Deaths were identified by next of kin or postal authorities, or by searching the National Death Index. At least 98% of deaths among the study participants were identified (Rich-Edwards et al. 1994). Physicians reviewed death certificates to classify individual causes of death. The end point of this study comprised all death cases of suicide and self-inflicted injuries (Eighth Revision International Classification of Diseases [ICD] codes E950 to E959) (US Dept of Health, Education, and Welfare 1963). Suicide might refer to several terminologies, e.g. behavior, ideation, plan, attempt, and completed suicide. In this study, the term “suicide” refer to death or completed suicide and "suicidal behaviors" for nonfatal suicidal thought, ideation, plan, and/or attempt.
