Suicide methods The suicide method of choice has been found by a number of studies, to be influenced by seasonality [2+] [26+] [40+].

The general view is that seasonality is found in violent suicides opposed to non violent suicides. Non violent suicides are defined as poisonings, where as violent suicides are all other methods, such as, hanging, jumping from a height and stabbings [2+]. Massing and Angermeyer, 1985, were the first authors to report seasonality in suicides by hanging, but not in poisoning [2+]. They suggested that the reason for this may be because when an individual hangs themselves there is less time for medical intervention, and hence death is less likely to be prevented [19+]. These findings have been replicated in Taiwan [40+], Italy [26+], Finland [11+] [38+], Australia [16+], Sweden [15+] [44], Germany [5+], and Switzerland [39+]. An Italian study, 1998, examining suicides in Italy from the period of 1984-1995 reported that only suicides committed by violent methods show clear evidence of seasonality, with a defined spring peak in both sexes [26+]. Male and females both showed seasonal patterns in hanging and submersion [26+]. Males however, showed greater seasonal differences when considering the suicide method of ‘jumping from a height’ where as in females they showed a greater seasonal difference when considering ‘poisoning’ [26+]. A study by Erazo et al, 2004, that analysed railway suicides in Germany from the period of 1997-2002, observed a distinctive suicide peak in April and September, but interestingly, this seasonality was only found in males and not females [5+]. Again not all studies agree with the notion that violent suicides show strong seasonality. In a study by Page et al, they found that no seasonality was observed for violent suicides in England and Wales during the period 1993-2001 [29+]. Interestingly, it has been suggested that the decline in overall seasonality during 20th century could be due to the decline in the use of methods with previously strong seasonal effects e.g. hanging and drowning [2+]. In support of this, Adjacic-Gross et al, conducted a study in which they analysed data from the WHO mortality database and found that pesticide and firearm suicide had replaced traditional suicide methods in many countries [41+]. Other authors have suggested that recent technological advances have led to a decrease in seasonal social contact, and social activities and thus this has also contributed to a decrease in the number of violent suicides (in keeping with Durkheim theory, as previously mentioned) [40+]. Differentiating between violent and non violent methods of suicide is difficult when assessing seasonality as some violent methods such as stabbing and firearm suicides, do not show seasonality whereas suicide via specific poisons described as non violent suicides do, for example, a study by Rasanen et al, 2002, demonstrated a summer peak in suicides by gaseous substances where as they found no seasonality in suicide by shooting [38+]. Similarly a Korean study, showed distinct seasonality in poisoning

One conclusion that many researchers appear to develop in regards to the association between violent methods of suicide and seasonality is that often. These include seasonal variations in physiological conditions such as plasma serotonin levels [40+]. This factor has also been associated with the diurnal distribution of suicides throughout the day [25+] [26+]. This is supported by one study that analyses the distribution of suicide methods across different countries. plasma melatonin concentrations and serum cholesterol level [40+]. and shows that for example. preti 1998 Plasma melatonin – souetre. salvati and darcout 1987 Cholesterol – maes et al 1996 . poisons such as herbicides and pesticides are more accessible [35+]. pills are available in Western countries throughout the year and hence. poisoning suicides show little seasonality where as pesticide suicides occur more often when pesticides are available in agriculture. it is not the violence of the method used that is important but the seasonal context determining when and how the methods are used [2+]. christrophe and Maes 2004 desienhammer et al 2003. as during the summer months. The biological and physiological contribution to suicide and seasonality A number of authors have suggested theories as to why there is such a defined association between seasonality and violent suicides [40+]. Deaths from drowning and jumping from a height occur mostly in months when outdoor activities common [38+]. opposed to these two classifications [40+]. thus it could be interpreted from this data that the availability of the means to commit suicide is what is important not the violence of the method [2+]. Ferri and Morselli – suggested that suicides peak in warm months due to a heat related excitability of the nervous system – Dixon and shulman 1983. Hence this biological system may have an influence in the seasonality of suicide [26+].suicides. kevan 1980 Weather variables and neuroendocrine cycles – de vriese. Other physiological conditions which have been considered the concentration of 3methoxy-4-hydroxyphenylglycol in cerebrospinal fluid. Unfortunately the classification of suicides into non violent and violent methods is simplistic and arbitrary. pesticide suicides are more common in Asian countries than in European ones [41+]. Lower serotonergic function has been associated with suicide risk and interestingly serotonergic functions show a clear circadian and seasonal pattern [25+]. It has been suggested that there is a 24-hour oscillation in biological processes which are timed by an endogenous clock which is specifically sensitive to the activity of serotonergic neurons [25+]. For instance. which is generally crop growing season [2+]. perhaps in future research. Low levels of serotonin are also often associated with impulsive and aggressive behaviour which may account for the seasonality often shown amongst suicides by violent methods [25+] [40+]. it would be more useful to look at the influence of specific suicide methods and seasonality.

