Evidence map›Paper›PMID 33685950›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2021

Changes over time in means of suicide in Canada: an analysis of mortality data from 1981 to 2018.

Li Liu, Colin A Capaldi, Heather M Orpana, Mark S Kaplan, Lil Tonmyr

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Suicide in neurodegenerative diseases: a systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Seasonal variations in suicide mortality in Canada: A nationwide analysis.Canadian journal of public health = Revue canadienne de sante publique · 2026
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Near-Fatal Self-Harm Among Canadian Adolescents.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2022
    Article
  14. Article
  15. Article
  16. Suicide ideation in Canada during the COVID-19 pandemic.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2021
    Article
  17. Correction to "Changes over time in means of suicide in Canada: an analysis of mortality data from 1981 to 2018".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021
    Article
  18. Article
  19. Determining intent behind poisoning suicides.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Li LiuCentre for Surveillance and Applied Research (Liu, Capaldi, Orpana, Tonmyr), Public Health Agency of Canada; School of Epidemiology and Public Health (Orpana), University of Ottawa, Ottawa, Ont.; Luskin School of Public Affairs (Kaplan), University of California, Los Angeles, Calif.; Department of Sociology and Anthropology (Tonmyr), Carleton University, Ottawa, Ont.
Colin A CapaldiCentre for Surveillance and Applied Research (Liu, Capaldi, Orpana, Tonmyr), Public Health Agency of Canada; School of Epidemiology and Public Health (Orpana), University of Ottawa, Ottawa, Ont.; Luskin School of Public Affairs (Kaplan), University of California, Los Angeles, Calif.; Department of Sociology and Anthropology (Tonmyr), Carleton University, Ottawa, Ont. colin.capaldi@canada.ca.
Heather M OrpanaCentre for Surveillance and Applied Research (Liu, Capaldi, Orpana, Tonmyr), Public Health Agency of Canada; School of Epidemiology and Public Health (Orpana), University of Ottawa, Ottawa, Ont.; Luskin School of Public Affairs (Kaplan), University of California, Los Angeles, Calif.; Department of Sociology and Anthropology (Tonmyr), Carleton University, Ottawa, Ont.
Mark S KaplanCentre for Surveillance and Applied Research (Liu, Capaldi, Orpana, Tonmyr), Public Health Agency of Canada; School of Epidemiology and Public Health (Orpana), University of Ottawa, Ottawa, Ont.; Luskin School of Public Affairs (Kaplan), University of California, Los Angeles, Calif.; Department of Sociology and Anthropology (Tonmyr), Carleton University, Ottawa, Ont.
Lil TonmyrCentre for Surveillance and Applied Research (Liu, Capaldi, Orpana, Tonmyr), Public Health Agency of Canada; School of Epidemiology and Public Health (Orpana), University of Ottawa, Ottawa, Ont.; Luskin School of Public Affairs (Kaplan), University of California, Los Angeles, Calif.; Department of Sociology and Anthropology (Tonmyr), Carleton University, Ottawa, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOngoing surveillance of the means of suicide is necessary for effective prevention. We examined how mortality rates owing to different means of suicide changed in Canada from 1981 to 2018.

methodsWe obtained data from 1981 to 2018 on suicide deaths of individuals aged 10 years and older, from the Canadian Vital Statistics Death Database. We used joinpoint regression analysis to examine changes over time in the suicide mortality rate for the 3 most common means of suicide.

resultsThe age-standardized suicide mortality rate declined in earlier decades for both sexes, but did not significantly change in recent decades for either sex. The age-standardized rate of suicide by suffocation increased from 1993 for females (2.1% per year) and from 1996 for males (0.4% per year). The age-standardized rate of suicide by poisoning decreased for females (2.2% per year) and males (2.1% per year) from 1981 to 2018. The age-standardized rate of suicide by firearm decreased from 1981 to 2008 (7.4% per year) but did not significantly change there-after for females; for males, it decreased 2.1% per year from 1981 to 1993 and 5.7% per year from 1993 to 2007, but did not significantly change thereafter.

interpretationFor both sexes, the rate of suicide by poisoning is decreasing, the rate of suicide by suffocation is increasing, and the rate of suicide by firearm has not significantly changed in the last decade. Given the high proportion of suicide deaths by suffocation, its increasing rate and the difficulty of restricting the means of suffocation, other approaches to suicide prevention are needed.

Indexed as

AdolescentAdultAgedAge DistributionAsphyxiaCanadaChildFemaleHumansMaleMiddle AgedPoisoningRegression AnalysisSex DistributionSuicide, CompletedVital Statistics

Identifiers

PMID33685950
PMCPMC8034317

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.