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KISSIMMEE, Fla. – A review of 15 years of suicides that were autopsied indicated that, most frequently, the person involved was a man, using a gun, in his home – and most of the time the individual left no explanation, researchers reported here.

In reviewing records of 657 suicide deaths autopsied at the University of Iowa Hospital and Clinics in Iowa City, Jane Persons, PhD, a postgraduate medical student at the university, reported that men were far more likely to die by suicide than women were -- 509 men died at their own hands compared with 146 women (gender data was missing in two autopsy reports).

"More than 50% of the decedents left no communications of intent to commit suicide," Persons told MedPage Today at her poster presentation at the . "About 22% of the deaths were accompanied by no known inciting event or identified life stressor, which was markedly more common among men."

For the study, she and her colleagues reviewed records from 2003 to 2018 of suicides, and included deaths by children as young as 10 and by persons as old as 90.

Among the other findings:

• 455 of the suicides took place in the person's residence, 71 took place in a vehicle, and 60 were done on public property

• 593 of the 657 individuals who died by suicide were white

• 157 were married

• 239 of the people were under psychiatric care, including 91 of 146 of the women; the difference was significant between men and women (P<0.0001)

• 187 of the individuals had a history of suicide attempts, and again that included a higher percentage of women compared with men – 75 of 146 women (P<0.0001)

• 281 individuals left suicide notes

• 300 of the suicides were caused by guns -- 268 used by men compared with 31 by women (P<0.0001)

• 169 people hanged themselves -- a similar percentage between men and women

• 12 people drowned themselves -- five men and seven women, a difference that was statistically significant (P=0.0025)

• Of those who died by suicide, the men were about 43 years old and the women were about 41

"Although it is a commonly held belief that more suicides occur in the winter, we found that it was in the spring that most suicides occurred," Persons said, noting that the findings in Iowa were consistent with those in the 2003-2014 National Violent Death Reporting System.

Asked for his perspective, Edwin Partovi, MD, a resident in forensic pathology at Yale-New Haven Hospital in Connecticut, who was not involved in the study, told MedPage Today that he was interested in whether suicide by firearms was more frequent on the basis of how tight local gun control laws were. "I don't have the figures, but in my experience it seems that in Connecticut the preferred method of suicide is by hanging."

"But overall, the experience shown in this study in Iowa is what I would expect in other states," he said. "The age of about 40s is about what we would expect."

Persons noted that all the Iowa cases that were included in the study had been ruled as definite suicides.

The long-term goal of her work, she said, was to help elucidate factors leading to suicide in the at-risk population – young men, with access to firearms, who are living alone.

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