Global, regional, and national burden of suicide, 1990–2021 : a systematic analysis for the global burden of disease study 2021

Article

DAVIS WEAVER, Nicole | BERTOLACCI, Gregory J. | ROSENBLAD, Emily | GHOBA, Sama | CUNNINGHAM, Matthew | IKUTA, Kevin S. | MOBERG, Madeline E. | MOUGIN, Vincent | HAN, Chieh | WOOL, Eve E. | ABATE, Yohannes Habtegiorgis | ADEWUYI, Habeeb Omoponle | ADNANI, Qorinah Estiningtyas Sakilah | ADZIGBLI, Leticia Akua | AFOLABI, Aanuoluwapo Adeyimika | AGAMPODI, Suneth Buddhika | AHINKORAH, Bright Opoku | AHMAD, Aqeel | AHMAD, Danish | AHMAD, Sajjad | AHMED, Ayman | AHMED, Haroon | HAMAD, Hanadi Al | AL-AJLOUNI, Yazan | AL-AMER, Rasmieh Mustafa | ALBASHTAWY, Mohammed | ALDHALEEI, Wafa A. | ALI, Syed Shujait | ALI, Waad | ALOMARI, Mahmoud A. | ALSABRI, Mohammed A. | ALVIS-GUZMAN, Nelson | AL-WORAFI, Yaser Mohammed | AMINDAROLZARBI, Alireza | AMIRI, Sohrab | ANDREI, Tudorel | ANVARI, Saeid | ARABLOO, Jalal | AREDA, Demelash | ARTAMONOV, Anton A. | ASHRAF, Tahira | ATHARI, Seyyed Shamsadin | ATOUT, Maha Moh'd Wahbi | AZZAM, Ahmed Y. | BADIYE, Ashish D. | BAGHCHEGHI, Nayereh | BAHRAMIAN, Saeed | BANACH, Maciej | BARKER-COLLO, Suzanne Lyn | BÄRNIGHAUSEN, Till Winfried | BARROW, Amadou | BASHIRI, Azadeh | BASHIRU, Hameed Akande | BASTAN, Mohammad-Mahdi | BATRA, Kavita | BATRA, Ravi | BAYATI, Mohsen | BENJET, Corina | BENZIAN, Habib | BERTUCCIO, Paola | BHAGAVATHULA, Akshaya Srikanth | BHATTACHARJEE, Priyadarshini | BILLS, Corey B. | BOPPANA, Sri Harsha | BORGES, Guilherme | BORHANY, Hamed | BUSTANJI, Yasser | SANTOS, Florentino Luciano Caetano dos | CASTELPIETRA, Giulio | CAYE, Arthur | CENDERADEWI, Muthia | CHANDIKA, Rama Mohan | CHANDRASEKAR, Eeshwar K. | CHARALAMPOUS, Periklis | CHEN, Yifan | CHIMORIYA, Ritesh | CHOPRA, Hitesh | CHOUDHARI, Sonali Gajanan | CHU, Dinh-Toi | CHUKWU, Isaac Sunday | CHUTIYAMI, Muhammad | COWDEN, Richard G. | DACHEW, Berihun Assefa | DADRAS, Omid | DAI, Xiaochen | DALAL, Koustuv | DANDONA, Lalit | DANDONA, Rakhi | DARCHO, Samuel Demissie | SOLTANI, Reza Darvishi Cheshmeh | DÁVILA-CERVANTES, Claudio Alberto | TORRE-LUQUE, Alejandro de la | DEBOPADHAYA, Shayom | DEGENHARDT, Louisa | DELGADO-ENCISO, Ivan | DERVISEVIC Emina | DIAZ, Michael J. | DONGARWAR, Deepa | DOSHI, Ojas Prakashbhai | DSOUZA, Haneil Larson | DUMITH, Samuel C. | DURAISAMY, Senbagam | EBOREIME, Ejemai | EFENDI, Ferry | EKHOLUENETALE, Michael | ARAB, Rabie Adel El | ELHADI, Muhammed | ELNAHAS, Gihan | ELTAHA, Chadi | HAQUE, Syed Emdadul Emdadul | ESKANDARIEH, Sharareh | FAHIM, Ayesha | FARO, Andre | FATEHIZADEH, Ali | FAZELI, Patrick | FEIZKHAH, Alireza | FEKADU, Ginenus | FERREIRA, Nuno | FISCHER, Florian | FRANKLIN, Richard Charles | FRIDAYANI, Ni Kadek Yuni | GAJDÁCS, Márió | GANDHI, Aravind P. | GANESAN, Balasankar | GEBREGERGIS, Miglas Welay | GEBREHIWOT, Mesfin | GEBREMESKEL, Teferi Gebru | GETIE, Molla | GHADIMI, Delaram J. | GHAILAN, Khalid Yaser | GHASHGHAEE, Ahmad | GHOLAMREZANEZHAD, Ali | GOLEIJ, Pouya | GRADA, Ayman | GRIVNA, Michal | GUAN, Shi-Yang | GULATI, Snigdha | GUPTA, Sapna | GUTIÉRREZ, Reyna Alma | GUTIÉRREZ-MURILLO, Roberth Steven | HAMILTON, Erin B. | HANIFI, Nasrin | HASAN, Ikramul | TABATABAEI, Mahgol Sadat Hassan Zadeh | HAY, Simon I. | HEIDARI, Mohammad | HEMMATI, Mehdi | HOAN, Nguyen Quoc | HOSSEINZADEH, Mehdi | HOSTIUC, Sorin | HUANG, Junjie | HUYNH, Hong-Han | IBITOYE, Segun Emmanuel | ILESANMI, Olayinka Stephen | ILIC, Irena M. | ILIC, Milena D. | IMMURANA, Mustapha | INOK, Arit | IWU, Chidozie Declan | JAHRAMI, Haitham | JAKA, Sanobar | YENGEJEH, Reza Jalilzadeh | JI, Zixiang | JIN, Shuai | JOSEPH, Nitin | JOSHUA, Charity Ehimwenma | JOZWIAK, Jacek Jerzy | KABIR, Zubair | KADASHETTI, Vidya | KANMODI, Kehinde Kazeem | KANTAR, Rami S. | KAPOOR, Neeti | KARAYE, Ibraheem M. | KARMAKAR, Shilpi | KAUR, Harkiran | KERR, Jessica A. | KHAJURIA, Himanshu | KHAN, Ajmal | KHATAB, Khaled | KHEIRALLAH, Khalid A. | KIM, Kwanghyun | KIM, Min Seo | SHIVAKUMAR, Shivakumar KM KM | KOLAHI, Ali-Asghar | KOOHESTANI, Hamid Reza | KRISHNA, Varun | KUGBEY, Nuworza | KULIMBET, Mukhtar | KUMAR, G. Anil | KUMAR, Manasi | KUNDU, Satyajit | KYTÖ, Ville | LANDIRES, Iván | LE, Nhi Huu Hanh | LEE, Doo Woong | LEE, Wei-Chen | LEE, Yo Han | LIM, Stephen S. | LIN, Jialing | LIU, Richard T. | LÓPEZ-GIL, José Francisco | LUCCHETTI, Giancarlo | MA, Zheng Feei | MALED, Venkatesh | MALHOTRA, Kashish | MALIK, Ahmad Azam | MARCONI, Agustina Maria | MARTINEZ-PIEDRA, Ramon | MARZO, Roy Rillera | MATHANGASINGHE, Yasith | MAULIK, Pallab K. | MELES, Hadush Negash | MENEZES, Ritesh G. | MERETOJA, Tuomo J. | MESTROVIC, Tomislav | MICHALEK, Irmina Maria | MILLER, Ted R. | MIRZA, Moonis | MISGANAW, Awoke | MITTAL, Chaitanya | MOHAMED, Abdalla Z. | MOHAMED, Nouh Saad | MOHAMMADIAN-HAFSHEJANI, Abdollah | MOKDAD, Ali H. | MOLINARO, Sabrina | MONASTA, Lorenzo | GHALIBAF, AmirAli Moodi | MORRISON, Shane Douglas | MOTAPPA, Rohith | MUGHAL, Faraz | MULITA, Francesk | MUNKHSAIKHAN, Yanjinlkham | MURRAY, Christopher J. L. | MUTHU, Sathish | MYUNG, Woojae | NAFEI, Ayoub | NAGHAVI, Pirouz | NAIK, Ganesh R. | NAIK, Gurudatta | NATTO, Zuhair S. | NAVEED, Muhammad | NAVID, Shadan | NAYAK, Biswa Prakash | NAZRI-PANJAKI, Athare | NETSERE, Henok Biresaw | NEUPANE, Sudan Prasad | NGUYEN, Hoang Anh Hoang | NGUYEN, Nhien Ngoc Y. | NGUYEN, Phat Tuan | NGUYEN, Phuong The | NGUYEN, Van Thanh | NIKOOBAR, Ali | NOGUER, Isabel | NOMURA, Shuhei | NRI-EZEDI, Chisom Adaobi | NUÑEZ-SAMUDIO, Virginia | NZOPUTAM, Ogochukwu Janet | OANCEA, Bogdan | ODURO, Michael Safo | OH, In-Hwan | OKEKE, Sylvester Reuben | OLUWAFEMI, Yinka Doris | ONG, Sok King | ORDAK, Michal | ORPANA, Heather M. | ORTIZ-PRADO, Esteban | OSUAGWU, Uchechukwu Levi | PADRON-MONEDERO, Alicia | PADUBIDRI, Jagadish Rao | PALMA-ALVAREZ, Raul Felipe | PANDEY, Anamika | PANDEY, Ashok | PANTAZOPOULOS, Ioannis | PARK, Seoyeon | PARK, Sungchul | PASHAEI, Ava | PATEL, Jay | PAWAR, Shrikant | PEPRAH, Prince | PERES, Mario F. P. | PETCU, Ionela-Roxana | PHILIP, Anil K. | PHILLIPS, Michael R. | PIRACHA, Zahra Zahid | PRADHAN, Jalandhar | PRATES, Elton Junio Sady | PRIBADI, Dimas Ria Angga | PUVVULA, Jagadeesh | QATTEA, Ibrahim | QIAN, Gangzhen | RADHAKRISHNAN, Venkatraman | RAGHAV, Pankaja | RAHIMIBARGHANI, Sarvenaz | RAHIMI-MOVAGHAR, Afarin | RAHIMI-MOVAGHAR, Vafa | RAHMAN, Md Mosfequr | RAHMAN, Mosiur | RAHMAN, Muhammad Aziz | RAHMANIAN, Mohammad | RAJPOOT, Pushp Lata | RAMADAN, Mahmoud Mohammed | RAMASAMY, Shakthi Kumaran | RANI, Smitha | RAO, Mithun | RAO, Sowmya J. | RASHIDI, Mohammad-Mahdi | RASTOGI, Prateek | RATHISH, Devarajan | RAWAF, David Laith | REIFELS, Lennart | REZAEIAN, Mohsen | RHEE, Taeho Gregory | RICKARD, Jennifer | ROEVER, Leonardo | RONY, Moustaq Karim Khan | N, Chandan S. | SADDIK, Basema Ahmad | SADEGHIAN, Farideh | SAEB, Mohammad Reza | SAEED, Umar | MOGHADDAM, Sahar Saeedi | SAFARI, Mehdi | SAGOE, Dominic | SHARIF-ASKARI, Narjes Saheb | SAHOO, Pragyan Monalisa | SAHOO, Soumya Swaroop | SALAMATI, Payman | SALIHU, Dauda | SALIMI, Sohrab | SALUM, Giovanni A. | SAMEEN, Sonia | SAMY, Abdallah M. | SANTRIC-MILICEVIC, Milena M. | SARKAR, Chinmoy | SARODE, Gargi Sachin | SARODE, Sachin C. | SATHIAN, Brijesh | SCHUMACHER, Austin E. | ŠEKERIJA, Mario | SEMREEN, Mohammad H. | SEPANLOU, Sadaf G. | SHAFIE, Mahan | SHAHID, Samiah | SHAIKH, Ahmed | SHAIKH, Masood Ali | SHARIFAN, Amin | RAD, Javad Sharifi | SHARMA, Anupam | SHARMA, Vishal | SHEIKHI, Rahim Ali | SHETTY, Mahabalesh | SHETTY, Pavanchand H. | SHETTY, Premalatha K. | SHIVAROV, Velizar | SHOOL, Sina | SINGH, Paramdeep | SINGH, Puneetpal | SINGH, Surjit | SOCEA, Bogdan | STEIN, Dan J. | STEIN, Murray B. | SUN, Jing | SWAIN, Chandan Kumar | SZARPAK, Lukasz | Y, Sree Sudha T. | TABATABAEI, Seyyed Mohammad | TABCHE, Celine | TAREKE, Minale | TEMSAH, Mohamad-Hani | THUM, Chern Choong | TIRUYE, Tenaw Yimer | TOVANI-PALONE, Marcos Roberto | TRAN, Nghia Minh | TRAN, Thang Huu | DUC, Nguyen Tran Minh | TROMANS, Samuel Joseph | TRUYEN, Thien Tan Tri Tai | TSEGAY, Guesh Mebrahtom | TUMURKHUU, Munkhtuya | VAHDATI, Sanaz | VAITHINATHAN, Asokan Govindaraj | VALDEZ, Pascual R. | VASANKARI, Tommi Juhani | VEROUX, Massimiliano | VERRAS, Georgios-Ioannis | VINAYAK, Manish | VOS, Theo | WALDE, Mandaras Tariku | WANG, Yanzhong | WARD, Joseph L. L. | WICKRAMASINGHE, Nuwan Darshana | WOJEWODZIC, Marcin W. | YESODHARAN, Renjulal | YIGIT, Arzu | YIN, Dehui | YIP, Paul | YON, Dong Keon | YONEMOTO, Naohiro | YU, Chuanhua | ZARE, Iman | ZEARIYA, Mohammed G. M. | ZHANG, Haijun | ZHONG, Claire Chenwen | ZHU, Bin | ZHUMAGALIULY, Abzal | NAGHAVI, Mohsen

