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Little is known about the effects of lithium intake through drinking water on suicide. This intake originates either from natural rock and soil elution and/or accumulation of lithium-based pharmaceuticals in ground water.
To examine the interplay between natural lithium in drinking water, prescribed lithium-based pharmaceuticals and suicide in Austria.
Spatial Bayesian regressions for males, females and pooled suicide mortality rates were estimated.
Although the expected inverse association between lithium levels in drinking water and suicide mortality was confirmed for males and for total suicide rates, the relationship for females was not significant. The models do not indicate that lithium from prescriptions, assumed to accumulate in drinking water, is related to suicide risk patterns either as an individual effect or as a moderator of lithium levels in drinking water. Gender-specific differences in risk factors and local risk hot spots are confirmed.
The findings do not support the hypotheses that lithium prescriptions have measureable protective effects on suicide or that they interact with lithium in drinking water.
There is some evidence that natural levels of lithium in drinking water
may have a protective effect on suicide mortality.
To evaluate the association between local lithium levels in drinking
water and suicide mortality at district level in Austria.
A nationwide sample of 6460 lithium measurements was examined for
association with suicide rates per 100 000 population and suicide
standardised mortality ratios across all 99 Austrian districts.
Multivariate regression models were adjusted for well-known socioeconomic
factors known to influence suicide mortality in Austria (population
density, per capita income, proportion of Roman Catholics, as well as the
availability of mental health service providers). Sensitivity analyses
and weighted least squares regression were used to challenge the
robustness of the results.
The overall suicide rate (R2 = 0.15, β =–0.39,
t =–4.14, P = 0.000073) as well as
the suicide mortality ratio (R2 = 0.17, β =–0.41,
t =–4.38, P = 0.000030) were
inversely associated with lithium levels in drinking water and remained
significant after sensitivity analyses and adjustment for socioeconomic
In replicating and extending previous results, this study provides strong
evidence that geographic regions with higher natural lithium
concentrations in drinking water are associated with lower suicide
The availability of firearms in homes and at aggregate levels is a risk factor for suicide and homicide. One method of reducing access to suicidal means is the restriction of firearm availability through more stringent legislation.
To evaluate the impact of firearm legislation reform on firearm suicides and homicides as well as on the availability of firearms in Austria.
Official statistics on suicides, firearm homicides and firearm licences issued from 1985 to 2005 were examined. To assess the effect of the new firearm law, enacted in 1997, linear regression and Poisson regressions were performed using data from before and after the law reform.
The rate of firearm suicides among some age groups, percentage of firearm suicides, as well as the rate of firearm homicides and the rate of firearm licences, significantly decreased after a more stringent firearm law had been implemented.
Our findings provide evidence that the introduction of restrictive firearm legislation effectively reduced the rates of firearm suicide and homicide. The decline in firearm-related deaths seems to have been mediated by the legal restriction of firearm availability. Restrictive firearm legislation should be an integral part of national suicide prevention programmes in countries with high firearm suicide rates.
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