Comparative epidemiology of attempted and fatal suicide in a defined catchment area in Israel

Background: Both attempted and fatal suicides are important public health issues and the relationship between these behaviors has great relevance to clinical practice. Aims: To determine how the epidemiology of attempted and fatal suicide relate to each other over time. Method: In an 18-year period consecutive admissions for suicide attempts (n = 4,645) to the emergency room of the central hospital of a well-defined catchment area were assessed using a structured interview. Data were compared with records of 425 fatal suicides from the same catchment area. Results: The relative rates of attempted and fatal suicide changed over time independent of both age and gender up to age 64. Rates of suicide and attempted suicide did not correlate over time in this age group. This was not true for the over 65 age group where attempted suicide and fatal suicide were significantly correlated over time in both men and women. Conclusions: In subjects over 65 attempted suicide is highly associated with eventual suicide. This relationship is much less clear in younger age groups. Thus age of attempt is of great importance when considering the prognostic import of a suicide attempt.