Suicidal behavior includes completed suicides and suicide attempts, which reflect different risk profiles and require joint analysis. In the Republic of Kazakhstan, recent data that simultaneously assess temporal trends, regional heterogeneity, and the probability of a fatal outcome remain limited. This study aimed to comprehensively assess the dynamics of completed suicides and suicide attempts in the Republic of Kazakhstan in 2023–2024, describe regional and age differences, and identify factors associated with a higher likelihood of completed suicide versus an attempt. A nationwide retrospective population-based observational study was conducted using anonymized officially registered data on suicidal behavior in Kazakhstan for 2023–2024. All registered episodes were included (n = 15,478), including completed suicides (n = 7102) and attempts (n = 8376). Age strata were 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, and 75+. Rates per 100,000 population, the attempt-to-completed ratio, and the proportion of completed suicides among all episodes were calculated. Associations were assessed using odds ratios (ORs) with 95% confidence intervals (reference group: 15–24 years) and the Cochran–Armitage χ2 test for trend (p < 0.05). In 2024 versus 2023, the number of completed suicides decreased from 3694 to 3408 (−7.7%), and attempts from 4340 to 4036 (−7.0%). Among minors, completed cases decreased (−14.2%), while attempts increased (+20.5%). The completed suicide rate declined from 18.6 to 17.2 per 100,000, and the attempt rate from 21.9 to 20.4 per 100,000. Across regions in 2024, completed suicide rates ranged from 11.7 to 28.8 per 100,000, attempt rates from 5.0 to 46.5 per 100,000, and the attempt-to-completed ratio from 0.3 to 3.6. Age showed a stable lethality gradient, with the proportion of completed suicides among all episodes increasing from 26.4% (15–24) to 67.7% (75+). The risk of completed suicide versus an attempt was highest in the 75+ group (OR = 5.86; 95% CI 5.15–6.67; p < 0.001) and increased sharply after age 45. In 2024, the likelihood of a fatal outcome was significantly higher for episodes with unestablished circumstances (OR = 2.29; 95% CI 2.08–2.52; p < 0.001) and severe somatic diseases (OR = 2.64; 95% CI 1.91–3.65; p < 0.001), whereas family/relationship conflicts were more common among attempts (e.g., conflict with parents OR = 0.12; 95% CI 0.06–0.21; p < 0.001). Similar patterns were observed in 2023 (unestablished circumstances OR = 1.92; severe somatic diseases OR = 2.22; conflict with parents OR = 0.17; all p < 0.001). In 2023–2024, Kazakhstan showed a decline in registered completed suicides and attempts; however, the structure of suicidal behavior is becoming more complex. Attempts among minors are increasing, high regional heterogeneity persists, and there is a pronounced age-related increase in the probability of a fatal outcome, especially after age 45. Prevention priorities should include targeted measures for older age groups and patients with severe somatic pathology, strengthening programs for early identification and support of minors, and improving the quality of registration and interagency analysis of the circumstances of fatal outcomes.
Altynbekova et al. (Thu,) studied this question.