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Every year, almost one million people die from suicide; a "global" mortality rate of 16 per 100,000, or one death every 40 seconds. In the last 45 years suicide rates have increased by 60% worldwide. Suicide is among the three leading causes of death among those aged 15-44 years in some countries, and the second leading cause of death in the 10-24 years age group. These figures do not include suicide attempts which are up to 20 times more frequent than actual suicides. Suicide worldwide is estimated to represent 1.8% of the total global burden of death in 1998, and 2.4% in 2002. Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a majority of countries, in both developed and developing countries. Mental disorders (particularly depression and alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries impulsiveness plays an important role. Suicide is a complex phenomenon because psychological, social, biological, cultural and environmental factors involved.