Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 140 No. 4344 (2010)

Suicides in the Canton of Zurich (Switzerland)

  • SD Klein
  • C Bischoff
  • W Schweitzer
DOI
https://doi.org/10.4414/smw.2010.13102
Cite this as:
Swiss Med Wkly. 2010;140:w13102
Published
25.10.2010

Summary

QUESTIONS: The Swiss Health Observatory recently reported that the Canton of Zurich ranked fourth highest among the Swiss cantons in regard to suicide rates. The aim of this study was to identify sociodemographic risk factors (such as sex, age, marital status, religion and place of residence) in relation to suicide rates in the Canton of Zurich, and to explore suicide methods and co-morbidities from all suicides in this area between 1995 and 2007.

METHOD: Data from Swiss statistics on causes of death were analysed using statistical modelling.

RESULTS: Suicides were found to be more frequent among men than women, and suicide was more prevalent in older or single people than in younger or married people, respectively. Age groups over 70 had increasingly high suicide rates compared to lower age groups. Investigating geographical distribution, highest suicide risks were found in the cities and high-income municipalities. The chosen suicide methods differed among age and sex groups. Poisoning was more than twice as frequent among women, and more common with increasing age in both sexes. Usage of firearms was about ten times as frequent among men. For train suicides, the age group of 10 to 19 years predominated. In 36% of suicide cases, mental disorders were listed as co-morbidities; in 12% malignant tumours were reported.

CONCLUSIONS: Relatively low rates of mental illness were reported in older suicide victims, despite a massively rising suicide rate with increase of age, indicating that undiagnosed depression could contribute to the high suicide rates in the elderly. Demographic changes in the coming years may result in larger numbers of suicides.

