Seasonality of suicide: a multi-country multi-community observational study.

Yu, J; Yang, D; Kim, Y; Hashizume, M; Gasparrini, A; Armstrong, B; Honda, Y; Tobias, A; Sera, F; Vicedo-Cabrera, A. M.; Kim, H; Íñiguez, C; Lavigne, E; Ragettli, M S; Scovronick, N; Acquaotta, F; Chen, B; Guo, Y L; de Sousa Zanotti Stagliori Coelho, M; Saldiva, P; ... (2020). Seasonality of suicide: a multi-country multi-community observational study. Epidemiology and psychiatric sciences, 29, e163. Cambridge University Press 10.1017/S2045796020000748

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We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations.


Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986-2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression.


We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The amplitude of seasonal patterns (i.e. the peak/trough relative risk) also varied from 1.47 (95% confidence interval [CI]: 1.33-1.62) to 1.05 (95% CI: 1.01-1.1) among 12 countries. The subgroup difference in the seasonal pattern also varied over countries. In some countries, larger amplitude was shown for females and for the elderly population (≥65 years of age) than for males and for younger people, respectively. The subperiod difference also varied; some countries showed increasing seasonality while others showed a decrease or little change. Finally, the amplitude was larger for communities with colder climates, higher proportions of elderly people and lower unemployment rates (p-values < 0.05).


Despite the common features of a spring peak and a winter trough, seasonal suicide patterns were largely heterogeneous in shape, amplitude, subgroup differences and temporal changes among different populations, as influenced by climate, demographic and socioeconomic conditions. Our findings may help elucidate the underlying mechanisms of seasonal suicide patterns and aid in improving the design of population-specific suicide prevention programmes based on these patterns.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Vicedo Cabrera, Ana Maria


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




Cambridge University Press




Andrea Flükiger-Flückiger

Date Deposited:

01 Sep 2020 17:50

Last Modified:

05 Dec 2022 15:40

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Climate heterogeneity seasonality socioeconomic suicide




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