Global, regional, and national burden of suicide, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Authors: Nicole Davis Weaver, Gregory J Bertolacci, Emily Rosenblad, Sama Ghoba, Matthew Cunningham, Kevin S Ikuta, Madeline E Moberg, Vincent Mougin, Chieh Han, Eve E Wool, Yohannes Habtegiorgis Abate, Habeeb Omoponle Adewuyi, Qorinah Estiningtyas Sakilah Adnani, Leticia Akua Adzigbli, Aanuoluwapo Adeyimika Afolabi, Suneth Buddhika Agampodi, Bright Opoku Ahinkorah, Aqeel Ahmad, Danish Ahmad, Sajjad Ahmad, Ayman Ahmed, Haroon Ahmed, Hanadi Al Hamad, Yazan Al-Ajlouni, Rasmieh Mustafa Al-amer, Mohammed Albashtawy, Wafa A Aldhaleei, Syed Shujait Ali, Waad Ali, Mahmoud A Alomari, Mohammed A Alsabri, Nelson Alvis-Guzman, Yaser Mohammed Al-Worafi, Alireza Amindarolzarbi, Sohrab Amiri, Tudorel Andrei, Saeid Anvari, Jalal Arabloo, Demelash Areda, Anton A Artamonov, Tahira Ashraf, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Ahmed Y Azzam, Ashish D Badiye, Nayereh Baghcheghi, Saeed Bahramian, Maciej Banach, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Amadou Barrow, Azadeh Bashiri, Hameed Akande Bashiru, Mohammad-Mahdi Bastan, Kavita Batra, Ravi Batra, Mohsen Bayati, Corina Benjet, Habib Benzian, Paola Bertuccio, Akshaya Srikanth Bhagavathula, Priyadarshini Bhattacharjee, Corey B Bills, Sri Harsha Boppana, Guilherme Borges, Hamed Borhany, Yasser Bustanji, Florentino Luciano Caetano dos Santos, Giulio Castelpietra, Arthur Caye, Muthia Cenderadewi, Rama Mohan Chandika, Eeshwar K Chandrasekar, Periklis Charalampous, Yifan Chen, Ritesh Chimoriya, Hitesh Chopra, Sonali Gajanan Choudhari, Dinh-Toi Chu, Isaac Sunday Chukwu, Muhammad Chutiyami, Richard G Cowden, Berihun Assefa Dachew, Omid Dadras, Xiaochen Dai, Koustuv Dalal, Lalit Dandona, Rakhi Dandona, Samuel Demissie Darcho, Reza Darvishi Cheshmeh Soltani, Claudio Alberto Dávila-Cervantes, Alejandro de la Torre-Luque, Shayom Debopadhaya, Louisa Degenhardt, Ivan Delgado-Enciso, Emina Dervišević, Michael J Diaz, Deepa Dongarwar, Ojas Prakashbhai Doshi, Haneil Larson Dsouza, Samuel C Dumith, Senbagam Duraisamy, Ejemai Eboreime, Ferry Efendi, Michael Ekholuenetale, Rabie Adel El Arab, Muhammed Elhadi, Gihan ELNahas, Chadi Eltaha, Syed Emdadul Emdadul Haque, Sharareh Eskandarieh, Ayesha Fahim, Andre Faro, Ali Fatehizadeh, Patrick Fazeli, Alireza Feizkhah, Ginenus Fekadu, Nuno Ferreira, Florian Fischer, Richard Charles Franklin, Ni Kadek Yuni Fridayani, Márió Gajdács, Aravind P Gandhi, Balasankar Ganesan, Miglas Welay Gebregergis, Mesfin Gebrehiwot, Teferi Gebru Gebremeskel, Molla Getie, Delaram J Ghadimi, Khalid Yaser Ghailan, Ahmad Ghashghaee, Ali Gholamrezanezhad, Pouya Goleij, Ayman Grada, Michal Grivna, Shi-Yang Guan, Snigdha Gulati, Sapna Gupta, Reyna Alma Gutiérrez, Roberth Steven Gutiérrez-Murillo, Erin B Hamilton, Nasrin Hanifi, Ikramul Hasan, Mahgol Sadat Hassan Zadeh Tabatabaei, Simon I Hay, Mohammad Heidari, Mehdi Hemmati, Nguyen Quoc Hoan, Mehdi Hosseinzadeh, Sorin Hostiuc, Junjie Huang, Hong-Han Huynh, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Arit Inok, Chidozie Declan Iwu, Haitham Jahrami, Sanobar Jaka, Reza Jalilzadeh Yengejeh, Zixiang Ji, Shuai Jin, Nitin Joseph, Charity Ehimwenma Joshua, Jacek Jerzy Jozwiak, Zubair Kabir, Vidya Kadashetti, Kehinde Kazeem Kanmodi, Rami S Kantar, Neeti Kapoor, Ibraheem M Karaye, Shilpi Karmakar, Harkiran Kaur, Jessica A Kerr, Himanshu Khajuria, Ajmal Khan, Khaled Khatab, Khalid A Kheirallah, Kwanghyun Kim, Min Seo Kim, Shivakumar KM KM Shivakumar, Ali-Asghar Kolahi, Hamid Reza Koohestani, Varun Krishna, Nuworza Kugbey, Mukhtar Kulimbet, G Anil Kumar, Manasi