The lethality of suicide methods: A systematic review and meta-analysis
Open accessAbstract
Background The use of suicide methods largely determines the outcome of suicide acts. However, no existing meta-analysis has assessed the case fatality rates (CFRs) by different suicide methods. The current study aimed to fill this gap. Methods We searched Scopus, Web of Science, PubMed, ProQuest and Embase for studies reporting method-specific CFRs in suicide, published from inception to 31 December 2020. A random-effect model meta-analysis was applied to compute pooled estimates. Results Of 10,708 studies screened, 34 studies were included in the meta-analysis. Based on the suicide acts that resulted in death or hospitalization, firearms were found to be the most lethal method (CFR:89.7%), followed by hanging/suffocation (84.5%), drowning (80.4%), gas poisoning (56.6%), jumping (46.7%), drug/liquid poisoning (8.0%) and cutting (4.0%). The rank of the lethality for different methods remained relatively stable across study setting, sex and age group. Method-specific CFRs for males and females were similar for most suicide methods, while method-CFRs were specifically higher in older adults. Conclusions This study is the first meta-analysis that provides significant evidence for the wide variation of the lethality of suicide methods. Restricting highly lethal methods based on local context is vital in suicide prevention.
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90% of firearm suicide attempts result in death.
“First, many patients with firearm injuries die at the scene, especially those who used a firearm to attempt suicide, 90% of which result in death [22].”
From Firearm injuries in Missouri (2023) · cites this paper as [22]
Many patients with firearm injuries die at the scene, especially those who used a firearm to attempt suicide.
“First, many patients with firearm injuries die at the scene, especially those who used a firearm to attempt suicide, 90% of which result in death [22].”
From Firearm injuries in Missouri (2023) · cites this paper as [22]
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Rivara, F. P., Hink, A. B., Kuhls, D., Banks, S., Agoubi, L. L., Kirkendoll, S., Winchester, A., Hoeft, C., Patel, B., & Nathens, A. (2023) · PLOS ONE · doi:10.1371/journal.pone.0294737 · Cited by 3 · see citing works
- Authors
- Cai, Z., Junus, A., Chang, Q., & Yip, P. S. F.
- Affiliations
- University of Hong Kong (HK)
- Xiamen University (CN)
- Hong Kong Jockey Club (HK)
- Corresponding author
- Chang, Qingsong
- Yip, Paul S.F.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 300
- Pages
- 121-129
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4200170086
- Cited by
- 155
- References
- 13
- Citations by year
- 2026: 52 · 2025: 39 · 2024: 35 · 2023: 21 · 2022: 7
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- The University of Hong Kong
- Xiamen University
- National Office for Philosophy and Social Sciences (21CSH057)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Keywords
- suicide methods, case fatality rate, firearms, drowning, gas poisoning, drug poisoning, suicide prevention, sex differences, older adults
- MeSH terms
- Aged, Drowning, Female, Firearms, Gas Poisoning, Hospitalization, Humans, Male, Suicide
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