Research
Association of holidays and the day of the week with suicide risk: multicountry, two stage, time series study
Whanhee Lee, Cinoo Kang, Chaerin Park, et al
BMJ 2024; 387 doi: https://doi.org/10.1136/bmj-2024-077262 (Published 23 October 2024)Cite this as: BMJ 2024;387:e077262
Abstract
Objectives To assess the short term temporal variations in suicide risk related to the day of the week and national holidays in multiple countries.
Design Multicountry, two stage, time series design.
Setting Data from 740 locations in 26 countries and territories, with overlapping periods between 1971 and 2019, collected from the Multi-city Multi-country Collaborative Research Network database.
Participants All suicides were registered in these locations during the study period (overall 1 701 286 cases).
Main outcome measures Daily suicide mortality.
Results Mondays had peak suicide risk during weekdays (Monday-Friday) across all countries, with relative risks (reference: Wednesday) ranging from 1.02 (95% confidence interval (CI) 0.95 to 1.10) in Costa Rica to 1.17 (1.09 to 1.25) in Chile. Suicide risks were lowest on Saturdays or Sundays in many countries in North America, Asia, and Europe. However, the risk increased during weekends in South and Central American countries, Finland, and South Africa. Additionally, evidence suggested strong increases in suicide risk on New Year’s day in most countries with relative risks ranging from 0.93 (95% CI 0.75 to 1.14) in Japan to 1.93 (1.31 to 2.85) in Chile, whereas the evidence on Christmas day was weak. Suicide risk was associated with a weak decrease on other national holidays, except for Central and South American countries, where the risk generally increased one or two days after these holidays.
Conclusions Suicide risk was highest on Mondays and increased on New Year’s day in most countries. However, the risk of suicide on weekends and Christmas varied by country and territory. The results of this study can help to better understand the short term variations in suicide risks and define suicide prevention action plans and awareness campaigns.
