Preference of lethal methods is not the only cause for higher suicide rates in males

Background: In most countries worldwide suicide rates are higher for males whereas attempted suicide rates are higher for females. The aim is to investigate if the choice of more lethal methods by males explains gender differences in suicide rates. Methods: Data on completed and attempted suicides were collected (n = 3235, Nuremberg and Wuerzburg, years 2000-2004). The research question was analyzed by comparing the method-specific case fatality (= completed suicides/completed + attempted suicides) for males and females. Results: Among the events captured, men chose high-risk methods like hanging significantly more often than women (phi = -0.27: p < 0.001). However, except for drowning, case fatalities were higher for males than for females within each method. This was most apparent in hanging (men 83.5%, women 55.3%; phi = -0.28; p < 0.001) and poisoning by drugs (men 7.2%, women 3.4%; phi = -0.09; p < 0.001). Limitations: The sample size (n = 3235) was not enough for comparing method and gender specific case fatalities with a fine-meshed stratification regarding age. Conclusions: Higher suicide rates in males not only result from the choice of more lethal methods. Other factors have to be considered. (C) 2011 Elsevier B.V. All rights reserved.