Background: Deaths from suicide are a tragic yet preventable cause of mortality. Quantifying the burden of suicide to understand its geographical distribution, temporal trends, and variation by age and sex is an essential step in suicide prevention. We aimed to present a comprehensive set of global, regional, and national estimates of suicide burden. Methods: We produced estimates of the number of deaths and age-standardised mortality rates of suicide globally, regionally, and for 204 countries and territories from 1990 to 2021, and disaggregated these results by age and sex. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 estimates of deaths attributable to suicide were broken down into two comprehensive categories: those by firearms and those by other specified means. For this analysis, we also produced estimates of mean age at the time of death from suicide, incidence of suicide attempts compared with deaths, and age-standardised rates of suicide by firearm. We acquired data from vital registration, verbal autopsy, and mortality surveillance that included 23 782 study-location-years of data from GBD 2021. Point estimates were calculated from the average of 1000 randomly selected possible values of deaths from suicide by age, sex, and geographical location. 95% uncertainty intervals (UIs) were derived from the 2·5th and 97·5th percentiles from a 1000-draw distribution. Findings: Globally, 746 000 deaths (95% UI 692 000–800 000) from suicide occurred in 2021, including 519 000 deaths (485 000–556 000) among males and 227 000 (200 000–255 000) among females. The age-standardised mortality rate has declined over time, from 14·9 deaths (12·8–15·7) per 100 000 population in 1990 to 9·0 (8·3–9·6) per 100 000 in 2021. Regionally, mortality rates due to suicide were highest in eastern Europe (19·2 [17·5–20·8] per 100 000), southern sub-Saharan Africa (16·1 [14·0–18·3] per 100 000), and central sub-Saharan Africa (14·4 [11·0–19·1] per 100 000). The mean age at which individuals died from suicide progressively increased during the study period. For males, the mean age at death by suicide in 1990 was 43·0 years (38·0–45·8), increasing to 47·0 years (43·5–50·6) in 2021. For females, it was 41·9 years (30·9–46·7) in 1990 and 46·9 years (41·2–52·8) in 2021. The incidence of suicide attempts requiring medical care was consistently higher at the regional level for females than for males. The number of deaths by suicide using firearms was higher for males than for females, and substantially varied by country and region. The countries with the highest age-standardised rate of suicides attributable to firearms in 2021 were the USA, Uruguay, and Venezuela. Interpretation: Deaths from suicide remain variable by age and sex and across geographical locations, although population mortality rates have continued to improve globally since the 1990s. This study presents, for the first time in GBD, a quantification of the mean age at the time of suicide death, alongside comprehensive estimates of the burden of suicide throughout the world. These analyses will help guide future approaches to reduce suicide mortality that consider a public health framework for prevention. Funding: Bill & Melinda Gates Foundation.

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00006-4/fulltext?dgcid=raven_jbs_aip_email

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