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Brazilian Journal of Psychiatry

versão impressa ISSN 1516-4446versão On-line ISSN 1809-452X

Rev. Bras. Psiquiatr. vol.37 no.3 São Paulo jul./set. 2015 

Letters to the Editors

Weighing the evidence for suicide prevention

Fiorela Flores-Cornejo1 

Mayumi Kamego-Tome1 

Mariana A. Zapata-Pachas1 

Germán F. Alvarado1 

1Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru

We are pleased note that, in early September 2014, the World Health Organization (WHO) published the first global report on suicide prevention, entitled Preventing suicide: a global imperative. Notably, this report states that the annual age-standardized suicide rate is 11 per 100,000 people, and that suicide is the second leading cause of death among people aged 15–29 years.1

Of all suicides, 75% occur in developing countries.1 This is especially important because WHO mentions that developing countries do not have an adequate system of registration for reporting of deaths by suicide, and that suicide accounts for 56% of violent deaths globally.1

Suicide is a global public health problem for which preventive interventions are available, both at the individual level,2,3 e.g., by assessment and management of mental health problems, including tracking people with suicidal intent, and at the community level,4,5 by restricting access to means of suicide and reducing harmful alcohol consumption.2 WHO notes that prevention plans in countries must be comprehensive and adopt an approach with predetermined parameters, but be flexible and adaptable to the culture and society which they address.1

While various interventions to prevent suicide are mentioned in the report, the level of evidence for each of these interventions is not very clear. In developing countries, where the health sector lacks the resources needed to implement several of these suggested interventions, it is imperative to prioritize and choose the best and most cost-effective measures.

In conclusion, we consider the WHO report to be a very important tool both to know the position of suicide worldwide and to explain the variety of interventions that can be employed to help prevent it. While interventions are recommended, we believe it might be more helpful if each intervention had an evidence level that could help decision-makers prioritize.


1. World Health Organization (WHO). Preventing suicide: a global imperative. Geneva: WHO; 2014. [ Links ]

2. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294:2064–74. [ Links ]

3. Matsubayashi T, Ueda M. The effect of national suicide prevention programs on suicide rates in 21 OECD nations. Soc Sci Med. 2011;73:1395–400. [ Links ]

4. Fountoulakis KN, Gonda X, Rihmer Z. Suicide prevention programs through community intervention. J Affect Disord. 2011;130:10–6. [ Links ]

5. Wasserman D, Hoven CW, Waserman C, Wall M, Eisenberg R, Hadlaczky G, et al. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial. Lancet. 2015;385:1536–44. [ Links ]

Received: February 17, 2015; Accepted: February 26, 2015

Disclosure The authors report no conflicts of interest.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.