Kumar, Satyajit Kundu, Ville Kytö, Iván Landires, Nhi Huu Hanh Le, Doo Woong Lee, Wei-Chen Lee, Yo Han Lee, Stephen S Lim, Jialing Lin, Richard T Liu, José Francisco López-Gil, Giancarlo Lucchetti, Zheng Feei Ma, Venkatesh Maled, Kashish Malhotra, Ahmad Azam Malik, Agustina Maria Marconi, Ramon Martinez-Piedra, Roy Rillera Marzo, Yasith Mathangasinghe, Pallab K Maulik, Hadush Negash Meles, Ritesh G Menezes, Tuomo J Meretoja, Tomislav Mestrovic, Irmina Maria Michalek, Ted R Miller, Moonis Mirza, Awoke Misganaw, Chaitanya Mittal, Abdalla Z Mohamed, Nouh Saad Mohamed, Abdollah Mohammadian-Hafshejani, Ali H Mokdad, Sabrina Molinaro, Lorenzo Monasta, AmirAli Moodi Ghalibaf, Shane Douglas Morrison, Rohith Motappa, Faraz Mughal, Francesk Mulita, Yanjinlkham Munkhsaikhan, Christopher J L Murray, Sathish Muthu, Woojae Myung, Ayoub Nafei, Pirouz Naghavi, Ganesh R Naik, Gurudatta Naik, Zuhair S Natto, Muhammad Naveed, Shadan Navid, Biswa Prakash Nayak, Athare Nazri-Panjaki, Henok Biresaw Netsere, Sudan Prasad Neupane, Hoang Anh Hoang Nguyen, Nhien Ngoc Y Nguyen, Phat Tuan Nguyen, Phuong The Nguyen, Van Thanh Nguyen, Ali Nikoobar, Isabel Noguer, Shuhei Nomura, Chisom Adaobi Nri-Ezedi, Virginia Nuñez-Samudio, Ogochukwu Janet Nzoputam, Bogdan Oancea, Michael Safo Oduro, In-Hwan Oh, Sylvester Reuben Okeke, Yinka Doris Oluwafemi, Sok King Ong, Michal Ordak, Heather M Orpana, Esteban Ortiz-Prado, Uchechukwu Levi Osuagwu, Alicia Padron-Monedero, Jagadish Rao Padubidri, Raul Felipe Palma-Alvarez, Anamika Pandey, Ashok Pandey, Ioannis Pantazopoulos, Seoyeon Park, Sungchul Park, Ava Pashaei, Jay Patel, Shrikant Pawar, Prince Peprah, Mario F P Peres, Ionela-Roxana Petcu, Anil K Philip, Michael R Phillips, Zahra Zahid Piracha, Jalandhar Pradhan, Elton Junio Sady Prates, Dimas Ria Angga Pribadi, Jagadeesh Puvvula, Ibrahim Qattea, Gangzhen Qian, Venkatraman Radhakrishnan, Pankaja Raghav, Sarvenaz Rahimibarghani, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Md. Mosfequr Rahman, Mosiur Rahman, Muhammad Aziz Rahman, Mohammad Rahmanian, Pushp Lata Rajpoot, Mahmoud Mohammed Ramadan, Shakthi Kumaran Ramasamy, Smitha Rani, Mithun Rao, Sowmya J Rao, Mohammad-Mahdi Rashidi, Prateek Rastogi, Devarajan Rathish, David Laith Rawaf, Lennart Reifels, Mohsen Rezaeian, Taeho Gregory Rhee, Jennifer Rickard, Leonardo Roever, Moustaq Karim Khan Rony, Chandan S N, Basema Ahmad Saddik, Farideh Sadeghian, Mohammad Reza Saeb, Umar Saeed, Sahar Saeedi Moghaddam, Mehdi Safari, Dominic Sagoe, Narjes Saheb Sharif-Askari, Pragyan Monalisa Sahoo, Soumya Swaroop Sahoo, Payman Salamati, Dauda Salihu, Sohrab Salimi, Giovanni A Salum, Sonia Sameen, Abdallah M Samy, Milena M Santric-Milicevic, Chinmoy Sarkar, Gargi Sachin Sarode, Sachin C Sarode, Brijesh Sathian, Austin E Schumacher, Mario Šekerija, Mohammad H Semreen, Sadaf G Sepanlou, Mahan Shafie, Samiah Shahid, Ahmed Shaikh, Masood Ali Shaikh, Amin Sharifan, Javad Sharifi Rad, Anupam Sharma, Vishal Sharma, Rahim Ali Sheikhi, Mahabalesh Shetty, Pavanchand H Shetty, Premalatha K Shetty, Velizar Shivarov, Sina Shool, Paramdeep Singh, Puneetpal Singh, Surjit Singh, Bogdan Socea, Dan J Stein, Murray B Stein, Jing Sun, Chandan Kumar Swain, Lukasz Szarpak, Sree Sudha T Y, Seyyed Mohammad Tabatabaei, Celine Tabche, Minale Tareke, Mohamad-Hani Temsah, Chern Choong Thum, Tenaw Yimer Tiruye, Marcos Roberto Tovani-Palone, Nghia Minh Tran, Thang Huu Tran, Nguyen Tran Minh Duc, Samuel Joseph Tromans, Thien Tan Tri Tai Truyen, Guesh Mebrahtom Tsegay, Munkhtuya Tumurkhuu, Sanaz Vahdati, Asokan Govindaraj Vaithinathan, Pascual R Valdez, Tommi Juhani Vasankari, Massimiliano Veroux, Georgios-Ioannis Verras, Manish Vinayak, Theo Vos, Mandaras Tariku Walde, Yanzhong Wang, Joseph L L Ward, Nuwan Darshana Wickramasinghe, Marcin W Wojewodzic, Renjulal Yesodharan, Arzu Yiğit, Dehui Yin, Paul Yip, Dong Keon Yon, Naohiro Yonemoto, Chuanhua Yu, Iman Zare, Mohammed G M Zeariya, Haijun Zhang, Claire Chenwen Zhong, Bin Zhu, Abzal Zhumagaliuly, Mohsen Naghavi
