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Suicide and homicide after the fall of communist regimes
Eurt’sychiat~ 0 Elsevier,
Short communication
1998 ; 13 : 98-100 Paris
Suicide and homicide after the fall of communist regimes D Lester Center
for
the Study
of Suicide,
(Received
5 Stonegate
28 April
Court
1997; accepted
(RR 41), Blackwood, 16 December
NJ, 08012,
USA
1997)
Summary - Both suicide and homicide rates rose in nations formed after the formal break-up of the Soviet Union in 1991. Homicide not suicide rates rose in Eastern European nations after the fall of their communist regimes in 1989. 0 1998, Elsevier, Paris. suicide
/ homicide
rates, but
/ new nations
Economic and political changes have been associated with changes in rates of personal violence - suicide and homicide. It is well documented that suicide rates decline during times of war [7] and rise during economic depressions [6]. In contrast, homicide rates increase after wars [I 1. In recent years there have been major political changes in Europe. The fall of communist regimes in Eastern Europe occurred in 1989 and the formal break-up of the Soviet Union in 1991 [2]. The present note examines the changes in the suicide and homicide rates after these political upheavals.
For the nations of Eastern Europe, 1989 was chosen as the change-over year. The mean suicide and homicide rates were calculated for the two periods 1985-1988 and 1990-1993 for each nation. These two figures were compared over the six nations with available data by means of two-sample dependent t-tests. For the former members of the Soviet Union, 1991 was chosen as the change-over year. The mean suicide and homicide rates were calculated for the two periods 1988-1990 and 1992-1994 for each nation. These two figures were compared over the 15 nations with available data by means of two-sample dependent t-tests.
METHOD The suicide and homicide rates for the nations involved were obtained from the annual publication of the World Health Organization [ 1 I]. The latest years for which mortality rates were available was 1994. The mortality rates per 100,000 per year areshown in table I. The political changes in these nations, which was often accompanied by civil unrest, may have resulted in the official determination of causes of death being less reliable and valid than before the changes. Furthermore, many of the nations involved began reporting death rates from suicide and homicide for the first time now that there was less censorship of information in those nations, and this openness may have decreased any tendency to “cover-up” suicidal and homicidal deaths. Despite these caveats, it is still of interest to examine changes in the official rates of death from suicide and homicide after the political changes.
RESULTS For the nations of Eastern Europe, the average suicide and homicide rates for the 4 years 1985-1988 were compared with the average rates for the 4 years 1990-1993. Four of the six nations with available data experienced a decline in suicide rates after 1989 (a mean decline of 1.09 per 100,000 per year), but this decline was not statistically significant (ts = 1.12). All six nations experienced an increase in homicide rates (a mean increase of I .43), an increase which was statistically significant (fs = 3.07, P = 0.03).
For the nations of the former Soviet Union, the average suicide and homicide rates for the 3 years 1988-1990 were compared with the average rates for the 3 years 1992-1994. Ten of the 15 nations experienced an increase in their suicide rata after 1991 (a mean increase of 3.99 per 100,OO per year), an
Suicide Table
I. Suicide
and homicide
rates of new European
1985
I986
and homicide
nations,
1987
1985-1994.
1988
99
after communism (Rates are per 100,000
1989
per year).
