The association between school calendar and youth suicide in Taiwan

J Formos Med Assoc. 2025 Apr 30:S0929-6646(25)00198-6. doi: 10.1016/j.jfma.2025.04.027. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: In East Asian countries, the emphasis on academic achievement is pronounced. In recent years, rising youth suicide rates have raised concerns about a potential link to academic stress. The aim of this study was to explore the relationship between academic periods and student suicide rates.

METHODS: Data on youth suicides (ages 12-21) from Taiwan’s national cause-of-death file, spanning 2012-2022, were analyzed using Poisson regressions. The analysis was further stratified by sex and academic level.

RESULTS: Among middle/high school students, suicide rates increased at the start of the second semester and slightly decreased during the winter break. No similar decline was observed during the summer break. Among undergraduate students, suicide rates also increased after the winter break, with an additional peak before the break. Male undergraduates showed decreased suicide rates during both winter and summer breaks, while female undergraduates showed no significant calendar-linked variation.

CONCLUSIONS: The association between academic periods and suicide rates differed by academic level and sex. A potential winter break effect, coinciding with the Lunar New Year, was observed in both middle/high school and undergraduate students. In contrast, a reduction in suicide rates during summer break was observed only among undergraduates, potentially reflecting sustained academic stress among middle/high school students even during summer break. Among undergraduates, only male students exhibited variations in suicide rates in accordance with the academic calendar, while no such variation was observed among female students. No sex-specific differences were identified in the middle/high school group.

PMID:40312159 | DOI:10.1016/j.jfma.2025.04.027