Int. J. Environ. Res. Public Health 2012, 9 WHO Region Country Europe Azerbaijan SE Asia Maldives Eastern Medit. Iran Eastern Medit. Egypt Eastern Medit. Jordan Americas Jamaica Eastern Medit. Syria Americas Grenada Americas Haiti Americas Antigua and Barbuda Americas Saint Kitts and Nevis Americas Honduras 4. Discussion Year 2007 2005 1991 2009 2008 1990 1985 2008 2003 1995 1995 1978 Table 3. Cont. Suicide rate per 100,000 inhabitants Male Female Total 1.0 0.3 0.6 0.7 0.0 0.3 0.3 0.1 0.2 0.1 0.0 0.1 0.2 0.0 0.1 0.3 0.0 0.1 0.2 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Number of suicides 55 1 111 52 6 3 10 0 2 0 0 0 768 Male-female rate ratio 3.3 3.0 The WHO has measured suicide since 1950—shortly after its creation in 1948. The list of countries, which have been leading in suicide rate in the world, is not a long one. Japan had the highest rate in the 1950s, Hungary was the top country for the next three decades, and Lithuania took over in the early 1990s for another two decades. Some other countries also deserve to be mentioned. Although available data are much scarcer before the 1950s, it is plausible to believe that Switzerland has been a world leader in suicide rate because coming into the 1950s its rate was already declining from higher levels in 1930s and 1940s [13]. Measurement of suicide rate has usually been more difficult in developing economies with less resources. Differently from the WHO figures, it has been estimated that the suicide rate in Sri Lanka has reached 47 cases per 100,000 inhabitants in the first half of 1990s [14] which would make it briefly the leading country between the ‘Hungarian period’ and the ‘Lithuanian period’. Suicide has been a big issue in Finland and Denmark but even when the rates surpassed 30 per 100,000 inhabitants, they were dwarfed by more extreme rates in Hungary at the same time. Similarly, very high suicide rates in Russia, Latvia, and Estonia were overshadowed by those of Lithuania. In the American region highest rates have been observed in Cuba and more recently in Guyana, which have experienced rates above 20 and 25 per 100,000 inhabitants respectively. Generally the suicide trend has been downward in Europe and there are currently no Western European welfare states in the world top ten for suicide rates. However, a different development has been evident in some other parts of the world—most notably in South Korea where a huge increase has occurred over the last 10 years. The suicide rate now exceeds 30 cases per 100,000 inhabitants and unless there is a dramatic turnaround of the trend, South Korea will take over the world leader’s position from Lithuania in a few years. Efforts have been made to explain the South Korean phenomenon, Kwon has suggested that the current situation has evolved due to the Asian economic crisis of 1997/98 and population cohort effects [15]. Ranking countries according to suicide rates based on data about different years is not perfect, although usually differences are not large. Near the top of the list in Table 3 it should be noted that