1990
1991
1992
1993
1994
14.7
1.5 17.x 19.3
17.4
17.3
19.3
15.4 18.5
39.9
3X.6
38.7
35.3
13.0 15.3
13.9
14.9
18.6 35.9 14.6
27.0
2.3 2.0 23.6 24.2 32.2
28.0 22.8 38.2
22.8 40.9
18.3 12.3
19.7 11.1
23.5
23.9
12.7
13.1
28.4 30.5
35.0 34.6 15.X
42.2
40.7 45.x
Suicide Eastern Europe Albania Bulgaria Czech Rep Hungary Poland Yugoslavia Soviet Union Armenia Azerbaijan Belarus Croatia Estonia Georgia Kazakhstan Kyrgyzstan Latvia Lithuania Moldova Russia Slovenia Tajikistan Turkmenistan The Ukraine Uzbekistan Eastern Europe Albania Bulgaria Czech Rep Hungary Poland Yugoslavia Soviet Union Armenia Azerbaijan Belarus Croatia Estonia Georgia Kazakhstan Kyrgyzstan Latvia Lithuania Moldova Russia Slovenia Tajikistan Turkmenistan The Ukraine Uzbekistan
16.0
15.7 20.9 45.3 12.6 15.9
2.3 3.7
1.9 3.5
16.3
44.4 13.3
23.1
22.1 27.7 4.5
11.7
9.3 25.3 25.5
34.1
20.3 31.2 32.8 5.9 7.5 22.3 8.3
16.7
18.4
23.1 30.0 5.3 8.9 7.7
2.9
1.8 3.3 18.5 23.4 24.5 4.3 17.0
24.3 25.6 4.2 16.4 Il.5 23.3 29.1 16.7
23.3 30. I 4.4 X.0 19.6 7.0
2.7
2.8
1.6
1.6 1.8
1.7 1.8
1.7 1.5
1.4
1.9
2.4 4.7 2.4 6.6 2.3 7.9
3.0
2.6 4.5 2.5 5.7 2.5 6.5 4.1 4.4 3.X 5.7 7.8 1.5
5.1
5.3 6.0 7.7 10.5 2.1
2.0 4.4 4.9 3.6
2.4 6.0 1.9
5.7 3.0 4.3 4.9 6.0 7.4 I .7 1.0
3.8
I .3
3.3 4.1
3.0
12.2
2.5 3.7
2.4 1.o 2.5
1.1
41.3 16.2
1.4
3.2
2.0 16.2 19.0
17.2
19.1
22.3 30.9 4.6 22.4 29.4
2.3 16.7 18.7 45.1 13.3
2.7
1 I .4
23.1 26.6 16.7 24.3 31.7
4.1 7.8 19.1
2.4 3.1 21.7 21.9
25.5 4.6 19.6 12.3 25.7 27.1 17.0
26.1 14.8
21.2
20.7 7.2
23.1
16.6
1 .o
3.2 1.9
2.9
3.1
2.2 2.5
2.6 3.3 5.4 2.0 6.0 2.8 7.1 4.9 5.9 4.6 7.6 9.8 1.6 1.9 5.6 5.4 3.x
12.5 26.0
2.2 1.9
26.6 32.3 3.x 7.3 20.8 6.X
I .s 2.6 0.8 2.7 1.7
19.1
26.5 27.6 4.4
7.5
1.7
2.8 1.6 20.4 23.9 27.1 3.6
25.X 33.9 4.6 7.1
6.4
increase which was statistically significant (r14= 2.62, P = 0.02). Twelve of the 15 nations experienced an increase in their homicide rate (a mean increase of 9.70), an increase which was statistically significant
(t,, = 2.98, P = 0.01).
