Gender differences in suicide methods

Original Paper

Abstract

Introduction

Gender differences in suicide completion rates have been attributed to the differences in lethality of suicide methods chosen by men and women, but few empirical studies have investigated factors other than demographic characteristics that might explain this differential.

Methods

Data from the 621 suicides in Summit County, Ohio during 1997–2006 were disaggregated by gender to compare known correlates of suicide risk on three methods of suicide—firearm, hanging and drug poisoning.

Results

Compared to women, men who completed suicide with firearms were more likely to be married and committed the act at home. Unmarried men were likelier to hang themselves than married men, but unmarried women were less likely to hang themselves than married women. Men with a history of depression were more likely to suicide by hanging, but women with depression were half as likely to hang themselves compared to the women without a history of depression. Men with a history of substance abuse were more likely to suicide by poisoning than men without such history, but substance abuse history had no influence on women’s use of poisoning to suicide. For both sexes, the odds of suicide by poisoning were significantly higher for those on psychiatric medications.

Keywords

Suicide methods Gender Firearms Poisoning Hanging 

References

  1. 1.
    Centers for Disease Control and Prevention (2009) Suicide fact sheet http://www.cdc.gov/violenceprevention/pdf/Suicide-FactSheet-a.pdf. Accessed 8 Dec 2009
  2. 2.
    Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R (2002) World report on violence and health. World Health Organization, GenevaGoogle Scholar
  3. 3.
    Moscicki E (1994) Gender differences in completed and attempted suicides. Ann Epidemiol 4:152–158PubMedCrossRefGoogle Scholar
  4. 4.
    Cannetto SS, Lester D (1995) The epidemiology of women’s suicidal behavior. In: Canetto SS, Lester D (eds) Women and suicidal behavior. Springer, New York, pp 35–57Google Scholar
  5. 5.
    Romero MP, Wintemute GJ (2002) The epidemiology of firearm suicide in the United States. J Urban Health 79:39–48PubMedCrossRefGoogle Scholar
  6. 6.
    Tadros G, Salib E (2000) Age and methods in fatal self harm (FSH). Is there a link? Int J Geriatr Psychiatry 15:848–852PubMedCrossRefGoogle Scholar
  7. 7.
    Cantor C, Neulinger K (2000) The epidemiology of suicide and attempted suicide among young Australians. Aust N Z J Psychiatry 34:370–387PubMedCrossRefGoogle Scholar
  8. 8.
    Stack S (2000) Suicide: a 15-year review of the sociological literature. Part I: cultural and economic factors. Suicide Life Threat Behav 30:145–162PubMedGoogle Scholar
  9. 9.
    Marks MS, Geling O (1999) Sociodemographic and geographic patterns of firearm suicide in the United States, 1989–1993. Health Place 5:179–185CrossRefGoogle Scholar
  10. 10.
    Kosky RJ, Dundas P (2000) Death by hanging: implications for prevention of an important method of youth suicide. Aust N Z J Psychiatry 34:836–841PubMedCrossRefGoogle Scholar
  11. 11.
    Denning DG, Conwell Y, King D, Cox C (2000) Method choice, intent and gender in completed suicide. Suicide Life Threat Behav 30:282–288PubMedGoogle Scholar
  12. 12.
    Beck AT, Schuyler D, Herman I (1974) Development of suicidal intent scales. In: Beck AT, Resnick HLP, Letteri DJ (eds) The prediction of suicide. Charles Press, Bowie, pp 45–46Google Scholar
  13. 13.
    Haw C, Hawton K, Houston K, Townsend E (2003) Correlates of relative lethality and suicidal intent among deliberate self-harm patients. Suicide Life Threat Behav 33:353–364PubMedCrossRefGoogle Scholar
  14. 14.
    Nock MK, Kessler RC (2006) Prevalence of and risk factors for suicide attempts versus suicide gestures: analysis of the National Comorbidity Survey. J Abnorm Psychol 115:616–623PubMedCrossRefGoogle Scholar
  15. 15.
    Townsend E, Hawton K, Harriss L, Bale E, Bond A (2001) Substances used in deliberate self-poisoning 1985–1997: trends and associations with age, gender, repetition and suicide intent. Soc Psychiatry Psychiatr Epidemiol 36:228–234PubMedCrossRefGoogle Scholar
  16. 16.
    Cannetto SS, Sakinofsky I (1998) The gender paradox in suicide. Suicide Life Threat Behav 28:1–23Google Scholar
  17. 17.
    McIntosh JL, Santos JF (1982) Changing patterns in methods of suicide by race and sex. Suicide Life Threat Behav 12:221–233PubMedGoogle Scholar
  18. 18.
    Smith TW, Smith RJ (1995) Changes in firearm ownership among women, 1980–1994. J Crim Law Criminol 86:133–149CrossRefGoogle Scholar
