Suicide is one of the leading causes of death in the United States. Now a study in the October issue of the American Journal of Public Health finds a steady decline in two age groups: adolescents and young adults, and Americans over 65. Robert McKeown, professor of epidemiology at the University of South Carolina and author of the new study, says those declines coincide with the use of a new generation of antidepressants.
McKeown notes that other recent research has suggested that these same drugs can put adolescents and young adults at greater risk for suicidal behavior. In fact, U.S. and British public health agencies have issued warnings about their use. McKeown takes issue with those warnings. "If indeed these medications are responsible for increases in suicidal behaviors, one would expect with the increase and use of these medications to see increases in suicide, when in fact just the opposite has happened," he says.
While rates are declining among the young and the old, rates of the middle age group, those between 25 and 64, have remained relatively unchanged over 20 years.
McKeown believes a variety of factors, not simply better antidepressants, is helping to lower suicide rates. "Maybe it has something to do with the new treatments. Maybe it has something to do with the economy. Another possibility is the increase of healthy life expectancy. Could it be that the things we have learned about trauma care enable us to help people who have attempted suicide who in earlier years might have died?" he asks.
McKeown calls for more research to evaluate more precisely the role of drugs and therapy, and why suicide rates are declining for one group but not for another.