Recent changes in the age- and gender-specific rates of attempted suicide in Gent.

The gender-specific rate of attempted suicide, calculated from hospital admission data, was significantly lower in 1990 than in 1986 in females and, when age is taken into account, in females younger than 35 and in males younger than 25 years. The incidence of suicide attempts seen by general practitioners also decreased. Indications for rejection of the artefact hypothesis as explanation for this decrease have been investigated. It was shown that the decrease in the prevalence was found at local and national levels and was not the result of a decrease in referrals to general hospitals. Moreover, the decrease in the rate was associated with an increase in the use of outpatient mental health facilities in females and with a trend to increase in the 15-24 age group. The number of suicide attempts referred by Community Mental Health Services to the general hospital and the suicide rate in out-patients remained constant during the study period. The findings do not support the artefact hypothesis but indicate that there was a real decrease in the rate of attempted suicide. Moreover, the findings suggest that out-patient treatment can be efficacious in the primary prevention of suicidal behaviour.