Pearson correlations between annual frequencies of Google searches with suicides in Germany, 2007–2015.

<p>Pearson correlations between annual frequencies of Google searches with suicides in Germany, 2007–2015.</p

Age-adjusted suicide rates (per 100000 inhabitants) in Germany (1998–2010) for males and females.

<p>The rates (reference year: 1998) were stratified for several suicide methods: <b>a)</b> Self-Poisoning by psychotropic drugs (according to ICD-10: X61-X63); <b>b)</b> Self-Poisoning by other drugs (according to ICD-10: X60, X64); <b>c)</b> Self-Poisoning by other means (according to ICD-10: X65-X69); <b>d)</b> Drowning or submersion (according to ICD-10: X71); <b>e)</b> Suicides by firearms (according to ICD-10: X72-X74); <b>f)</b> Stab with sharp instrument (according to ICD-10: X78); <b>g)</b> Jumping from high places (according to ICD-10: X80); <b>h)</b> Being overrun (according to ICD-10: X81); <b>i)</b> Other suicide methods (according to ICD-10: X75-X77, X79, X82-X84). –– Age-adjusted suicide rates for men (with squares); - - - Age-adjusted suicide rates for women (with triangles). Vertical lines represent the joinpoints which had been identified for the overall suicide mortality trends in Germany 1998–2010. The numbers in the figures represent suicide frequencies in males and females, for the years 1998 and 2010, respectively.</p

Changes of method-specific suicide frequencies between 2007 and 2010 in men and women in Germany.

<p>Changes of method-specific suicide frequencies between 2007 and 2010 in men and women in Germany.</p

Why Has the Continuous Decline in German Suicide Rates Stopped in 2007?

<div><p>Background</p><p>Whereas German suicide rates had a clear decreasing tendency between 1991 and 2006, they increased from 2007 to 2010. Deeper analyses of suicide data might help to understand better this change. The aim of this study was to analyze 1) whether recent trends can be related to changes in specific suicide methods and diverge by gender and age; 2) whether the decrease of suicide rates before 2007 as well as the increase from 2007 to 2010 are driven by the same suicide method.</p><p>Methods</p><p>Analyses were based on suicide data from the Federal Statistical Office of Germany. For 1998–2010, 136.583 suicide cases of men and women with known age and suicide method could be identified. These data were analyzed by joinpoint regression analysis, allowing identification of the best fitting point in time (“joinpoint”) at which the suicide rate significantly changes in magnitude or direction.</p><p>Results</p><p>The national downward trend between 1998 and 2007 was mainly due to corresponding changes in self-poisoning by other means than drugs (e.g., pesticides) (annual percentage change (APC) ≤ −4.33), drowning (APC ≤ −2.73), hanging (APC ≤ −2.69) and suicides by firearms (APC ≤ −1.46) in both genders. Regarding the overall increase of age-adjusted suicide rates in Germany 2007–2010, mainly the increase of self-poisoning (e.g., by drugs) and “being overrun” (APC ≥ 1.50) contributed to this trend.</p><p>Limitations</p><p>The true suicide rates might have been underestimated because of errors in the official death certificates.</p><p>Conclusions</p><p>Increase in suicide rates in Germany since 2007 went along with corresponding changes for “being overrun” and “self-poisoning”. Copycat suicides following the railway suicide of the goalkeeper Robert Enke partly contributed to the results. Thus, prevention of Werther effects and limitation of the availability of high pack sizes for drugs are of special relevance for the reversal of this trend.</p></div

Suicide mortality in Germany (1998–2010).

<p>Based on the results of joinpoint regression analyses, age-adjusted suicide rates in all subjects (no symbol), males (squares) and females (rhombi), corresponding trends (lines) and Annual Percentage Changes (APC) are given. * p<0.05.</p

Age-adjusted suicide rates for hanging in Germany (1998–2010) for males and females, separately.

<p>Suicide rate per 100000 inhabitants (reference year: 1998); suicide method: “Hanging, strangling or suffocation” (according to ICD-10: X70). –– Age-adjusted suicide rates for men (with squares); …….Age-adjusted suicide rates for women (with triangles). Vertical lines represent the joinpoints which had been identified for the overall suicide mortality trends in Germany 1998–2010. The numbers in the figure represent suicide frequencies in males and females, for the years 1998 and 2010, respectively. obs. = observed values; mod. = modelled values (according to the joinpoint regression analysis).</p

Annual percentage change in age-adjusted mortality rates for different suicide methods (+95% confidence intervals) (1998–2010) in Germany.

<p><b>Notes:</b> Significant findings are in bold.</p

Additional file 1: of Minor depression in older, long-term unemployed people seeking vocational support

Dataset of the study. Table with all variables, their labels and their values. (XLS 439 kb

MOESM3 of Impact of brain arousal and time-on-task on autonomic nervous system activity in the wake-sleep transition

Additional file 3. Results of pared sample t tests for ANS parameters between different EEG-vigilance stages in the ignored and attended condition

MOESM3 of Evoked potentials and behavioral performance during different states of brain arousal

Additional file 3. Grand average waveforms for deviant stimuli and results of multiple comparisons