Attempted suicide and major public holidays in Europe: findings from the WHO EURO Multicentre Study on Parasuicide

Objective: The aim of the study was to examine the relationship between sui cide attempts and major public holidays in Europe. Method: The analysis was based on data on 24388 suicide attempts by persons aged 15 years or older in the period 1989-1996. Data from 13 centres (repr esenting 11 countries) participating in the WHO/EURO Multicentre Study on P arasuicide were analysed. The analysis of the fluctuation of suicide attemp ts around public holidays was based on the daily number of suicide attempts for each centre. For each day in the period under examination a mean numbe r of suicide attempts (mu) was calculated. The analysis was based on the as sumption that the data followed a Poisson distribution. The observed number of daily suicide attempts was compared with the expected number of attempt s. A multiplicative model for the expected number in each centre was develo ped. Results: Before Christmas there were fewer suicide attempts than expected, and after Christmas there were approximately 40% more attempts than expecte d. Tn addition, more attempts than expected were registered on New Year's D ay. In countries where people have the day off work on Whit Monday there we re significantly fewer attempts during the 3 days before, but where Whit Mo nday is a normal working day significantly fewer attempts occurred on the M onday to Wednesday after Whit Sunday. Conclusion: There appears to be a transposition of a significant number of suicide attempts from before land during) a major public holiday until afte r it. The division of holidays into non-working and working days showed tha t a 'holiday effect' could only be found around major public holidays, part icularly Christmas, Easter and Whitsun. These findings support the theory o f the 'broken-promise effect' for major public holidays.