Who attempts suicide by burning? An analysis of age patterns of mortality by self-inflicted burning in the United States

Objective: The objective of this study was to compare age patterns of completed suicide by burning in the USA to age patterns in suicide by all methods as an indicator of whether suicide by burning may be a phenomenon related to altered mental status (psychosis and/or intoxication). Methods: Analysis of three national databases: Fatal injury data from the U.S. National Vital Statistics System, estimates of nonfatal injury data from the U.S. National Electronic Injury Surveillance System All-Injury Program and mortality data from the American Burn Association National Burn Repository. Results: Risk of suicide by burning is highest between 30 and 59 years (odds by decile of age compared to 18-29 years, 1.47 to 1.82), whereas risk by all methods is highest for ages 70 and older (odds, 1.26 to 1.55). Of patients admitted to burn centers with large self-inflicted burns (total body surface area ≥20%), 58.6% live. Among those with specified psychiatric or substance abuse/dependence disorders, 69.2% had either a disorder that included psychosis and/or a substance abuse/dependence disorder. Conclusions: Age patterns of suicide by burning suggest that psychotic and/or substance-related disorders may be present in a substantial proportion of victims. Further research is needed, however, to document the psychiatric characteristics of these patients.