Violent suicide methods across life stages - a national population-based register study

Aim: To examine the use of violent suicide methods across life stages, and associations with sociodemographic characteristics, healthcare utilization, and place of death. Methods: Data from Swedish national registers encompassing all recorded suicide deaths between 2013 and 2019 were analyzed. Suicide methods were categorized as violent or non-violent. Associations were assessed using univariable and multivariable logistic regression, with age modeled using restricted cubic splines to capture nonlinear effects. Interaction analyses were conducted to examine how associations varied by age. Results: A total of 8,325 suicides were included, with 77% involving violent methods. The likelihood of violent method use peaked at age 20 and declined until around age 60, after which a modest increase was observed. The use of violent suicide methods was stable across all ages for men but there was a steady decrease in women until age 60. Foreign-born older adults were less likely to use violent methods than their Swedish-born counterparts. Lower educational attainment, living with others, and dying in nursing homes or other institutional settings were also associated with higher odds of violent method use. Conclusions: This study contributes to the literature by highlighting distinct age- and subgroup-specific trends in the use of violent suicide methods. We noted a consistent decrease among women up to age 60, and lower rates among older migrants. These insights underscore the value of a lifespan approach in understanding suicide risk and method choice, and point to the need for tailored, context-aware prevention strategies.