PDF(Pubmed)
Abstract：
BACKGROUND: The rate of suicide death has been increasing, making understanding risk factors of growing importance. While exposure to explicit suicide-related media, such as description of means in news reports or sensationalized fictional portrayal, is known to increase population suicide rates, it is not known whether prosuicide website forums, which often promote or facilitate information about fatal suicide means, are related to change in suicide deaths overall or by specific means.
OBJECTIVE: This study aimed to estimate the association of the frequency of Google searches of known prosuicide web forums and content with death by suicide over time in the United States, by age, sex, and means of death.
METHODS: National monthly Google search data for names of common prosuicide websites between January 2010 and December 2021 were extracted from Google Health Trends API (application programming interface). Suicide deaths were identified using the CDC (Centers for Disease Control and Prevention) National Vital Statistics System (NVSS), and 3 primary means of death were identified (poisoning, suffocation, and firearm). Distributed lag nonlinear models (DLNMs) were then used to estimate the lagged association between the number of Google searches on suicide mortality, stratified by age, sex, and means, and adjusted for month. Sensitivity analyses, including using autoregressive integrated moving average (ARIMA) modeling approaches, were also conducted.
RESULTS: Months in the United States in which search rates for prosuicide websites increased had more documented deaths by intentional poisoning and suffocation among both adolescents and adults. For example, the risk of poisoning suicide among youth and young adults (age 10-24 years) was 1.79 (95% CI 1.06-3.03) times higher in months with 22 searches per 10 million as compared to 0 searches. The risk of poisoning suicide among adults aged 25-64 was 1.10 (95% CI 1.03-1.16) times higher 1 month after searches reached 9 per 10 million compared with 0 searches. We also observed that increased search rates were associated with fewer youth suicide deaths by firearms with a 3-month time lag for adolescents. These models were robust to sensitivity tests.
CONCLUSIONS: Although more analysis is needed, the findings are suggestive of an association between increased prosuicide website access and increased suicide deaths, specifically deaths by poisoning and suffocation. These findings emphasize the need to further investigate sites containing potentially dangerous information and their associations with deaths by suicide, as they may affect vulnerable individuals.
OBJECTIVE: This study aimed to estimate the association of the frequency of Google searches of known prosuicide web forums and content with death by suicide over time in the United States, by age, sex, and means of death.
METHODS: National monthly Google search data for names of common prosuicide websites between January 2010 and December 2021 were extracted from Google Health Trends API (application programming interface). Suicide deaths were identified using the CDC (Centers for Disease Control and Prevention) National Vital Statistics System (NVSS), and 3 primary means of death were identified (poisoning, suffocation, and firearm). Distributed lag nonlinear models (DLNMs) were then used to estimate the lagged association between the number of Google searches on suicide mortality, stratified by age, sex, and means, and adjusted for month. Sensitivity analyses, including using autoregressive integrated moving average (ARIMA) modeling approaches, were also conducted.
RESULTS: Months in the United States in which search rates for prosuicide websites increased had more documented deaths by intentional poisoning and suffocation among both adolescents and adults. For example, the risk of poisoning suicide among youth and young adults (age 10-24 years) was 1.79 (95% CI 1.06-3.03) times higher in months with 22 searches per 10 million as compared to 0 searches. The risk of poisoning suicide among adults aged 25-64 was 1.10 (95% CI 1.03-1.16) times higher 1 month after searches reached 9 per 10 million compared with 0 searches. We also observed that increased search rates were associated with fewer youth suicide deaths by firearms with a 3-month time lag for adolescents. These models were robust to sensitivity tests.
CONCLUSIONS: Although more analysis is needed, the findings are suggestive of an association between increased prosuicide website access and increased suicide deaths, specifically deaths by poisoning and suffocation. These findings emphasize the need to further investigate sites containing potentially dangerous information and their associations with deaths by suicide, as they may affect vulnerable individuals.
摘要：
背景：自杀死亡率一直在上升，让理解风险因素变得越来越重要。在接触明确的自杀相关媒体时，例如新闻报道中的手段描述或耸人听闻的虚构写照，已知会增加人口自杀率，不知道自杀网站论坛，经常宣传或促进有关致命自杀手段的信息，与自杀死亡的总体变化或特定方式有关。
目的：这项研究旨在估计在美国，随着时间的推移，谷歌搜索已知自杀网络论坛的频率和内容与自杀死亡的关联。按年龄,性别,和死亡的手段。
方法：2010年1月至2021年12月期间，针对常见自杀网站名称的全国每月Google搜索数据是从GoogleHealthTrendsAPI（应用程序编程接口）中提取的。自杀死亡是使用CDC（疾病控制和预防中心）国家生命统计系统（NVSS）确定的。并确定了3种主要死亡方式(中毒，窒息,和枪支）。然后使用分布式滞后非线性模型（DLNMs）来估计Google搜索次数与自杀死亡率之间的滞后关联，按年龄分层，性别,和手段，并调整了一个月。敏感性分析，包括使用自回归综合移动平均(ARIMA)建模方法，也进行了。
结果：在美国，自杀网站搜索率增加的几个月中，有更多记录的青少年和成年人因故意中毒和窒息而死亡。例如,青少年和青少年(10~24岁)的中毒自杀风险为1.79倍(95%CI1.06~3.03),与0次搜索相比,每10百万人中有22次搜索.在25-64岁的成年人中，中毒自杀的风险是1.10（95％CI1.03-1.16）倍，在搜索达到9/10万后1个月，而0搜索。我们还观察到，搜索率的增加与青少年枪支自杀死亡人数减少有关，青少年的时间滞后3个月。这些模型对敏感性测试是稳健的。
结论：虽然需要更多的分析，这些发现暗示了自杀网站访问量增加与自杀死亡人数增加之间的关联，特别是中毒和窒息死亡。这些发现强调需要进一步调查包含潜在危险信息的地点及其与自杀死亡的关联，因为它们可能会影响弱势群体。
目的：这项研究旨在估计在美国，随着时间的推移，谷歌搜索已知自杀网络论坛的频率和内容与自杀死亡的关联。按年龄,性别,和死亡的手段。
方法：2010年1月至2021年12月期间，针对常见自杀网站名称的全国每月Google搜索数据是从GoogleHealthTrendsAPI（应用程序编程接口）中提取的。自杀死亡是使用CDC（疾病控制和预防中心）国家生命统计系统（NVSS）确定的。并确定了3种主要死亡方式(中毒，窒息,和枪支）。然后使用分布式滞后非线性模型（DLNMs）来估计Google搜索次数与自杀死亡率之间的滞后关联，按年龄分层，性别,和手段，并调整了一个月。敏感性分析，包括使用自回归综合移动平均(ARIMA)建模方法，也进行了。
结果：在美国，自杀网站搜索率增加的几个月中，有更多记录的青少年和成年人因故意中毒和窒息而死亡。例如,青少年和青少年(10~24岁)的中毒自杀风险为1.79倍(95%CI1.06~3.03),与0次搜索相比,每10百万人中有22次搜索.在25-64岁的成年人中，中毒自杀的风险是1.10（95％CI1.03-1.16）倍，在搜索达到9/10万后1个月，而0搜索。我们还观察到，搜索率的增加与青少年枪支自杀死亡人数减少有关，青少年的时间滞后3个月。这些模型对敏感性测试是稳健的。
结论：虽然需要更多的分析，这些发现暗示了自杀网站访问量增加与自杀死亡人数增加之间的关联，特别是中毒和窒息死亡。这些发现强调需要进一步调查包含潜在危险信息的地点及其与自杀死亡的关联，因为它们可能会影响弱势群体。
