A comparative analysis of suicides in Greece's main port city area of Piraeus before (2006-2010) and during (2011-2015) the country's severe economic crisis.

We investigated all cases of completed suicide in the city area of Piraeus -the largest port in Greece- for the years 2006 up to 2015. We searched, among others, parameters regarding the victims' psychiatric medication intake and drug and alcohol use that -to the best of our knowledge- had never been investigated before by a study on suicides in Greece within the crisis' years. We documented variations before (2006-2010) and during (2011-2015) crisis. Information was provided by the victims' forensic records at the Piraeus Department of Forensic Medicine. During the period of the study 435 individuals died by suicide. "Before" crisis: 227 cases, 77,1% males, mean age 48.6 years (SD:19.8), 85% Greek. "During": 208 cases, 79,8% males, mean age 51.4 years (SD:17.7), 83.2% Greek. Psychiatric medication intake: "Before"-"During": 16.3%-29.8% (p=0.003), males: 16.1%-31.7%, females: 19.6%-27.5% (p=0.003). Drug use: opioids 2.7%(5.5%), cannabis 1.4%(5.5%), cocaine 0(1.5%), alcohol 14.5%(13.4%). Significant seasonality was observed only for suicides by jumping with a peak late in the month of July in the "Before" group. There were no significant differences regarding suicide method, place of suicide or place of death. The slight decrease in suicides within the crisis' years, together with the higher medication intake observed within the same period, could imply that more individuals were willing to accept their psychological difficulties and/or to commence treatment. Probably the stigma of psychiatric illness is somewhat lower after the beginning of the crisis and/or non-psychiatrists became more aware of the psychological origins of some of their patients' problems. Our findings tentatively suggest that, as the crisis persists, adaptive mechanisms have been set in motion.