Analysis of the representation of a number of causes of suicidal mortality in Ryazan, Ryazan and Rybnovsky districts of Ryazan region in 2013-2015 and 2019-2021

Suicide, unfortunately, remains one of the most common causes of death in many countries around the world. Analysis of variability in the structure of causes and methods of suicide makes it possible to more effectively plan preventive strategies, including restrictions on access to means of suicide, as well as personalization of psychosocial prevention. Aim of the study: to analyze the dynamics of suicide mortality in the city of Ryazan, Ryazan and Rybnovsky districts of the Ryazan region in 2013-2015 and 2019-2021, the gender and age composition of the deceased, the frequency of using self-hanging, self-cutting and jumping from heights as a method of committing suicide. Materials and methods: on the basis of the State Budgetary Institution of the Russian Federation “Bureau of Forensic Medical Examination named after. D.I. Mastbaum " (Ryazan) analyzed about 20 thousand death reports, of which those meeting the inclusion criteria were selected for the periods 2013-2015 and 2019-2021, which included, respectively, the financial crisis (2014-15) and the pandemic COVID-19 (2019-21). ICD-10 codes listed as causes of death: Y20, X78, X80. Mathematical processing of the data was carried out using the STATISTICA program using the x 2 criterion. Results: Among men who committed suicide from 2019 to 2021, the proportion of falls from height increases by 53.5% and the number of hangings decreases by 39.4%. In the female group, the same trend is observed: an increase in the frequency of falls from a height by 61.5% with a simultaneous decrease in the number of hangings by 120%. There is a tendency for those who committed suicide to grow older by an average of five years: during 2013-2015 regardless the influence of gender, mean age is about 45, while during 2019-2021 mean age is 50. The average values for the two time periods studied in relation to falls from height were 37.0 and 47.8 years in the male group, the same for the age of men who hanged themselves 42.6 and 49.5 years. In the female group, similar values were: 56.2 and 54.63 years for falls from a height, and 52.1 and 52.9 years for self-hangings, which demonstrates the absence of any significant age dynamics. That is, the noted “maturing” of suicide attempters in 2019-21 is mainly explained by the increase in the age of the dead men. A comparative analysis of the standardized suicide mortality rate (SMR) and the data obtained in the study likely indicates the existence of a paradoxical medical-legal situation that makes it difficult to truly understand the prevalence of the suicidal phenomenon. Conclusions: Neither the financial turmoil of 2014-15 nor the response to the COVID-19 pandemic of 2019-21 led to noticeable surges in suicidal activity in relation to the methods under consideration. Between 2019-2021 there is an increase in the number of falls from heights, which is accompanied by a decrease in the number of people who commit suicide through self-hanging. The discovered trends may be related to the conditions created by the lockdown during the pandemic, as well as the increase in the number of floors in buildings in modern cities.