Sándor Kalmár M.D. Ph.D.

The Hungarian population has been suffering from the high rates suicide for centuries. In 2005, the Suicide Standard Mortality Rate was 2.3 times higher in Hungary than in the Eu-15 countries.

There is no other social phenomenon and general public health problem, other than the suicide, which is not only tragic, painful, passionately unreasonable, multifactorial, controversial, mysterious, incurable but preventable human behavior as well. It does not simply mean the loss of life, but inflicts serious pain on the members of the family and imposes a great economic burden on the society.

Suicide has a lot of deep, complicated, ramified psychiatric, biologic, somatic, social, historical, mysterious, spiritual and unknown roots. Almost everything that can be written about it, has already been written, while we still do not know much about the reasons, nor about the ways to cease it. However, what seems to be sure is, that suicide exists only at a certain level  of  human development, so it is the ability – or rather the characteristics of  humans of that level.

Among the different methods of committing suicide self-hanging is still the most common way in both genders in Hungary, and the incidence proportion in our county is higher than the national average. At certain settlements self-hanging is almost the only method used.

The national suicide rate has decreased by 46.19% from 1983-2008 (1983: 45.9/100 000 people; 2008: 24.7/100 000). The suicide rate has decreased by 54.97% in the Bács-Kiskun County (1983: 66.4/100 000 people; 2008: 29.9/100 000). In spite of this huge decrease, the suicide rate is extremely high in Hungary and Bács-Kiskun County today too, and it increases again.

Bács-Kiskun County is located in the middle of Hungary between the rivers Danube and Tisza. The county town is Kecskemét. It is an agricultural county with large vineyards and orchards. Unfortunatelly there is no National Suicide Preventive Program in Hungary.

The weekly distribution of suicides comparing with Akita prefecture (Japan) is interesting.

Table 1. The weekly distribution of suicides in Akita Prefecture, Japan by Masahito Fushimi 

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Male (n=99)	19 19,19%	18 18,18%	16 16,16%	10 10,1%	9 9,09%	13 13,13%	14 14,14%
Female (n=34)	2 5,88%	4 11,76%	7 20,59%	8 23,53%	5 14,71%	3 8,82%	5 14,71%
Total (n=133)	21 15,79%	22 16,54%	23 17,29%	18 13,53%	14 10,53%	16 12,03%	19 14,29%

15-20 years ago the distribution of suicides in Bács-Kiskun County was the following:

Table 2. Weekly distribution of suicides in Bács-Kiskun County, 1988-1992.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Total: (n=1549)	328 21,17%	269 17,37%	256 16,53%	238 15,36%	218 14,07%	123 7,94%	117 7,55%

The most suicide cases occurred on Mondays and decreased till Sunday in Bács-Kiskun County during these five years. The difference between the two days was 211 cases. It is 64.34% decrease. 15 years later this distribution has changed considerably.

Table 3. Weekly distribution of suicides in Bács-Kiskun County, 2007.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Male (n=139)	18 12,95%	28 20,14%	25 17,99%	23 16,55%	12 8,63%	18 12,95%	15 10,79%
Female (n= 26)	5 19,23%	3 13,04%	4 15,38%	3 13,04%	5 19,23%	2 7,69%	4 15,38%
Total (n=165)	23 13,94%	31 18,79%	29 17,58%	26 15,76%	17 10,3%	20 12,12%	19 11,51%

In the year 2007, the most suicides cases occurred on Tuesday and Wednesday, the least cases on Friday, which is the same as in Akita prefecture in Japan.

Table 4. Weekly distribution of suicides in Bács-Kiskun County, 2008.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Male (n=116)	21 18,1%	16 13,79%	16 13,79%	14 12,07%	18 15,52%	11 9,48%	20 17,24%
Female (n=43)	7 16,28%	9 20,93%	4 9,3%	3 6,98%	6 13,95%	5 11,63%	9 20,93%
Total (n=159)	28 17,61%	25 15,72%	20 12,58%	17 10,69%	24 15,09%	16 10,06%	29 18,24%

In the year of 2008, the most suicides cases occurred on Sunday and Monday, the least cases on Saturday.

Table 5.Weekly distribution of suicides in Bács-Kiskun County, 2009.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Male (n=140)	26 18,57%	21 15%	19 13,57%	19 13,57%	15 10,71%	19 13,57%	21 15%
Female (n=41)	7 17,07%	8 19,51%	4 9,76%	6 14,63%	2 4,88%	6 14,63%	8 19,51%
Total (n=181)	33 18,23%	29 16,02%	23 12,71%	25 13,81%	17 9,39%	25 13,81%	29 16,02%

In the year of 2009, the most suicides cases occurred on Monday, the least cases on Friday.

Table 6.Weekly distribution of suicides in Bács-Kiskun County, 2007-2009.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Male (n=395)	65 16,46%	65 16,46%	60 15,19%	56 14,18%	45 11,39%	48 12,15%	56 14,18%
Female (n=110)	19 17,27%	20 18,18%	12 10,91%	12 10,91%	13 11,82%	13 11,82%	21 19,09
Total (n=505)	84 16,63%	85 16,83%	72 14,26%	68 13,46%	58 11,48%	61 12,08%	77 15,25%

Summing up the last three years the the most suicides cases occurred on Tuesday and Monday, the least cases on Friday, which is the same in general as in Akita prefecture in Japan but different in females.

We do not know the real reasons of the weekly distribution of suicides in our county,  which is changing year after year, but we suppose that, like in Akita prefecture, the reasons are not medical but first of all social ones.

References

1. Masahito Fushimi: The weekly distribution of suicides in Akita prefecture, Japan.
2. Kalmár S. M, Rihmer Z, Kalmár S. Demographical characteristics and some aspects of periodicity of 1549 suicide events in Bács Kiskun county Hungary, 1988-1992. Xth World Congress of Psychiatry, Madrid. Spain. 23-28 August, 1996.  Satellite Symposium on ”Suicidal Behaviour”. National characteristics of suicidal behaviour 21-22 August, 1996. Budapest, Hungary.
3. Kalmár S. Suicides in Bács Kiskun County. (poster) XIIIth World Congress of Psychiatry, Cairo 10-15 September, 2005.
4. Kalmár S. Bács-Kiskun megye: 8489 értelmetlen halál az elmúlt harminc év alatt. MPT VII. Nemzeti Kongresszus, Budapest, 2010. Január 27-30.
5. Hungarian Central Statistical Office.