  19. 19.
    Kellermann AL, Rivara FP, Somes G, Reay DT, Francisco J, Banton JG, Prodzinski J, Fligner C, Hackman BB (1992) Suicide in the home in relation to gun ownership. N Engl J Med 327:467–472PubMedCrossRefGoogle Scholar
  20. 20.
    Wintemute GJ, Parham CA, Beaumont JJ, Wright M, Drake C (1999) Mortality among recent purchasers of handguns. N Engl J Med 341:1583–1589PubMedCrossRefGoogle Scholar
  21. 21.
    Lester D (2000) Why people kill themselves. Charles Thomas, SpringfieldGoogle Scholar
  22. 22.
    Stack S, Wasserman I (2009) Gender and suicide risk: the role of wound site. Suicide Life Threat Behav 39:13–20PubMedCrossRefGoogle Scholar
  23. 23.
    Schmeling A, Strauch H, Rothschild MA (2001) Female suicides in Berlin with the use of firearms. Forensic Sci Int 124:178–181PubMedCrossRefGoogle Scholar
  24. 24.
    Kaplan AG, Klein RB (1989) Women and suicide. In: Jacobs D, Brown HN (eds) Suicide: understanding and responding: Harvard Medical School perspectives. International Universities Press, Madison, pp 257–282Google Scholar
  25. 25.
    Barber ME, Marzuk PM, Leon AC, Portera L (1998) Aborted suicide attempts: a new classification of suicidal behavior. Am J Psychiatry 155:385–389PubMedGoogle Scholar
  26. 26.
    Rich CL, Ricketts JE, Fowler RC, Young D (1988) Some differences between men and women who commit suicide. Am J Psychiatry 145:718–722PubMedGoogle Scholar
  27. 27.
    Steer RA, Beck AT, Garrison B, Lester D (1988) Eventual suicide in interrupted and uninterrupted attempters: a challenge to the cry-for-help hypothesis. Suicide Life Threat Behav 18:119–128PubMedGoogle Scholar
  28. 28.
    Kessler RC, Borges G, Walters EE (1999) Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 56:617–626PubMedCrossRefGoogle Scholar
  29. 29.
    Skogman K, Alsen M, Ojehagan A (2004) Sex differences in risk factors for suicide after attempted suicide: a follow-up study of 1052 suicide attempters. Soc Psychiatry Psychiatr Epidemiol 39:113–120PubMedCrossRefGoogle Scholar
  30. 30.
    Conwell Y, Brent D (1995) Suicide and aging: I. Patterns of psychiatric diagnosis. Int Psychogeriatr 7:149–181PubMedCrossRefGoogle Scholar
  31. 31.
    Grava G, Ceroni GB, Rucci P, Scudellari P (2006) Suicidal behavior and personality structure. Suicide Life Threat Behav 36:569–577PubMedCrossRefGoogle Scholar
  32. 32.
    Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eschleman S et al (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from a national comorbidity survey. Arch Gen Psychiatry 51:8–19PubMedCrossRefGoogle Scholar
  33. 33.
    Jick SS, Dean AD, Jick H (1995) Antidepressants and suicide. Br Med J 310:315–318CrossRefGoogle Scholar
  34. 34.
    Cyranowski JM, Frank E, Young E, Shear K (2000) Adolescent onset of the of the gender difference in lifetime rates of major depression. Arch Gen Psychiatry 57:21–27PubMedCrossRefGoogle Scholar
  35. 35.
    Hankin BL, Abramson LY (2001) Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychol Bull 127:773–796PubMedCrossRefGoogle Scholar
  36. 36.
    Norman J (2004) Gender bias in the diagnosis and treatment of depression. Int J Ment Health 33:32–43Google Scholar
  37. 37.
    Henrikksson MM, Hellivi MA, Marttunen MJ, Heikkinnen ME, Isometsa ET, Kuoppasalmi KI, Lonnqvist JK (1993) Mental disorders and comorbidity in suicide. Am J Psychiatry 150:935–940Google Scholar
  38. 38.
    Martunnen MJ, Henriksson MM, Hillevi MA, Heikkinen ME, Isometsa ET, Lonnqvist JK (1995) Suicide among female youth: Characteristics and comparisons with males in age groups 13 to 22 years. J Am Acad Child Adolesc Psychiatry 34:1297–1307CrossRefGoogle Scholar
  39. 39.
    Kposowa AJ, McElvain JP (2006) Gender, place, and method of suicide. Soc Psychiatry Psychiatr Epidemiol 41:435–443PubMedCrossRefGoogle Scholar
  40. 40.
    Kaplan MS, Adamek ME, Geling O, Calderon A (1997) Firearm suicide among older women in the U.S. Soc Sci Med 44:1427–1430PubMedCrossRefGoogle Scholar
  41. 41.
    Centers for Disease Control and Prevention (2009) WISQARS injury mortality reports. http://www.cdc.gov/injury/wisqars/. Accessed 3 Oct 2010
  42. 42.
    Rawlinson C, Crews P (2003) Access to quality health services in rural areas. Emergency medical services. Rural Healthy People 2010: a companion document to healthy people 2010. The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center, College StationGoogle Scholar
  43. 43.
    Menard SW (2002) Applied logistic regression analysis, 2nd edn. Sage, Thousand OaksGoogle Scholar
  44. 44.