Journal: The Lancet Public Health (2025)

Deaths from suicide are a tragic yet preventable cause of mortality. Quantifying the burden of suicide to understand its geographical distribution, temporal trends, and variation by age and sex is an essential step in suicide prevention. We aimed to present a comprehensive set of global, regional, and national estimates of suicide burden. We produced estimates of the number of deaths and age-standardised mortality rates of suicide globally, regionally, and for 204 countries and territories from 1990 to 2021, and disaggregated these results by age and sex. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 estimates of deaths attributable to suicide were broken down into two comprehensive categories: those by firearms and those by other specified means. For this analysis, we also produced estimates of mean age at the time of death from suicide, incidence of suicide attempts compared with deaths, and age-standardised rates of suicide by firearm. We acquired data from vital registration, verbal autopsy, and mortality surveillance that included 23 782 study-location-years of data from GBD 2021. Point estimates were calculated from the average of 1000 randomly selected possible values of deaths from suicide by age, sex, and geographical location. 95% uncertainty intervals (UIs) were derived from the 2·5th and 97·5th percentiles from a 1000-draw distribution. Globally, 746 000 deaths (95% UI 692 000-800 000) from suicide occurred in 2021, including 519 000 deaths (485 000-556 000) among males and 227 000 (200 000-255 000) among females. The age-standardised mortality rate has declined over time, from 14·9 deaths (12·8-15·7) per 100 000 population in 1990 to 9·0 (8·3-9·6) per 100 000 in 2021. Regionally, mortality rates due to suicide were highest in eastern Europe (19·2 [17·5-20·8] per 100 000), southern sub-Saharan Africa (16·1 [14·0-18·3] per 100 000), and central sub-Saharan Africa (14·4 [11·0-19·1] per 100 000). The mean age at which individuals died from suicide progressively increased during the study period. For males, the mean age at death by suicide in 1990 was 43·0 years (38·0-45·8), increasing to 47·0 years (43·5-50·6) in 2021. For females, it was 41·9 years (30·9-46·7) in 1990 and 46·9 years (41·2-52·8) in 2021. The incidence of suicide attempts requiring medical care was consistently higher at the regional level for females than for males. The number of deaths by suicide using firearms was higher for males than for females, and substantially varied by country and region. The countries with the highest age-standardised rate of suicides attributable to firearms in 2021 were the USA, Uruguay, and Venezuela. Deaths from suicide remain variable by age and sex and across geographical locations, although population mortality rates have continued to improve globally since the 1990s. This study presents, for the first time in GBD, a quantification of the mean age at the time of suicide death, alongside comprehensive estimates of the burden of suicide throughout the world. These analyses will help guide future approaches to reduce suicide mortality that consider a public health framework for prevention. Bill & Melinda Gates Foundation.