Research Trends Epidemiology of Completed Suicides in Singapore for 2001 and 2002 Marie Loh 1 , Chay Hoon Tan 2 , Kang Sim 3 , Gilbert Lau 4 , Adrian Mondry 1 , Jern-Yi Leong 2 , and Ene-Choo Tan 5,6 1 Bioinformatics Institute, 2 Department of Pharmacology, National University of Singapore, 3 Institute of Mental Health/Woodbridge Hospital, Center for Forensic Medicine, Health Sciences Authority, 5 KK Research Center, KK Women’s and Children’s Hospital, 6 Department of Psychological Medicine, National University of Singapore, all Republic of Singapore Abstract. This study provides an analysis of 640 completed suicide cases in Singapore for the years 2001 and 2002, compared to previous years and in relation to demographic and socioeconomic factors, as well as to the characteristics of a subgroup of suicide victims with prior psychiatric illness. There was little change in the suicide pattern over the 2 years studied compared to previous years. The sex ratio was constant at 1.5. Population-adjusted ratios were 1 for Chinese, 0.5 for Malays, and > 1 for both Indians and other ethnic groups. Falling from heights ranked first in terms of method adopted for both years. A disproportionately higher number of suicides were recorded for the 25–34 and the ≥ 75-year-old age groups. A total of 47 (17.2%) in 2001 and 74 (20.2%) in 2002 of the cases had a history of prior psychiatric illness, with psychotic disorders being the most common diagnostic category. There was also a statistically significant corre- lation between unemployment and incidence rates. Although the overall rate of elderly suicides had gone down since the 1990s, prevention strategy should focus on the elderly as this rate is still about 3–4 times the national average. Keywords: age, gender, ethnicity, methods, psychiatric disorders, Singapore Introduction Suicides occur in almost all populations, age groups, and in both genders, but with pronounced differences between these identifiers and shifting incidence patterns (Canetto & Lester, 1995). In a comparison with 57 countries, the sui- cide rate in Singapore, at about 13/100,000, ranks in the middle and is comparable to most developed countries (La Vecchia, Lucchini, & Levi, 1994). As suicide rate is a marker for social cohesion, perceived stress level, and qual- ity of social and medical services, both changes in rate and the point at which changes occurs can be important for bet- ter understanding of risk factors and the identification of possible determinants amenable to intervention. In previously published studies of suicide epidemiology in Singapore, factors such as sex, ethnicity, and seasonality were investigated with respect to the cause and trend for suicides in Singapore (Lester, 1998; Ng & Lau, 2003; Parker & Yap, 2001; Parker, Gao, & Machin, 2001; Peng & Choo, 1990; Voracek & Fisher, 2001; Yip & Tan, 1998). It was found that suicide rates increase with age, with the highest rate of about four to five times the national average reported for the elderly. In addition, lower male:female ratio and teenage suicide rates were also found when compared to other countries. The last few years have seen rapid social, economic, and technological changes. This study presents an epidemio- logical update for the first 2 years at the turn of the century. The role of age, gender, ethnicity, and accessibility to meth- ods is examined and the data put into the context of social and economic changes at the national level. As there is ev- idence that mental illness is a risk factor for suicidality, there was a special focus on preexisting psychiatric diag- noses. Materials and Methods Suicide Cases Data for completed suicides in Singapore from 2001–2002 were drawn from the Center for Forensic Medicine data- base. All suspected suicides are reported to the State Cor- oner and investigated by the police in Singapore. While the forensic pathologist who conducts the coronial autopsy cer- tifies the medical cause of death, it is the Coroner who de- termines the manner of death, based on the autopsy find- ings, the known circumstances under which death oc- curred, and the results of police investigations. The DOI 10.1027/0227-5910.28.3.148 Crisis 2007; Vol. 28(3):148–155 © 2007 Hogrefe & Huber Publishers ${protocol}://econtent.hogrefe.com/doi/pdf/10.1027/0227-5910.28.3.148 - Tuesday, February 05, 2019 2:58:44 AM - Universitätsbibliothek LMU München IP Address:129.187.254.47