BMJ  2005;330 (22 January), doi:10.1136/bmj.330.7484.0-g

Editor's choice

Explaining suicide

Death comes quickly this week, which is why I urge you to grow your brains, guard your privileges, and age a bit. Don't descend into bitterness and self pity, as I was advised recently; you will gain nothing. Find something to console you or make you laugh, like the story about the Pentagon's cunning plan to build a "gay bomb," containing an aphrodisiac chemical that would make enemy soldiers sexually irresistible to each other, delivering a non-lethal blow to morale.

Also, there's probably someone with a worse deal than you. Take George W Bush, for example—his second term officially begins this week, and he faces a challenge to leave the world in a better state than he found it, say Martin McKee and Susan Foster (p 155). Domestic and international health policies are likely to be controversial, although there are some good ideas among Bush's reforms.

This issue, though, explores the harbingers of suicide. Our journey of sorrow across Europe begins in Sweden, where Rasmussen and colleagues explore the controversial relation between intelligence and suicide (p 167). Previous studies produced conflicting results. Israeli conscripts with higher intelligence ratings were more likely to commit suicide, although the opposite was reported in Australian conscripts. In Sweden, we find that low intelligence at age 18 predicts later suicide.

One explanation is that poor performance on intelligence tests is associated with depression and schizophrenia, but Rasmussen's team finds this does not explain their results. A second explanation is that people with lower intelligence scores are less able to identify solutions to problems in times of crisis.

Moving westwards, researchers from the University of St Andrews examine the relationship between suicide rates and deprivation over the past two decades in Scotland (p 175). They find a growing polarisation of suicide among young people in deprived areas. The suicide gap between the most and least deprived areas has widened; the number of suicides among young adults has increased, but it has declined among older adults. People in isolated or rural communities are already defined as a priority risk group in Scotland. Boyle and others argue that deprived areas should receive the same priority.

A leap towards Russia finds us in Estonia, where Swedish and Estonian investigators have carried out an intriguing analysis of suicide rates among Russians living in Estonia before and after independence in 1991 (p 176). During the Soviet era the Russian minority in Estonia reached 30% of the population and had a lower suicide rate than their hosts. The trappings of privilege enjoyed by Russians—an unusual scenario for immigrants—were an important explanation. Those privileges were lost with independence, and the suicide rate in Russians in Estonia became higher than in native Estonians.