Factors associated with the choice of suicide method in Kermanshah Province, Iran

BACKGROUND: Identification of factors in the choice of suicide methods is important in understanding the phenomenon. OBJECTIVES: We aimed to quantify the effect of gender, age, living area, education level and marital status on the choice of suicide method among residents of Kermanshah province in the west of Iran. DESIGN: A cross-sectional study of all completed suicides from March 2006 to September 2013. SETTING: Kermanshah Province, Iran METHODS: Data were extracted from suicide forms in the electronic files of the Forensic Medicine Organization. A total of 1901 (1138 men), suicide cases were identified. After preliminary analysis, a multinomial logistic model was fitted to the data to test and quantify the impact of each influential factor on the choice of suicide method. The relative risk of each suicide method over hanging as the reference method was estimated by calculating relative-risk ratios from the multinomial logistic model. MAIN OUTCOME MEASURES: Relative risk of suicide by self-immolation, drug and toxic poisoning and firearms. RESULTS: We found that women are at a higher relative risk than men for suicide by self-immolation, intentional drug poisoning and toxic poisoning. The relative risk of suicide by self-immolation and intentional drug poisoning was higher for urban residents and young individuals. On the other hand, men and rural residents were at higher relative risk of suicide by firearm. CONCLUSION: In Kermanshah province, the impact of rapid social changes on women and the availability of firearms in rural areas and drugs in urban households require more attention in any suicide prevention planning. LIMITATIONS: The lack of data prevented analysis of factors that may be more influential in choosing suicide.