Thus. as discussed previously. A study by and found that seasonality was more pronounced for black South Africans. covering the 1960s to 1980s. 1995. It has been put forward that the reason for a decline in seasonality over more recent years. for example. which had relatively small ones [36+]. Suicide seasonality and a concomitant disorder A previous history of a mood disorder is considered to be a prominent risk factor for suicide. in an office job. This notion is supported by Swiss data.amm tansella – Italian study. This is because the farming year is subject to cyclical workload. This has led to the hypothesis that the spring peak in suicide is driven by a seasonal inability of an individual with a mood disorder to maintain normal psychological defences during this period [39]. Chew and McCleary. Similarly. in a comprehensive analysis. it would be expected that suicides in farmers should show a seasonal pattern. however. with spring and summer being busy times for people in this profession [15+]. in which they examined suicide in patients with previous admission into . and revealed that agricultural populations portrayed relatively large spring peaks when compared with industrial populations. In addition. a lot of farming work is performed outdoors which means that farmers may be more vulnerable to climatic influences than someone who works. that showed seasonality to be absent in Geneva and Basle City which are both urban cantons [39+]. no evidence of major differences in seasonal distribution of suicides was detected [15+]. higher association seasonality and suicide in urban areas of Italy Male farmers are considered an occupational group which portrays a high risk for suicide [15+].1991 Contrast – micciolo zimmer. This was investigated in British study.. 2003. A study by Postolache et al. Durkheim 2002/1897 Other studies – chew McCleary. analysing data from the entire national population in Denmark over a 32-year period supported this theory in that they found that there was an increased relative risk of suicide in spring among those with history of hospitalisation for mood disorders when compared to those without such a history [13+]. micciolo Williams.Pollen data postolache et al 2005 Urban vs. examined monthly suicide data from 28 nations. Coincidentally this risk factor also shows a spring peak in exacerbation [39]. may be due to the modernisation and urbanisation of rural communities and hence suicide seasonality is expected to further decrease in future years. consistent with the expectation that less urbanised sectors of the population would display greater seasonal variation in suicide. Rural Suicide seasonality has been associated with rural rather than urban communities. This supports a similar study by Reutfors et al. granberg and Westerberg 199. 2010. 2009.

Alcoholism is thought to also govern the seasonality of suicide. 2004. There was found to be a significant peak in October/November for men. Sisti Miotto et al. atopic dermatitis occur predominantly in the first half of the year opposed to no difference in other patients. One Swedish study. Evidence not strong – Rocchi. In a study by Bradvik and Berglund. – Lester and frank 1988. yip et al. 2002. meares mendelsohn and milgrom-friedman 1981 – micciolo 1989 Micciolo et al 1989 – suggested explanation. yip. The association between depression and suicide seasonality has led researchers to theorise that the reason seasonality in suicide is decreasing is due to the advances in antidepressant medication. and found distinct seasonal variation (spring/summer peaks) [44]. Other disorders – finish data linkage e study = suicides in patients hospitalised with atopic disorders in previous months or years – such as asthma. in fact. atopic patients who committed suicide showed greater suicide seasonality than those who did not have any atopic disorders [45]. and thus the association between depression and the seasonality of suicide has been considered by a number of studies [24+]. influence this psychiatric disorder has on this phenomenon [15+]. it was observed that alcoholics were found to commit suicide more frequently during the second quarter of the year coinciding with the spring peak often reported in literature [43]. reported a monthly distribution in the number of suicides in patients who had been diagnosed previously with severe depression [24+].hospital for a psychiatric disorder. 2002. Jessen and Jensen 1999 . 2000. Granberg and Westerberg 1999. atopy and allergic disease have also been indicated. with predominance for suicides on Sundays for both sexes [24+]. Depression has been found in many cases to show a seasonal pattern [13+]. allergic rhinitis. social activities of women in autumn trigger more frequent suicides Explanation Durkheim – seasonality with suicide characteristic of the intensity of social life – seasonal peaks with level of social activity – high in spring and summer Gabennesch – broken promise theory – unmet expectations – more suicide at the beginning of a cycle – coincides with return to school/work does not explain differences in suicide method/sex Corcoran et al 2004. In a study by Timmonen et al. Depression has been reported as one of the most common diagnosis among patients who commit suicide [24+]. this highlights the. yang and qin2006 Evidence of a psychiatric illness is not the only predisposing factor towards suicide. it was reported that in Northern Finland.

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