Trends in suicide in a Lithuanian urban population over the period 1984–2003

BACKGROUND Throughout the last decade of the twentieth century, Lithuania had the highest suicide rates in Europe among both men and women aged 25-64 years. The rates increased from 1986 until 1995, but later there was a slight decrease. This paper describes the trends in suicide deaths in urban population in Lithuania by gender, dates and suicide method over the period 1984-2003. METHODS Data from the regional mortality register were used to analyze suicide deaths among all men and women aged 25-64 years in Kaunas city, Lithuania over the period 1984-2003. Age-standardized death rates per 100,000 persons (using European standard population) were calculated by gender, suicide method and dates. A joinpoint regression method was used to estimate annual percentage changes (EPACs) and to detect points where the trends changed significantly. RESULTS The frequency of death by suicide among males was 48% higher in 1994-2003 than in 1984-1993. The corresponding increase among females was 28%. The most common methods of suicide among men were hanging, strangulation and suffocation (87.4% among all suicide deaths). The proportions of hanging, strangulation and suffocation in males increased by 6.9% - from 83.9% to 89.7% - compared to a 24.2% increase in deaths from handgun, rifle and shotgun firearm discharges and a 216.7% increase in deaths from poisoning with solvents, gases, pesticides and vapors. Among females, the most common methods of suicide were hanging, strangulation and suffocation (68.3% of all suicide deaths). The proportion of hanging deaths among females increased during the time period examined, whereas the proportion of poisonings with solid or liquid substances decreased. CONCLUSION Suicide rates increased significantly among urban men aged 25-64 years in Lithuania throughout the period 1984-2003, whereas among women an increasing but statistically insignificant trend was observed. There were changes in the suicide methods used by both men and women. Changes in the choice of method may have contributed to the changes in suicide rates.