Short Communication Suicide attempts and suicide in Iran: Results of national hospital surveillance data M. Sharif-Alhoseini a , M.R. Rasouli b , S. Saadat a , M. Haddadi c , M.M. Gooya d , M. Afsari e , V. Rahimi-Movaghar a,f, * a Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences, Tehran, Iran b Rothman Institute of Orthopedics at Thomas Jefferson University, Philadelphia, PA, USA c Injury Prevention and Safety Promotion Department, Disaster and Emergency Management Centre, Iran Ministry of Health and Medical Education, Tehran, Iran d Centre for Disease Control, Iran Ministry of Health and Medical Education, Tehran, Iran e Injury Prevention, Iran Ministry of Health and Medical Education, Tehran, Iran f Research Centre for Neural Repair, University of Tehran, Tehran, Iran article info Article history: Received 8 June 2011 Received in revised form 2 April 2012 Accepted 14 June 2012 Available online 4 October 2012 Keywords: Suicide Attempted suicide Epidemiology Injury Iran A suicide attempt or suicide is defined as ‘an act of self- inflicted injury or self-poisoning with non-fatal or fatal outcome’. 1 Suicide has become an increasingly widespread form of morbidity in the developing world. Over the last 45 years, the rate of suicide attempts and suicides has increased by 60% worldwide. The estimated average annual rate of suicide attempts in recent decades ranges from 2.6 to 1100 per 100,000 person-years. 2 According to the World Health Orga- nization, suicide is the third leading cause of death among people aged 15e44 years. 3 In 2002, it was estimated that 877,000 lives were lost worldwide due to suicide, representing 1.5% of the global burden of disease. 4 As epidemiological data on suicide attempts and suicide are lacking in many devel- oping countries, 5 further studies are needed to investigate the rates and to help the authorities in planning and monitoring prevention programmes. This study aimed to elucidate the epidemiological pattern of suicide attempts and suicide in Iran. The recorded national injury surveillance system (ISS) data from 20 March 2005 to 19 March 2008 were used. ISS data include demographics, place of residence, type of trauma and emergency department (ED) deaths. Hospital-based ISS is limited to injured patients who enter the EDs of governmental hospitals. These hospitals (68.9% of the 942 hospitals in Iran) are under the coverage of the Ministry of Health, which controls medical education in the country. Their services are cheap and available for all people. These hospitals are in the same geographical locations as other types of hospitals with similar distribution, and they cover the whole country and not particular locations. Therefore, everyone can use their services. As injured patients present at the ED, the afore- mentioned data are recorded in their medical records by the medical staff. The paper records are sent from hospitals to the Centre for Disease Control and converted into electronic format. Deaths were only registered as fatal injuries if the case * Corresponding author. Sina Trauma and Surgery Research Centre, Sina Hospital, Hassan-Abad Square, Imam Khomeini Ave, Tehran University of Medical Sciences, Tehran, 11365-3876, Iran. Tel.: þ98 915 342 2682, þ98 216 671 8311; fax: þ98 216 670 5140. E-mail address: v_rahimi@sina.tums.ac.ir (V. Rahimi-Movaghar). Available online at www.sciencedirect.com Public Health journal homepage: www.elsevier.com/puhe public health 126 (2012) 990 e992 0033-3506/$ e see front matter ª 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.puhe.2012.06.006