{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T10:34:55Z","timestamp":1792924495527,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Suffocation, strangulation, and hanging are among the deadly forms of intentional self\u2010harm, which is a serious global public health issue. These types of self\u2010harm frequently have high fatality rates and greatly increase the United States\u2019 suicide burden. Analyzing trends over time is essential for noticing evolving patterns, directing preventative measures, and developing successful policy interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      To assess mortality data from the Centers for Disease Control and Prevention Wide\u2010ranging Online Data for Epidemiologic Research (CDC WONDER), ICD\u201010 codes for intentional self\u2010harm by hanging, strangulation, and suffocation (X70) were utilized. Age\u2010adjusted mortality rates (AAMRs) were considered for analysis. Trends were assessed using the joinpoint regression software, and\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05 was deemed statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall AAMR per 100,000 rose from 2.41 in 1999 to 4.57 in 2023, peaking at 5.28 in 2018. Men, young adults, and Non\u2010Hispanic Whites had disproportionately higher AAMR, with Hawaii, South Dakota, and New Mexico showing the highest rates. Rural areas and the West and Midwest regions experienced the greatest mortality burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Targeted mental health policy and resource allocation in vulnerable communities are necessary in light of these disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71838","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:03:43Z","timestamp":1792134223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A 25\u2010Year Nationwide Analysis of Mortality Trends due to Intentional Self\u2010Harm by Hanging, Strangulation, and Suffocation"],"prefix":"10.1002","volume":"16","author":[{"given":"Sarim Hassan","family":"Shahab","sequence":"first","affiliation":[{"name":"Department of Psychiatry Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad Ahmed","family":"Idrees","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddique","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa","family":"Rafique","sequence":"additional","affiliation":[{"name":"Department of Epidemiology FMH College of Medicine and Dentistry  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muddassir","family":"Khalid","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Segawa","sequence":"additional","affiliation":[{"name":"Department of Public Health Makerere University College of Health Sciences, Kampala  Central Region Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcrp.2025.200404"},{"key":"e_1_2_11_3_1","first-page":"1","article-title":"Age Standardization of Death Rates: Implementation of the Year 2000 Standard","volume":"47","author":"Anderson R. 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