2.1 16.2 1x.5 41.6 11.3 16.5
x.1
2.1 I .7
2.9 2.0
2.9 2.2 6.8 2.2 7.8 4.2
6.1 6.0 7.0 2.x
10.1
7.2 8.X
5.7 x.4 12.6
2.4 2.3 6.4 7.2 5.6
11.0
1.6
42.1 16.7
14.3
0.6
18.0
37.9 30.9
41.x 31.2
7.0 22.6 6.2
6.1
5.X
4.0
4.1 4.7
6.0 4.9
1.8
1.9
4.0 2.9
4.0 2.9
2.1 4.1
9.7 4.9
25.3 51.8
41.4
62.5
3.8
8.7 5.1 19.6
10.5 4.8 25.8
3.5 28.2
14.4 11.5
17.4 12.8
13.X
16.0
24.5 12.5
22.9
12.6
10.8
2.8 11.8 14.0
12.1
9.2 7.6
11.5 9.1
9.1
x.9
14.3 2.0 2.3 6.7 X.0 6.1
2.3
9.0
15.3
2.5 2.3 5.2 8.7 5.6
31.1
29.5
10.5 13.x
6.2
2.7
5.1
3.5 3.0
17.7 13.4
22.9 1.9
30.4 1.4
14.4 32.4 2.0
5.1 11.4
5.5
4.4
5.2
4.3
DISCUSSION It appearsthat the political changes in 1989 in Eastern Europe and in 1991 in the Soviet Union were accompanied by increases in the rates of homicide, and the
100
D Lester
breakup of the Soviet Union in 1991 resulted in an increase in suicide rates. The increase in suicide rates was especially noticeable in Russia and the Baltic nations of Estonia, Latvia and Lithuania, where the suicide rates increased by 50 percent or more. The increases in homicide rates were most noticeable in Russia, the Baltic nations, and those which experienced civil wars or wars with neighboring nations, such as Armenia and Azerbaijan. The increase in homicide rates was more consistent after these political changes and, aside from civil war, may be a reflection of the immediate break-down in public services experienced by many of these new nations as they attempted the transition from communist dictatorships to a more democratic society, however, the increase in suicide is a puzzle. Perhaps it reflects the disappointment in the changes in the standard of living after initial hope that social conditions would change quickly for the better. The increase may also be a result of the lack of a harsh dictatorship to blame now for one’s misery, increasing the chances of depression and self-directed aggression, as proposed in the theory of Henry and Short [4]. In addition, there may have been changes in both the medical and psychiatric services in these new nations which may have led to changes in the rates of death from suicide and homicide. A breakdown in medical services could result in those, whose lives would have bean saved in the past by efficient emergency medical care, now dying, a hypothesis explored by Lester [5] and Doerner and Speir [3]. Changes in the provision of psychiatric treatment may also have had an impact, particularly on deaths from suicide which are much more common in those with psychiatric disorders than in those with no such disorders. Future studies of suicide and homicide in individual nations may be able to explore whether measures of such changes in health care are available and, if so,
how they impacted on the death rates from suicide and homicide. In recent years, epidemiological reports on suicide in some of these nations have appeared, for example, in Estonia and other Baltic nations [8, 91. However, as yet, there have been no in-depth studies of the precipitants of and motivations behind suicide in these nation. Methodologically sound psychological autopsy studies on suicides in these nations would be of great value for proposing hypotheses about the causes of changes in the suicide rates in recent years. For example, Wasserman, Varnik and Eklund [lo] have speculated that the changes in suicide rates in the nations from the former Soviet Union may be a result of the decrease in alcohol consumption, but they have not yet confirmed this with a sound methodology.
REFERENCES 1 Archer D, Gartner D. Violent acts and violent times. Am Sociological Rev 1976 ; 41 : 937-63 2 Central Intelligence Agency. Worldfactbook 1994. Washington, DC: CIA; 1994 3 Doemer WG, Speir JC. Stitch and sew. Criminology 1986 ; 24 : 319-30 4 Henry AP, Short JF. Suicide and homicide. New York: Free Press; 1954 5 Lester D. Medical resources and the prevention of suicide and homicide. Ear /Psychiatry 1995 ; 9 : 97-9 6 Platt SD. Unemployment and suicidal behavior. Snc Sci Med 1984 ; 19 : 93-115 7 Rojcewicz S. War and suicide. Life-Threatening Behavior 1971 ; 1 : 46-54 8 Vamik A. Suicide in Estonia and other former USSR Republics. Crisis 1993 ; 14 : 185-6 9 Wasserman D, Vamik A. Increase in suicide among men in the Baltic countries. Lancer 1994 ; 343 : 1504-5 10 Wassermann D, Vamik A, Eklund G. Male suicides and alcohol consumption in the former USSR. Acta Psychiatr Stand 1994 ; 89 : 306-13 11 World Health Organization. Statistics annual. Geneva: WHO; annual
Short communication
1998 ; 13 : 98-100 Paris
Suicide and homicide after the fall of communist regimes D Lester Center
for
the Study
of Suicide,
(Received
5 Stonegate
28 April
Court
1997; accepted
(RR 41), Blackwood, 16 December
NJ, 08012,
USA
1997)
Summary - Both suicide and homicide rates rose in nations formed after the formal break-up of the Soviet Union in 1991. Homicide not suicide rates rose in Eastern European nations after the fall of their communist regimes in 1989. 0 1998, Elsevier, Paris. suicide
/ homicide
rates, but
/ new nations
Economic and political changes have been associated with changes in rates of personal violence - suicide and homicide. It is well documented that suicide rates decline during times of war [7] and rise during economic depressions [6]. In contrast, homicide rates increase after wars [I 1. In recent years there have been major political changes in Europe. The fall of communist regimes in Eastern Europe occurred in 1989 and the formal break-up of the Soviet Union in 1991 [2]. The present note examines the changes in the suicide and homicide rates after these political upheavals.
