Trends in suicide mortality rates in the Republic of Cyprus between 2004 and 2020: changes in age, gender and suicide method.
Level 4 - case-series / case-control
Retrospective population-based registry and trend analysis (surveillance/ecological study).
PubMed 39387231 · doi:10.1192/bjo.2024.770
What was done
Suicide mortality data (ICD-10 codes, including 'undetermined' deaths) and population denominators in the Republic of Cyprus from 2004 to 2020 were obtained from the National Mortality Registry and Statistical Office. Directly standardised mortality rates were calculated across age and gender groups, and annual percentage changes were estimated using Poisson regression models with interaction terms across distinct time periods.
What was found
Across the study period, 560 suicide deaths were recorded, occurring four times more frequently in men, with approximately 80% classified as 'violent' in both genders. Male suicide rates doubled from 4–5 to 9–10 per 100,000 prior to 2012 (9% annual increase; rate ratio 1.09, 95% CI 1.03 to 1.15; P = 0.002). After 2013, the male trend reversed (P < 0.001) to a 4% annual decrease (95% CI -9% to 1%), though rates among men aged 45–64 years continued to climb. Female rates decreased from 4–5 to 2–3 per 100,000. Consequently, the male-to-female suicide rate ratio increased from 2.73 (95% CI 1.88 to 3.95) in 2004–2008 to 5.33 (95% CI 3.46 to 8.19) in 2017–2020.
Why it matters
The study identifies shifting demographic vulnerabilities in Cyprus, showing that while overall suicide rates remain relatively low, middle-aged men have experienced sustained increases and the gender disparity has expanded substantially.
Limits
The dataset is derived strictly from registry records and lacks individual-level clinical, psychological, and socioeconomic variables. The absolute count of deaths is modest (560 over 17 years), yielding wider confidence intervals in subgroup analyses, and trends may be sensitive to shifts in death classification or reporting practices over time.