{
  "abstract": "Suicide is a major global health concern causing over 720,000 annual deaths, with most occurring in low- and middle-income countries. Official reports in Iran demonstrate increasing and regionally varied patterns, with distinctly elevated risk levels observed in certain province. This study applies epidemiological and spatial analyses to identify factors associated with suicide death among individuals with suicide attempts, as well as geographic patterns in northern Iran to inform targeted prevention strategies. This cross-sectional study investigated suicide patterns in the population covered by Mazandaran University of Medical Sciences, Iran, from 2018 to 2022. Data were obtained from the provincial Suicide Registry System, covering all counties of Mazandaran Province except Babol, and population denominators were derived from the national census. Variables included demographic, social, and clinical characteristics of suicide cases. Data were cleaned, recoded, and analyzed using descriptive statistics, age- and sex-specific incidence rates, and temporal trend analyses. Spatial clustering was assessed using Anselin Local Moran’s I statistics, while Bayesian spatial logistic regression was used to examine the association between the suicide death and socio-demographic characteristics among individuals with suicide attempts. Analyses were performed in SPSS, R, and ArcGIS. From 2018 to 2022, a total of 20,275 suicide attempts were recorded in Mazandaran province, with 826 deaths (4.1%). The mean age was 25.3 years for survivors and 38 years for decedents; men comprised 63.7% of deaths versus 35.2% of survivors. Rural residents accounted for 41.8% of deaths. Illiteracy was more frequent among the deceased (8.1% vs. 1.8%). The odds of suicide death were significantly higher in males (OR = 1.79, 95% CI: 1.38–2.25), rural residents (OR = 1.43, 95% CI: 1.21–1.68), and increased with age (OR = 1.04 per year). Violent, aggressive methods and rice tablet ingestion were associated with substantially higher odds of suicide death than drug poisoning (OR = 36.7, 26.48, and 25.0, respectively). Spatial analysis identified persistent high-risk clusters in western and central counties. This study identified several individual- and area-level characteristics associated with suicide death among individuals with suicide attempts in Mazandaran Province. Higher risk was observed among men, older adults, divorced or widowed individuals, rural residents, and those with lower education. Use of highly lethal methods, especially hanging and aluminum phosphide ingestion, contributed substantially to fatalities. Spatial analysis identified high-risk clusters in the central and western districts, coinciding with areas of seasonal population influx. These findings emphasize the importance of context-specific, spatio-temporal prevention strategies, including limiting access to lethal means and strengthening mental health services.",
  "abstract_shown": true,
  "affiliations": [
    "Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences",
    "Health Sciences Research Center, Mazandaran University of Medical Sciences",
    "Mental Health Department, Deputy of Health of Mazandaran, University of Medical Sciences",
    "Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences",
    "Psychosomatic Research Center, Faculty of Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences",
    "Preventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Psychosocial Health Research Institute, Iran University of Medical Sciences",
    "Department of Community Medicine, School of Medicine, Mazandaran University of Medical Sciences"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Eisa Nazar"
    },
    {
      "affs": [
        1
      ],
      "name": "Mehran Asadi-Aliabadi"
    },
    {
      "affs": [
        2
      ],
      "name": "Somayeh Taghavi"
    },
    {
      "affs": [
        3
      ],
      "name": "Sara Eslami"
    },
    {
      "affs": [
        3
      ],
      "name": "Moozhan Mofidi"
    },
    {
      "affs": [
        2
      ],
      "name": "Mahmoud Reza Hashemvarzi"
    },
    {
      "affs": [
        4
      ],
      "name": "Mahmood Moosazadeh"
    },
    {
      "affs": [
        5
      ],
      "name": "Ebrahim Babaee"
    },
    {
      "affs": [
        6
      ],
      "name": "Abbas Alipour"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/08c07457r1wgc.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-65519-z",
  "fulltext_url": "https://doi.org/10.1038/s41598-026-65519-z",
  "id": "08c07457r1wgc",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://doi.org/10.1038/s41598-026-65519-z",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "Q"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "3203|Suicide and Self-Harm Studies"
    ]
  ],
  "openalex": "W7172393870",
  "pdf_url": "https://www.nature.com/articles/s41598-026-65519-z_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-01",
  "publisher": "Nature Portfolio",
  "ris": "https://research.draconitic.com/paper/08c07457r1wgc.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T14:21:19Z",
      "native_id": "0756eae6aae14620a7450ac75b6c7367",
      "source": "doaj",
      "url": "https://doi.org/10.1038/s41598-026-65519-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Suicide and Self-Harm Studies",
      "subfield": "psychiatry"
    }
  ],
  "title": "Spatial patterns and factors associated with suicide death among individuals with suicide attempts in northern Iran",
  "title_text": "Spatial patterns and factors associated with suicide death among individuals with suicide attempts in northern Iran",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T14:20:45Z",
  "url": "https://research.draconitic.com/paper/08c07457r1wgc",
  "venue": "Scientific Reports",
  "versions": []
}