Mark Sinyor1,2, Marissa Williams1, Ulrich S Tran3, Ayal Schaffer1,2, Paul Kurdyak2,4,5,6, Jane Pirkis7, Thomas Niederkrotenthaler8. 1. Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 2. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 3. Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria. 4. Health Systems Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada. 5. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 6. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. 7. Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. 8. Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Abstract
OBJECTIVE: "13 Reasons Why," a Netflix series, included a controversial depiction of suicide that has raised fears about possible contagion. Studies of youth suicide in the United States found an increase on the order of 10% following release of the show, but this has not been replicated in other countries. This study aims to begin to address that gap by examining the relationship between the show's release and youth suicide in Canada's most populous province. METHODS: Suicides in young people (under the age of 30) in the province of Ontario following the show's release on March 31, 2017, were the outcome of interest. Time-series analyses were performed using data from January 2013 to March 2017 to predict expected deaths from April to December 2017 with a simple seasonal model (stationary R 2 = 0.732, Ljung-Box Q = 15.1, df = 16, P = 0.52, Bayesian information criterion = 3.09) providing the best fit/used for the primary analysis. RESULTS: Modeling predicted 224 suicides; however, 264 were observed corresponding to 40 more deaths or an 18% increase. In the primary analysis, monthly suicides exceeded the 95% confidence limit for 3 of the 9 months (May, July, and October). CONCLUSION: The statistical strength of the findings here is limited by small numbers; however, the results are in line with what has been observed in the United States and what would be expected if contagion were occurring. Further research in other locations is needed to increase confidence that the associations found here are causal.
OBJECTIVE: "13 Reasons Why," a Netflix series, included a controversial depiction of suicide that has raised fears about possible contagion. Studies of youth suicide in the United States found an increase on the order of 10% following release of the show, but this has not been replicated in other countries. This study aims to begin to address that gap by examining the relationship between the show's release and youth suicide in Canada's most populous province. METHODS: Suicides in young people (under the age of 30) in the province of Ontario following the show's release on March 31, 2017, were the outcome of interest. Time-series analyses were performed using data from January 2013 to March 2017 to predict expected deaths from April to December 2017 with a simple seasonal model (stationary R 2 = 0.732, Ljung-Box Q = 15.1, df = 16, P = 0.52, Bayesian information criterion = 3.09) providing the best fit/used for the primary analysis. RESULTS: Modeling predicted 224 suicides; however, 264 were observed corresponding to 40 more deaths or an 18% increase. In the primary analysis, monthly suicides exceeded the 95% confidence limit for 3 of the 9 months (May, July, and October). CONCLUSION: The statistical strength of the findings here is limited by small numbers; however, the results are in line with what has been observed in the United States and what would be expected if contagion were occurring. Further research in other locations is needed to increase confidence that the associations found here are causal.
Authors: Thomas Niederkrotenthaler; King-wa Fu; Paul S F Yip; Daniel Y T Fong; Steven Stack; Qijin Cheng; Jane Pirkis Journal: J Epidemiol Community Health Date: 2012-04-21 Impact factor: 3.710
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Authors: John W Ayers; Benjamin M Althouse; Eric C Leas; Mark Dredze; Jon-Patrick Allem Journal: JAMA Intern Med Date: 2017-10-01 Impact factor: 21.873
Authors: Gabriel Santana da Rosa; Gustavo Santos Andrades; Arthur Caye; Maria Paz Hidalgo; Melissa Alves Braga de Oliveira; Luísa K Pilz Journal: J Psychiatr Res Date: 2018-10-30 Impact factor: 4.791
Authors: Ruth Benson; Jan Rigby; Christopher Brunsdon; Grace Cully; Lay San Too; Ella Arensman Journal: Int J Environ Res Public Health Date: 2022-04-27 Impact factor: 4.614
Authors: Thomas Niederkrotenthaler; Stefanie Kirchner; Benedikt Till; Mark Sinyor; Ulrich S Tran; Jane Pirkis; Matthew J Spittal Journal: EClinicalMedicine Date: 2021-06-04