References

  1. Swiss Health Observatory. 2.3.2 Suizide und Suizidversuche. 2009 May [cited 2009 Sep 02]. Available from: http://www.obsandaten.ch/indikatoren/2_3_2/2006/d/232.pdf
  2. Murphy GE. Why women are less likely than men to commit suicide. Compr Psychiatry. 1998;39(4):165–75.
  3. Rich, CL, Ricketts, JE, Fowler, RC, Young, D. Some differences between men and women who commit suicide. Am J Psychiatry. 1988;145(6): 718–22.
  4. Shiner M, Scourfield J, Fincham B, Langer S. When things fall apart: Gender and suicide across the life-course. Soc Sci Med. 2009;69(5):738–46.
  5. Phillips MR, Li X, Zhang Y. Suicide rates in China 1995–99. Lancet. 2002;359(9309):835–40.
  6. Wanta BT, Schlotthauer AE, Guse CE, Hargarten SW. The burden of suicide in Wisconsin's older adult population. WMJ. 2009;108(2):87–93.
  7. Shah A. The relationship between suicide rates and age: an analysis of multinational data from the World Health Organization. Int Psychogeriatr. 2007;19(6):1141–52.
  8. Durkheim É. Le suicide. Étude de sociologie. 1897 [cited 2009 Sep 04]. Available from: http://classiques.uqac.ca/classiques/Durkheim_emile/suicide/suicide.html
  9. Lorant V, Kunst AE, Huisman M, Bopp M, Mackenbach J, EU Working Group. A European comparative study of marital status and socio-economic inequalities in suicide. Soc Sci Med 2005;60(11):2431–41.
  10. Reisch T, Schuster U, Michel K. Suicide by jumping and accessibility of bridges: results from a national survey in Switzerland. Suicide Life Threat Behav. 2007;37(6):681–7.
  11. Conwell Y, Duberstein PR, Caine ED. Risk factors for suicide in later life. Biol Psychiatry. 2002;52(3):193–204.
  12. Flensborg-Madsen T, Knop J, Mortensen EL, Becker U, Sher L, Grønbaek M. Alcohol use disorders increase the risk of completed suicide – irrespective of other psychiatric disorders. A longitudinal cohort study. Psychiatry Res. 2009;167(1–2):123–30.
  13. Levi F, Bulliard JL, La Vecchia C. Suicide risk among incident cases of cancer in the Swiss Canton of Vaud. Oncology. 1991;48(1):44–7.
  14. Crocetti E, Arniani S, Acciai S, Barchielli A, Buiatti E. High suicide mortality soon after diagnosis among cancer patients in central Italy. Br J Cancer. 1998;77(7):1194–6.
  15. Denney JT, Rogers RG, Krueger PM, Wadsworth T. Adult suicide mortality in the United States: marital status, family size, socioeconomic status, and differences by sex. Soc Sci Q. 2009;90(5):1167.
  16. Inoue K, Tanii H, Abe S, Nishimura Y, Kaiya H, Nata M, et al. The report in the correlation between the factor of unemployment and suicide in Japan. Am J Forensic Med Pathol. 2008;29(2):202–3.
  17. Kanchan T, Menon A, Menezes RG. Methods of choice in completed suicides: gender differences and review of literature. J Forensic Sci. 2009;54(4):938–42.
  18. Wiebe DJ. Guns in the home: risky business. LDI Issue Brief. 2003;8(8):1–4.
  19. Killias M. International correlations between gun ownership and rates of homicide and suicide. CMAJ. 1993;148(10):1721–5.
  20. Ajdacic-Gross V, Killias M, Hepp U, Gadola E, Bopp M, Lauber C, et al. Changing times: a longitudinal analysis of international firearm suicide data. Am J Public Health. 2006;96(10):1752–5.
  21. Ajdacic-Gross V, Weiss MG, Ring M, Hepp U, Bopp M, Gutzwiller F, et al. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bull World Health Organ. 2008;86(9):726–32.
  22. Frei A, Han A, Weiss MG, Dittmann V, Ajdacic-Gross V. Use of army weapons and private firearms for suicide and homicide in the region of Basel, Switzerland. Crisis. 2006;27(3):140–6.
  23. Schuler M, Joye D. Typologie der Gemeinden der Schweiz: 1980 – 2000. Swiss Federal Statistical Office [cited 02 Sep 2009]. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/regionen/11/geo/raeumliche_typologien/01.parsys.0003.downloadList.00031.DownloadFile.tmp/typocommtextde.pdf
  24. Hailpern SM, Visintainer PF. Odds ratios and logistic regression: further examples of their use and interpretation. The Stata Journal. 2003;3(3):213–25.
  25. WHO. Suicide rates. 2003 May [cited 2009 Sep 02]. Available from: http://www.who.int/mental_health/prevention/suicide/suiciderates/en/
  26. Bosshard G, Ulrich E, Bär W. 748 cases of suicide assisted by a Swiss right-to-die organisation. Swiss Med Wkly. 2003;133(21–22):310–7.
  27. Pescosolido BA, Georgianna S. Durkheim, suicide, and religion: toward a network theory of suicide. Am Sociol Rev. 1989;54(1):33–48.
  28. Connolly JF. Suicide and the Irish problem: Comments on under-reporting. Arch Suicide Res. 1997;3:25–9.
