Completed and attempted suicide in Ilam, Iran (1995 - 2002): incidence and associated factors

Understanding the epidemiology of suicide will increase awareness of suicide as a major public health problem. The epidemiology of suicide is described for the first time in Ilam, Iran. To describe the incidence of and factors associated with completed and attempted suicide in Ilam (western part of Iran), a longitudinal prospective case-register study was conducted from 1995 to 2002. In the province of Ilam, Iran, all individual contacts concerning parasuicidal behavior were registered by the participating facilities. Demographic and case-related information were recorded. Two thousand five hundred twelve people committed suicide from the year 1995 to 2002. Cases were selected on the basis of information from the scene of crime, police inquest, office of welfare organization, autopsy findings, emergency medical services, mental health clinics and hospital records, Ilam Central Bureau of Statistics, and interview with the acquaintances of the victims and suicide attempted persons. The overall annual completed suicide rate (95% confidence interval [CI]) was 10.0 (8.5 to 11.5) and 26.4 (23.9 to 28.9) per 100,000 men and women. The attempted suicide rate was 41.8 (38.7 to 44.8) and 64.5 (60.7 to 68.4) per 100,000 men and women. More women than men completed (relative risk = 2.7 [95% CI: 2.2 to 3.2]) or attempted suicide (relative risk = 1.5 [95% CI: 1.4 to 1.7]). Suicide and attempted suicide rates were highest among 20 – 29 years old and decreased with increasing the age. Self-immolation was the most common method of suicide, while drug overdose was the predominant method of suicide attempt. Suicidal behavior was associated with a higher level of education. A higher completed and attempted suicide rate was found among the married people than those who never married. The findings of this study highlight the need for further studies to identify population at high risk for suicide as the first step towards planning a well-organized approach to reduce the suicide rate