For the nations of Eastern Europe, 1989 was chosen as the change-over year. The mean suicide and homicide rates were calculated for the two periods 1985-1988 and 1990-1993 for each nation. These two figures were compared over the six nations with available data by means of two-sample dependent t-tests. For the former members of the Soviet Union, 1991 was chosen as the change-over year. The mean suicide and homicide rates were calculated for the two periods 1988-1990 and 1992-1994 for each nation. These two figures were compared over the 15 nations with available data by means of two-sample dependent t-tests.
METHOD The suicide and homicide rates for the nations involved were obtained from the annual publication of the World Health Organization [ 1 I]. The latest years for which mortality rates were available was 1994. The mortality rates per 100,000 per year areshown in table I. The political changes in these nations, which was often accompanied by civil unrest, may have resulted in the official determination of causes of death being less reliable and valid than before the changes. Furthermore, many of the nations involved began reporting death rates from suicide and homicide for the first time now that there was less censorship of information in those nations, and this openness may have decreased any tendency to “cover-up” suicidal and homicidal deaths. Despite these caveats, it is still of interest to examine changes in the official rates of death from suicide and homicide after the political changes.
RESULTS For the nations of Eastern Europe, the average suicide and homicide rates for the 4 years 1985-1988 were compared with the average rates for the 4 years 1990-1993. Four of the six nations with available data experienced a decline in suicide rates after 1989 (a mean decline of 1.09 per 100,000 per year), but this decline was not statistically significant (ts = 1.12). All six nations experienced an increase in homicide rates (a mean increase of I .43), an increase which was statistically significant (fs = 3.07, P = 0.03).
For the nations of the former Soviet Union, the average suicide and homicide rates for the 3 years 1988-1990 were compared with the average rates for the 3 years 1992-1994. Ten of the 15 nations experienced an increase in their suicide rata after 1991 (a mean increase of 3.99 per 100,OO per year), an
Suicide Table
I. Suicide
and homicide
rates of new European
1985
I986
and homicide
nations,
1987
1985-1994.
1988
99
after communism (Rates are per 100,000
1989
per year).