  29. Neeleman J, Halpern D, Leon D, Lewis G. Tolerance of suicide, religion and suicide rates: an ecological and individual study in 19 Western countries. Psychol Med. 1997;27(5):1165–71.
  30. Dervic K, Oquendo MA, Grunebaum MF, Ellis SE, Burke AK, Mann JJ. Religious affiliation and suicide attempt. Am J Psychiatry. 2004;161(12):2303–8.
  31. Agerbo E, Mortensen PB, Eriksson T, Qin P, Westergaard-Nielsen N. Risk of suicide in relation to income level in people admitted to hospital with mental illness: nested case-control study. BMJ. 2001;322(7282):334–5.
  32. Penn DL, Martin J. The stigma of severe mental illness: some potential solutions for a recalcitrant problem. Psychiatr Q. 1998 Fall;69(3):235–47.
  33. Kurt H. Über Scheininvalide und Psychiater… Schweizerische Ärztezeitung. 2007;88(23):1000–2.
  34. Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS. Stigma as a barrier to recovery: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv. 2001;52(12):1615–20.
  35. Kapusta ND, Zorman A, Etzersdorfer E, Ponocny-Seliger E, Jandl-Jager E, Sonneck G. Rural-urban differenced in Austrian suicides. Soc Psychiatry Psychiatr Epidemiol. 2008;43(4):311–8.
  36. Yip PS, Callanan C, Yuen HP. Urban/rural and gender differentials in suicide rates: east and west. J Affect Disord. 2000;57(1):99–106.
  37. Swiss Federal Statistical Office, Regional Comparator [cited 2010 Apr 05]. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/regionen/regionalportraets/comparator.html
  38. Fischer S, Huber CA, Imhof L, Mahrer Imhof R, Furter M, Ziegler SJ, Bosshard G. Suicide assisted by two Swiss right-to-die organisations. J Med Ethics. 2008;34:810–4.
  39. Värnik A, Kõlves K, van der Feltz-Cornelis CM, Marusic A, Oskarsson H, Palmer A, et al. Suicide methods in Europe: a gender-specific analysis of countries participating in the "European Alliance Against Depression". J Epidemiol Community Health. 2008;62(6):545–51.
  40. Kolonel LN, Altshuler D, Henderson BE. The multiethnic cohort study: exploring genes, lifestyle and cancer risk. Nat Rev Cancer. 2004;4(7):519–27.
  41. Swiss Association of Cancer Registries. Switzerland – statistics of cancer incidence 1986–2005. 2007 Dec [cited 2009 Sep 02]. Available from: http://www.asrt.ch/asrt/newstat/in4ch8605.pdf
  42. Stoppe G. Depression in old age. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2008;51(4):406–10.
  43. Cheng AT. Mental illness and suicide. A case-control study in east Taiwan. Arch Gen Psychiatry. 1995;52(7):594–603.
  44. Angst J, Gamma A, Neuenschwander M, Ajdacic-Gross V, Eich D, Rössler W, Merikangas KR. Prevalence of mental disorders in the Zurich Cohort Study: a twenty year prospective study. Epidemiol Psichiatr Soc. 2005;14(2):68–76.
  45. Angst J, Angst F, Stassen HH. Suicide risk in patients with major depressive disorder. J Clin Psychiatry. 1999;60(Suppl 2):57–62.
  46. Angst F, Stassen HH, Clayton PJ, Angst J. Mortality of patients with mood disorders: follow-up over 34–38 years. J Affect Disord. 2002;68(2–3):167–81.
  47. Borja B, Borja CS, Gade S. Psychiatric emergencies in the geriatric population. Clin Geriatr Med. 2007;23(2):391–400, vii.
  48. Luber MP, Hollenberg JP, Williams-Russo P, DiDomenico TN, Meyers BS, Alexopoulos GS, et al. Diagnosis, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice. Int J Psychiatry Med. 2000;30(1):1–13.
  49. Bentz D, Gerber V, Priester T, Gruber B, Ruch T, Jankowski T, et al. Sozialbericht Kanton Zürich 2007. 2008 [cited 2009 Sep 02]. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/themen/13/22/publ.Document.113856.pdf
  50. Beautrais AL, Joyce PR, Mulder RT. Youth suicide attempts: a social and demographic profile. Aust N Z J Psychiatry. 1998;32(3):349–57.
  51. Agerbo E, Nordentoft M, Mortensen PB. Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case-control study. BMJ. 2002;325(7355):74–8.
  52. Bucher H-P. Babyboomer kommen ins Rentenalter. statistik.info 06/08. 2008 Jun [cited 2009 Sep 21]. Available from: http://www.statistik.zh.ch/themenportal/themen/down.php?id=2152&fn=2008_06.pdf
  53. Gmel G, Kuntsche E. Alkohol-Intoxikationen bei Jugendlichen und jungen Erwachsenen. Eine Analyse der Schweizer Krankenhausstatistik. Abhängigkeiten. 2007;1/07:36–49.
  54. Brühlmann T. Psychiatrische Hospitalisation als Rettungsanker in einer Hochleistungsgesellschaft – eine neue Indikation zur stationären Behandlung. Schweizerische Ärztezeitung. 2009;90:184–7.
  55. Iga M. Suicide of Japanese youth. Suicide Life Threat Behav. 1981;11(1):17–30.
  56. Amagasa T, Nakayama T, Takahashi Y. Karojisatsu in Japan: characteristics of 22 cases of work-related suicide. J Occup Health. 2005;47(2):157–64.