Correspondence

Retraction

Retraction: Suicide after Natural Disasters

N Engl J Med 1999; 340:148-149January 14, 1999DOI: 10.1056/NEJM199901143400213

Article

To the Editor:

In the February 5 issue, we reported the results of a study designed to determine whether natural disasters affect suicide rates.1 Previous research on the victims of disasters had reported an increased prevalence of post-traumatic stress disorder and depression,2-4 known risk factors for suicidal thinking.5,6 In our article, we reported increases in suicide rates among the people living in the 377 U.S. counties affected by a single, severe natural disaster between 1982 and 1989.

We regretfully report that we have discovered an error in computer programming and that our previous results are incorrect. The error was discovered when we tried to repeat the analysis to determine whether there are changes in homicide rates after natural disasters. When we retraced the process of assembling the set of data on suicide, we discovered that deaths occurring in 1990 had been counted twice. Because we included only disasters that occurred between 1982 and 1989, 1990 could only be a postdisaster year. The double counting of suicides in 1990 raised the postdisaster rates to levels that differed statistically from the predisaster rates. After the error was corrected, a new analysis showed no significant increase in suicide rates after natural disasters, either for all types of disasters combined or for individual types of disasters. The corrected rates are shown in Table 1Table 1Corrected Predisaster and Postdisaster Suicide Rates per 100,000 Population According to the Type of Disaster, 1982 to 1989..

In our article, we reported a separate analysis of suicide rates in 70 counties affected by two disasters. When we compared rates before the disasters with rates in the first two years after the second disaster, we found an increase of 14.8 percent (95 percent confidence interval, 5.4 to 24.2 percent; P<0.001). This result was obtained with the use of a different set of computer programs and was not affected by the programming error.

The new results for counties affected by a single natural disaster do not support the hypothesis that suicide rates increase after natural disasters. However, it is important to note that suicides are an extreme sign of psychological distress. Prior research shows that victims of severe disasters may suffer less extreme forms of psychological distress, such as anxiety, depression, and post-traumatic stress disorder.2-4,7 Our original conclusion that “mental health support is needed after severe disasters” remains consistent with this body of knowledge.

Etienne G. Krug, M.D., M.P.H.
Marcie-jo Kresnow, M.S.
John P. Peddicord, M.S.
Linda L. Dahlberg, Ph.D.
Kenneth E. Powell, M.D., M.P.H.
Alex E. Crosby, M.D., M.P.H.
Joseph L. Annest, Ph.D.
Centers for Disease Control and Prevention, Atlanta, GA 30341

7 References

1. 1

   Krug EG, Kresnow M, Peddicord JP, et al. Suicide after natural disasters. N Engl J Med 1998;338:373-378
   Free Full Text | Web of Science | Medline

2. 2

   Rubonis AV, Bickman L. Psychological impairment in the wake of disaster: the disaster-psychopathology relationship. Psychol Bull 1991;109:384-399
   CrossRef | Web of Science | Medline

3. 3

   Ollendick DG, Hoffman M. Assessment of psychological reactions in disaster victims. J Community Psychol 1982;10:157-167
   CrossRef | Web of Science | Medline

4. 4

   Murphy SA. Status of natural disaster victims' health and recovery 1 and 3 years later. Res Nurs Health 1986;9:331-340
   CrossRef | Web of Science | Medline

5. 5

   Blumenthal SJ. Suicide: a guide to risk factors, assessment, and treatment of suicidal patients. Med Clin North Am 1988;72:937-971
   Web of Science | Medline

6. 6

   Haynes MA. Suicide prevention: a US perspective. In: Goldbloom RB, Lawrence RS, eds. Preventing disease: beyond the rhetoric. New York: Springer-Verlag, 1990:129-36.
   

7. 7

   Gerrity ET, Flynn BW. Mental health consequences of disasters. In: Noji E, ed. The public health consequences of disasters. New York: Oxford University Press, 1997:101-21.
   

Citing Articles (14)

Citing Articles

1. 1

   Tetsuya Matsubayashi, Yasuyuki Sawada, Michiko Ueda. (2013) Natural disasters and suicide: Evidence from Japan. Social Science & Medicine 82, 126-133
   

2. 2

   Kairi Kõlves, Keili E. Kõlves, Diego De Leo. (2013) Natural disasters and suicidal behaviours: A systematic literature review. Journal of Affective Disorders 146:1, 1-14
   

3. 3

   Paolo Stratta, Alessandro Rossi. (2013) Suicide in the Aftermath of the L’Aquila (Italy) Earthquake. Crisis: The Journal of Crisis Intervention and Suicide Prevention 34:2, 142-144
   

4. 4

   Patricia Santucci. Mental Health Outcomes of Disasters and Terrorism. In: Behavioral Health Response to Disasters. CRC Press, 2012:115-140.
   

5. 5

   Kathryn H. Gordon, Konrad Bresin, Joseph Dombeck, Clay Routledge, Joseph A. Wonderlich. (2011) The Impact of the 2009 Red River Flood on Interpersonal Risk Factors for Suicide. Crisis: The Journal of Crisis Intervention and Suicide Prevention 32:1, 52-55
   

6. 6

   Xiao-nan Yu, Joseph T.F. Lau, Jianxin Zhang, Winnie W.S. Mak, Kai Chow Choi, Wacy W.S. Lui, Jianxin Zhang, Emily Y.Y. Chan. (2010) Posttraumatic growth and reduced suicidal ideation among adolescents at month 1 after the Sichuan Earthquake. Journal of Affective Disorders 123:1-3, 327-331
   

7. 7

   A. Rodrigo, A. McQuillin, J. Pimm. (2009) Effect of the 2004 tsunami on suicide rates in Sri Lanka. Psychiatric Bulletin 33:5, 179-180
   

8. 8

   N. Iniesta Arandia, J.J. Ríos Blanco, M.C. Fernández Capitán, F.J. Barbado Hernández. (2009) Cambio climático: ¿nuevas enfermedades para un nuevo clima?. Revista Clínica Española 209:5, 234-240
   

9. 9

   Briana Mezuk, Gregory Luke Larkin, Marta R. Prescott, Melissa Tracy, David Vlahov, Kenneth Tardiff, Sandro Galea. (2009) The influence of a major disaster on suicide risk in the population. Journal of Traumatic Stressn/a-n/a
   

10. 10

    Yung-Po Liaw, Po-Wen Wang, Chiu-Chin Huang, Chia-Ming Chang, Wen-Chung Lee. (2008) The Suicide Mortality Rates between 1997–1998 and 2000–2001 in Nantou County of Taiwan Following the Earthquake of September 21 in 1999. Journal of Forensic Sciences 53:1, 199-202
    

11. 11

    Ryan Larrance, Michael Anastario, Lynn Lawry. (2007) Health Status Among Internally Displaced Persons in Louisiana and Mississippi Travel Trailer Parks. Annals of Emergency Medicine 49:5, 590-601.e12
    

12. 12

    M. Ahern. (2005) Global Health Impacts of Floods: Epidemiologic Evidence. Epidemiologic Reviews 27:1, 36-46
    

13. 13

    Daniel Castellanos, Miguel Perez, John Lewis, Jon A. Shaw. (2003) YOUTH SUICIDE AND HURRICANE ANDREW. Journal of the American Academy of Child & Adolescent Psychiatry 42:2, 131-131
    

14. 14

    D. John Doyle. (2000) New media. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 47:2, 188-190