24 岁青少年和青年的按性别、年龄组、社会人口指数（SDI）、地区和国家划分的自杀死亡率和生命损失年（YLLs）趋势，并分析年龄、时期和出生队列效应对自杀死亡率的影响。
自杀死亡率和 YLLs 的估计值和 95%置信区间取自 2021 年全球疾病负担研究。采用 Joinpoint 分析计算年度百分比变化（APC）和平均年度百分比变化（AAPC），以描述死亡率和 YLLs 趋势。采用年龄、时期和队列模型，以区分年龄、时期和出生队列效应对自杀死亡率趋势的影响。
全球范围内，青少年和青年的自杀死亡率和 YLLs 均呈下降趋势（AAPC：-1.6[-2.1 至-1.2]）。2021 年，全球自杀死亡人数为 112.9 万例[103.9-122.2 万例]，导致 790 万例 YLLs[7.2-8.6 万例]。所有性别和年龄组的自杀死亡率均显著下降。按 SDI 五分位数划分，高 SDI 地区（AAPC：-0.3[-0.6 至 0.0]）的下降趋势最慢，低中 SDI 地区的自杀死亡率一直居高不下，直至 2021 年仍为最高（7.8/10 万人口[6.9-8.6]）。大多数 SDI 地区在研究期间表现出普遍较低的时期和队列效应，而高 SDI 地区表现出更多不利的风险，尤其是女性的时期和队列效应。区域方面，中拉丁美洲（AAPC：1.7[1.1-2.3]）、热带拉丁美洲（AAPC：1.5[0.9-2.0]）、高收入亚太地区（AAPC：1.2[0.7-1.7]）和南部撒哈拉以南非洲（AAPC：0.8[0.4-1.2]）的自杀死亡率呈显著上升趋势。2021 年，南部撒哈拉以南非洲的死亡率最高（10.5/10 万人口[8.6-12.5]）。在 2021 年，共有 29 个国家的自杀死亡率和 YLLs 在过去 30 年呈显著上升趋势，中低和中等地区的某些国家的自杀负担极为严重。
全球范围内，1990 年至 2021 年期间，青少年和青年的自杀死亡率和 YLLs 均呈下降趋势，但各地区和国家之间存在明显差异。某些地区的青少年和青年急需开展早期心理健康教育和有针对性的管理。