    Altman DG, Bland JM (2003) Interaction revisited: the difference between two estimates. Br Med J 326:219CrossRefGoogle Scholar
  45. 45.
    Kaplan MS, Geling O (1998) Firearm suicides and homicides in the United States: regional variations and patterns of gun ownership. Soc Sci Med 46:1227–1233PubMedCrossRefGoogle Scholar
  46. 46.
    Conwell Y, Duberstein PR, Connor K, Eberly S, Cox C, Caine ED (2002) Access to firearms and risk for suicide in middle-aged and older adults. Am J Geriatr Psychiatry 10:407–416PubMedGoogle Scholar
  47. 47.
    Dahlberg LL, Ikeda RM, Kresnow M (2004) Guns in the home and risk of a violent death in the home: Findings from a national survey. Am J Epidemiol 160:929–936PubMedCrossRefGoogle Scholar
  48. 48.
    Kellermann AL, Somes G, Rivara FP, Lee RK, Vanton JG (1998) Injuries and deaths due to firearms in the home. J Trauma 45:263–267PubMedCrossRefGoogle Scholar
  49. 49.
    Kreitman N, Platt S (1984) Suicide, unemployment, and domestic gas detoxification in Britain. J Epidemiol Community Health 38:1–6PubMedCrossRefGoogle Scholar
  50. 50.
    Lester D (1990) The effects of detoxification of domestic gas on suicide in the United States. Am J Public Health 80:1–2CrossRefGoogle Scholar
  51. 51.
    Daigle MS (2005) Suicide prevention through means restriction: assessing the risk of substitution. A critical review and synthesis. Accid Anal Prev 37:625–632PubMedCrossRefGoogle Scholar
  52. 52.
    Pomerantz JM (2008) FDA warning about suicidality: Balancing risk and benefit. Drug Benefit Trends 20:149–150Google Scholar
  53. 53.
    Brent D (2007) Antidepressant and suicidal behavior: cause or cure? Am J Psychiatry 164:989–991PubMedCrossRefGoogle Scholar
  54. 54.
    Isacsson G, Bergman U, Rich CL (1996) Epidemiological data suggest antidepressant reduce suicide risk among depressives. J Affect Disord 41:1–8PubMedCrossRefGoogle Scholar
  55. 55.
    Spijker J, de Graaf R, ten Have M, Nolen WA, Speckens A (2010) Predictors of suicidality in depressive spectrum disorders in the general population: Results of the Netherlands Mental Health Survey and Incidence Study. Soc Psychiatry Psychiatr Epidemiol 45:513–521PubMedCrossRefGoogle Scholar
  56. 56.
    Donovan S, Kelleher MJ, Lambourn J, Foster T (1999) The occurrence of suicide following the prescription of antidepressant drugs. Arch Suicide Res 5:181–192Google Scholar
  57. 57.
    Mikula L, Bronson A, Reitman D (2007) Do antidepressant medications really increase suicide risk for adolescents? Reflections on the FDA’s black box warning. Behav Ther 30:99–103Google Scholar
  58. 58.
    Stack S, Bowman B (2009) Suicide in movies: gender and choice of suicide method. In: Stack S, Lester D (eds) Suicide and the creative arts. Nova Science Publishers, New York, pp 57–61Google Scholar
  59. 59.
    Oslin DW, Zubritsky C, Brown G, Mullahy M, Puliafico A, Ten Have T (2004) Managing suicide risk late in life: access to firearms as a public health risk. Am J Geriatr Psychiatry 12:30–36PubMedGoogle Scholar
  60. 60.
    Rockett IRH, Wang S, Stack S, De Leo D, Frost JL, Ducatman AM, Walker RL, Kapusta ND (2010) Race/ethnicity and potential suicide misclassification: window on a minority suicide paradox? BMC Psychiatry 10:1–8CrossRefGoogle Scholar
  61. 61.
    DeJong T, Overholser JC, Stockmeier CA (2010) Apples to oranges? A direct comparison between suicide attempters and suicide completers. J Affect Disord 124:90–97PubMedCrossRefGoogle Scholar
  62. 62.
    Bradvick L (2007) Violent and nonviolent methods of suicide: different patterns may be found in men and women with sever depression. Arch Suicide Res 11:255–264CrossRefGoogle Scholar
  63. 63.
    Sen B (2004) Adolescent propensity for depressed mood and help seeking: race and gender differences. J Ment Health Policy Econ 7:133–145PubMedGoogle Scholar
  64. 64.
    Sussman L, Robins L, Earls F (1987) Treatment-seeking for depression by black and white Americans. Soc Sci Med 24:187–196PubMedCrossRefGoogle Scholar
  65. 65.
    Hawton K, Appleby L, Platt S, Foster T, Cooper J, Malmberg A, Simkin S (1998) The psychological autopsy approach to studying suicide: a review of methodological issues. J Affect Disord 50:269–276PubMedCrossRefGoogle Scholar
  66. 66.
    Pouliot L, De Leo D (2006) Critical issues in psychological autopsy studies. Suicide Life Threat Behav 36:491–510PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of SociologyThe University of AkronAkronUSA
  2. 2.Criminal Justice Research CenterThe Ohio State UniversityColumbusUSA

Personalised recommendations