Association Between the Release of Netflix's 13 Reasons Why and Suicide Rates in the United States: An Interrupted Time Series Analysis
Association Between the Release of Netflix's 13 Reasons Why and Suicide Rates in the United States: An Interrupted Time Series Analysis
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DOI：
10.1016/j.jaac.2019.04.020
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发表时间：
2020-02-01
影响因子：
13.3
通讯作者：
Campo, John, V
中科院分区：
文献类型：
--
作者：
Bridge, Jeffrey A.;Greenhouse, Joel B.;Campo, John, V
目的：估计Netflix系列13 Reasons Why的发布与美国自杀率之间的关联。方法：使用分段准泊松回归和霍尔特-温特斯预测模型，我们评估了10至64岁的个人分为3个年龄组的每月自杀率（10-17，18-29和30-64岁）在2013年1月1日和2017年12月31日之间，在2017年3月31日发布13个原因之前和之后。我们还评估了该节目的释放对控制结果的影响，杀人死亡。结果：在考虑了季节效应和每月自杀率的潜在增长趋势后，10- 17岁青少年的整体自杀率在13个原因释放后的一个月内显着增加（发病率比[IRR]，1.29; 95%CI，1.09-1.53）; Holt-Winters预测显示，相对于相应的预测率，在释放后的一个月和随后的两个月，观察到的自杀率升高。与预期相反，这些协会仅限于男孩。在18至29岁和30至64岁的人群中，我们发现，无论是整体还是性别，该剧上映后的自杀水平或趋势都没有显着变化。该节目的释放没有明显的影响，在任何年龄组内的杀人死亡的控制分析：13个原因，为什么是释放与美国青少年10至17岁之间的每月自杀率显着增加。应谨慎对待儿童和青少年对该系列的接触。
Objective: To estimate the association between the release of the Netflix series 13 Reasons Why and suicide rates in the United States.Method: Using segmented quasi-Poisson regression and Holt-Winters forecasting models, we assessed monthly rates of suicide among individuals aged 10 to 64 years grouped into 3 age categories (10-17, 18-29, and 30-64 years) between January 1, 2013, and December 31, 2017, before and after the release of 13 Reasons Why on March 31, 2017. We also assessed the impact of the show's release on a control outcome, homicide deaths.Results: After accounting for seasonal effects and an underlying increasing trend in monthly suicide rates, the overall suicide rate among 10- to 17-year-olds increased significantly in the month immediately following the release of 13 Reasons Why (incidence rate ratio [IRR], 1.29; 95% CI, 1.09-1.53); Holt-Winters forecasting revealed elevated observed suicide rates in the month after release and in two subsequent months, relative to corresponding forecasted rates. Contrary to expectations, these associations were restricted to boys. Among 18- to 29-year-olds and 30- to 64-year-olds, we found no significant change in level or trend of suicide after the show's release, both overall and by sex. The show's release had no apparent impact in the control analyses of homicide deaths within any age group.Conclusion: The release of 13 Reasons Why was associated with a significant increase in monthly suicide rates among US youth aged 10 to 17 years. Caution regarding the exposure of children and adolescents to the series is warranted.