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Robert E. McKeown, PhD, Steven P. Cuffe, MD and Richard M. Schulz, PhD

Robert E. McKeown is with the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia. Steven P. Cuffe is with the Department of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, and the William S. Hall Psychiatric Institute, South Car-olina Department of Mental Health, Columbia. Richard M. Schulz is with the College of Pharmacy, University of South Carolina, Columbia.

Correspondence: Requests for reprints should be sent to Robert E. McKeown, PhD, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 (e-mail: rmckeown{at}sc.edu).

US suicide rates have declined in recent years, reversing earlier trends. We examined suicide rates among 4 age groups from 1970 to 2002 and the factors that may have contributed to the decline. We paid particular attention to newer anti-depressants because of recent concerns and controversy about a possible association with suicidal behaviors. These trends warrant more extensive analysis of suicide rates among specific subgroups, including consideration of additional variables that may influence rates differentially.

The relative contributions of depression diagnosis and treatment, postsuicide attempt care, and other contextual factors (e.g., overall economic conditions) also deserve attention. If the decline is associated with contextual factors, clarifying these associations will better inform public policy decisions and contribute to more effective interventions for preventing suicide.

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