Background: According to recent figures, Amsterdam is the municipality with the highest absolute number of suicides and the second highest suicide rate in the Netherlands. Aims: The aim of the study was to identify time trends and demographic differences in the occurrence of nonfatal suicide attempts versus suicides. Methods: We used registrations of forensic physicians and ambulance services of the Municipal Health Service of Amsterdam to study 1,004 suicides and 6,166 nonfatal attempts occurring in Amsterdam over the period 1996–2005. Results: The number of nonfatal attempts declined from 1996 to 2005, but the number of completed suicides remained relatively stable. Although case fatality was strongly associated with method used, we also found higher case fatalities for men and older people independent of method. Conclusions: The case fatality results suggest differences in motive among different demographic groups: possibly the wish to die is stronger among men and elderly. This finding had implications for the success to be expected from different preventive measures.
