Document Type : Original Article


School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran


Background: There are few diverse studies that have reported the case fatality rates of different
methods of suicide, none of them are originated from developing countries. The aim of the
present article is to report the case fatality rates of different methods of suicide in Ilam province
of Iran. Materials and Methods: Data on 611 cases of suicide and 1807 cases of deliberate
self harm (DSH) that were recorded in a comprehensive registry during 1995 through 2002
were analyzed for both genders together and for males and females, separately. Findings: For
both genders together, the two most fatal methods were hanging (75.4%) and self-immolation
(68.3%); for males, hanging (76.3%) and self-immolation (64.7%); and for females, firearms
(75%) and hanging (73.7%), respectively. The least fatal methods for both genders together and
for females and males separately were drug ingestion and cutting. Conclusion: The results of
present study, which for the first time has reported the case fatality rates of suicide methods in
a developing world, would not only help to better plan the local suicide prevention strategies
and clinical assessment of suicidal cases but to shed light on overall understanding of this
mysterious human phenomenon.


1. Chen VC, Cheng AT, Tan HK, Chen CY, Chen TH, Stewart R, et al.
A community-based study of case fatality proportion among those
who carry out suicide acts. Soc Psychiatry Psychiatr Epidemiol
2. Elnour AA, Harrison J. Lethality of suicide methods. Inj Prev
3. Miller M, Azrael D, Hemenway D.The epidemiology of case fatalityrates
for suicide in the northeast. Ann Emerg Med 2004;43:723-30.
4. Shenassa ED, Catlin SN, Buka SL. Lethality of firearms relative to
other suicide methods: A population based study. J Epidemiol
Community Health 2003;57:120-4.
5. Rezaeian M, Sharifi G. Self-immolation is the most important way
for suicide in Ilam province. J Andishe va raftar 2004;21:289.
6. Rezaeian M, Sharifi G. Seasonal pattern of suicide and attempted
suicide in Ilam province during 1995-2002. Sci J Ilam Med Univ
7. Rezaeian M, Sharifi G, Foroutani MR, Moazam N. Recognition of
some of the risk factors for suicide and attempted suicide within
Ilam province and their direction of function. Health Syst Res
8. Janghorbani M, Sharifirad G. Completed and Attempted suicide in
Ilam, Iran (1995-2002): Incidence and associated factors. Arch Iran
Med 2005;2:119-26.
9. Poeschla B, Combs H, Livingstone S, Romm S, Klein MB. Selfimmolation: Socioeconomic, cultural and psychiatric patterns.
Burns 2011;37:1049-57.
10. Rezaeian M. Suicide among young Middle Eastern Muslim females.
Crisis 2010;31:36-42.
11. Campbell EA, Guiao IZ. Muslim culture and female self-immolation:
Implications for global women’s health research and practice.
Health Care Women Int 2004;25:782-93.
12. Mesoudi A. The cultural dynamics of copycat suicide. PLoS One
2009 30;4:e7252.
13. Hazell P. Adolescent suicide clusters: Evidence, mechanisms and
prevention. Aust N Z J Psychiatry 1993;27:653-65.
14. Ahmadi A, Ytterstad B. Prevention of self-immolation by communitybased intervention. Burns 2007;33:1032-40.
15. Rezaeian M. Age and sex suicide rates in the Eastern Mediterranean
Region based on global burden of disease estimates for 2000. East
Mediterr Health J 2007;13:953-60.
16. Rezaeian M. Suicide/homicide ratios in countries of the Eastern
Mediterranean Region. East Mediterr Health J 2008;14:1459-65.