Suicide in Bosnia and Herzegovina and the city of Sarajevo.

BACKGROUND Besides the war experience (1992-1995), Bosnia and Herzegovina (BiH) constitutes an interesting area for studies on suicidal behavior from an ethnic and religious perspective with its mixed ethnic population of Bosniaks, Serbs, and Croats. AIMS The study investigates suicide in BiH and the capital city of Sarajevo before (1985-1991) and after the war (1998-2006), with special reference to gender and ethnicity. METHOD Official suicide data were gathered for the two periods with regard to gender, ethnicity, and suicide methods used. RESULTS No differences in suicide rates were found in BiH and Sarajevo before and after the war. The male-to-female suicide rate ratio in BiH was significantly higher after the war than before the war, with an opposite tendency seen in Sarajevo. Before and after the war, the highest and stable suicide rates were among Serbs in BiH. In Sarajevo the highest suicide rates were found among Croats after the war. Hanging was the most common suicide method used, both before and after the war, while firearms were more commonly used after the war. Poisoning was a rarely used method in both periods. CONCLUSION The stable suicide rates in BiH over the pre- and postwar periods indicate no evident influence of the Bosnian war on the postwar level of suicide rates, except for women in Sarajevo. Beside this exception, the findings indicate a long-established underlying pattern in suicide rates that was not immediately changed, even by war. The study supports earlier findings that the accessibility of means influences the choice of suicide method used.