Trends in mortality for suicide and hospitalization rates for attempted suicide in Taiwan: 1959-2005

Background: A dramatic rise in suicide has been observed recently in Taiwan. This study aims to examine the trends in suicide mortality during the period from 1959 to 2005, with emphasis on age, period, and cohort effects. Also examined were the recent trends in hospitalization rates for attempted suicide. Methods: Mortality data were obtained from official vital statistics. Hospitalization rates were calculated using data extracted from the National Health Insurance Database, which was available from 1996 to 2004. Results: There has been an ubiquitous period effect on suicide mortality in both genders and across all age groups over the past few decades, with peak rates in the early 1960s and the mid 1980s, and uprising trends ever since the mid 1990s. Hospitalization rates for attempted suicide also rose substantially in recent years. In consistent with most countries, suicide mortality increased with age in Taiwan. However, higher hospitalization rates for attempted suicide were observed in young men and women aged 25-34 years. Evidences of some age-by-period interaction were found: young people aged 15-24 years, especially women, appeared to be affected more greatly during the peak years in the 1960s than in later time. Effects of birth cohort on suicide rates appear to be associated with changes in period, and may not be a function of the cohort itself. Conclusions: The changing patterns of suicide highlight the importance of social conditions in determining populations' risk of suicide. Further research should be conducted to explore the social and economic factors behind such changes.