1990
1991
1992
1993
1994
14.7
1.5 17.x 19.3
17.4
17.3
19.3
15.4 18.5
39.9
3X.6
38.7
35.3
13.0 15.3
13.9
14.9
18.6 35.9 14.6
27.0
2.3 2.0 23.6 24.2 32.2
28.0 22.8 38.2
22.8 40.9
18.3 12.3
19.7 11.1
23.5
23.9
12.7
13.1
28.4 30.5
35.0 34.6 15.X
42.2
40.7 45.x
Suicide Eastern Europe Albania Bulgaria Czech Rep Hungary Poland Yugoslavia Soviet Union Armenia Azerbaijan Belarus Croatia Estonia Georgia Kazakhstan Kyrgyzstan Latvia Lithuania Moldova Russia Slovenia Tajikistan Turkmenistan The Ukraine Uzbekistan Eastern Europe Albania Bulgaria Czech Rep Hungary Poland Yugoslavia Soviet Union Armenia Azerbaijan Belarus Croatia Estonia Georgia Kazakhstan Kyrgyzstan Latvia Lithuania Moldova Russia Slovenia Tajikistan Turkmenistan The Ukraine Uzbekistan
16.0
15.7 20.9 45.3 12.6 15.9
2.3 3.7
1.9 3.5
16.3
44.4 13.3
23.1
22.1 27.7 4.5
11.7
9.3 25.3 25.5
34.1
20.3 31.2 32.8 5.9 7.5 22.3 8.3
16.7
18.4
23.1 30.0 5.3 8.9 7.7
2.9
1.8 3.3 18.5 23.4 24.5 4.3 17.0
24.3 25.6 4.2 16.4 Il.5 23.3 29.1 16.7
23.3 30. I 4.4 X.0 19.6 7.0
2.7
2.8
1.6
1.6 1.8
1.7 1.8
1.7 1.5
1.4
1.9
2.4 4.7 2.4 6.6 2.3 7.9
3.0
2.6 4.5 2.5 5.7 2.5 6.5 4.1 4.4 3.X 5.7 7.8 1.5
5.1
5.3 6.0 7.7 10.5 2.1
2.0 4.4 4.9 3.6
2.4 6.0 1.9
5.7 3.0 4.3 4.9 6.0 7.4 I .7 1.0
3.8
I .3
3.3 4.1
3.0
12.2
2.5 3.7
2.4 1.o 2.5
1.1
41.3 16.2
1.4
3.2
2.0 16.2 19.0
17.2
19.1
22.3 30.9 4.6 22.4 29.4
2.3 16.7 18.7 45.1 13.3
2.7
1 I .4
23.1 26.6 16.7 24.3 31.7
4.1 7.8 19.1
2.4 3.1 21.7 21.9
25.5 4.6 19.6 12.3 25.7 27.1 17.0
26.1 14.8
21.2
20.7 7.2
23.1
16.6
1 .o
3.2 1.9
2.9
3.1
2.2 2.5
2.6 3.3 5.4 2.0 6.0 2.8 7.1 4.9 5.9 4.6 7.6 9.8 1.6 1.9 5.6 5.4 3.x
12.5 26.0
2.2 1.9
26.6 32.3 3.x 7.3 20.8 6.X
I .s 2.6 0.8 2.7 1.7
19.1
26.5 27.6 4.4
7.5
1.7
2.8 1.6 20.4 23.9 27.1 3.6
25.X 33.9 4.6 7.1
6.4
increase which was statistically significant (r14= 2.62, P = 0.02). Twelve of the 15 nations experienced an increase in their homicide rate (a mean increase of 9.70), an increase which was statistically significant
(t,, = 2.98, P = 0.01).
2.1 16.2 1x.5 41.6 11.3 16.5
x.1
2.1 I .7
2.9 2.0
2.9 2.2 6.8 2.2 7.8 4.2
6.1 6.0 7.0 2.x
10.1
7.2 8.X
5.7 x.4 12.6
2.4 2.3 6.4 7.2 5.6
11.0
1.6
42.1 16.7
14.3
0.6
18.0
37.9 30.9
41.x 31.2
7.0 22.6 6.2
6.1
5.X
4.0
4.1 4.7
6.0 4.9
1.8
1.9
4.0 2.9
4.0 2.9
2.1 4.1
9.7 4.9
25.3 51.8
41.4
62.5
3.8
8.7 5.1 19.6
10.5 4.8 25.8
3.5 28.2
14.4 11.5
17.4 12.8
13.X
16.0
24.5 12.5
22.9
12.6
10.8
2.8 11.8 14.0
12.1
9.2 7.6
11.5 9.1
9.1
x.9
14.3 2.0 2.3 6.7 X.0 6.1
2.3
9.0
15.3
2.5 2.3 5.2 8.7 5.6
31.1
29.5
10.5 13.x
6.2
2.7
5.1
3.5 3.0
17.7 13.4
22.9 1.9
30.4 1.4
14.4 32.4 2.0
5.1 11.4
5.5
4.4
5.2
4.3
DISCUSSION It appearsthat the political changes in 1989 in Eastern Europe and in 1991 in the Soviet Union were accompanied by increases in the rates of homicide, and the
100
D Lester
breakup of the Soviet Union in 1991 resulted in an increase in suicide rates. The increase in suicide rates was especially noticeable in Russia and the Baltic nations of Estonia, Latvia and Lithuania, where the suicide rates increased by 50 percent or more. The increases in homicide rates were most noticeable in Russia, the Baltic nations, and those which experienced civil wars or wars with neighboring nations, such as Armenia and Azerbaijan. The increase in homicide rates was more consistent after these political changes and, aside from civil war, may be a reflection of the immediate break-down in public services experienced by many of these new nations as they attempted the transition from communist dictatorships to a more democratic society, however, the increase in suicide is a puzzle. Perhaps it reflects the disappointment in the changes in the standard of living after initial hope that social conditions would change quickly for the better. The increase may also be a result of the lack of a harsh dictatorship to blame now for one’s misery, increasing the chances of depression and self-directed aggression, as proposed in the theory of Henry and Short [4]. In addition, there may have been changes in both the medical and psychiatric services in these new nations which may have led to changes in the rates of death from suicide and homicide. A breakdown in medical services could result in those, whose lives would have bean saved in the past by efficient emergency medical care, now dying, a hypothesis explored by Lester [5] and Doerner and Speir [3]. Changes in the provision of psychiatric treatment may also have had an impact, particularly on deaths from suicide which are much more common in those with psychiatric disorders than in those with no such disorders. Future studies of suicide and homicide in individual nations may be able to explore whether measures of such changes in health care are available and, if so,
how they impacted on the death rates from suicide and homicide. In recent years, epidemiological reports on suicide in some of these nations have appeared, for example, in Estonia and other Baltic nations [8, 91. However, as yet, there have been no in-depth studies of the precipitants of and motivations behind suicide in these nation. Methodologically sound psychological autopsy studies on suicides in these nations would be of great value for proposing hypotheses about the causes of changes in the suicide rates in recent years. For example, Wasserman, Varnik and Eklund [lo] have speculated that the changes in suicide rates in the nations from the former Soviet Union may be a result of the decrease in alcohol consumption, but they have not yet confirmed this with a sound methodology.
REFERENCES 1 Archer D, Gartner D. Violent acts and violent times. Am Sociological Rev 1976 ; 41 : 937-63 2 Central Intelligence Agency. Worldfactbook 1994. Washington, DC: CIA; 1994 3 Doemer WG, Speir JC. Stitch and sew. Criminology 1986 ; 24 : 319-30 4 Henry AP, Short JF. Suicide and homicide. New York: Free Press; 1954 5 Lester D. Medical resources and the prevention of suicide and homicide. Ear /Psychiatry 1995 ; 9 : 97-9 6 Platt SD. Unemployment and suicidal behavior. Snc Sci Med 1984 ; 19 : 93-115 7 Rojcewicz S. War and suicide. Life-Threatening Behavior 1971 ; 1 : 46-54 8 Vamik A. Suicide in Estonia and other former USSR Republics. Crisis 1993 ; 14 : 185-6 9 Wasserman D, Vamik A. Increase in suicide among men in the Baltic countries. Lancer 1994 ; 343 : 1504-5 10 Wassermann D, Vamik A, Eklund G. Male suicides and alcohol consumption in the former USSR. Acta Psychiatr Stand 1994 ; 89 : 306-13 11 World Health Organization. Statistics annual. Geneva: WHO; annual