1
|
Øien-Ødegaard C, Hauge LJ, Stene-Larsen K, Christiansen STG, Bjertness E, Reneflot A. Widening the knowledge of non-employment as a risk factor for suicide: a Norwegian register-based population study. BMC Public Health 2023; 23:1181. [PMID: 37337178 DOI: 10.1186/s12889-023-16084-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/08/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND There is a known association between employment status and suicide risk. However, both reason for non-employment and the duration affects the relationship. These factors are investigated to a lesser extent. About one third of the Norwegian working age population are not currently employed. Due to the share size of this population even a small increase in suicide risk is of importance, and hence increased knowledge about this group is needed. METHODS We used discrete time event history analysis to examine the relationship between suicide risk and non-employment due to either unemployment or health-problems, and the duration of these non-employment periods. We analyze data from the Norwegian population registry from 2004 to 2014, which includes all Norwegian residents in the ages 19-58 born between 1952 and 1989. In total the data consists of 1 063 052 men and 1 024 238 women, and 2 039 suicides. RESULTS The suicide risk among the non-employed men and women is significantly higher than that of the employed. For the unemployed men, the suicide risk is significantly higher than the employed within the first 18 months. For the unemployed women we only find a significant association with suicide risk among those unemployed for six to twelve months. The suicide risk is especially increased among those with temporary health-related benefits. In the second year of health-related non-employment men have eightfold and women over twelvefold the OR for suicide, compared to the employed. CONCLUSION There is an association between non-employment and suicide risk. Compared to the employed both unemployed men and men and women with health-related non-employment have elevated suicide risk, and the duration of non-employment may be the driving force. Considering the large share of the working age population that are not employed, non-employment status should be considered in suicide risk assessment by health care professionals and welfare providers.
Collapse
Affiliation(s)
- Carine Øien-Ødegaard
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Lars Johan Hauge
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Stene-Larsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Espen Bjertness
- Department of Community Medicine and Global Health (Department of Health and Society), University of Oslo, Oslo, Norway
| | - Anne Reneflot
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
2
|
Stoychev K, Dimitrova E, Nakov V, Stoimenova-Popova M, Chumpalova P, Veleva I, Mineva-Dimitrova E, Dekov D. Socio-Demographic and Clinical Characteristics of Psychiatric Patients Who Have Committed Suicide: Analysis of Bulgarian Regional Suicidal Registry for 10 Years. Front Psychiatry 2021; 12:665154. [PMID: 34489748 PMCID: PMC8417357 DOI: 10.3389/fpsyt.2021.665154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Suicide is a major public health problem but factors determining suicide risk are still unclear. Studies in this field in Bulgaria are limited, especially on a regional level. Methods: By a cross-sectional design, we accessed the medical records of all psychiatric patients committed suicide over a 10-year period (2009-2018) in one major administrative region of Bulgaria. A statistical analysis was performed of the association between age of suicide as an indirect yet measurable expression of the underlying suicidal diathesis and a number of socio-demographic and clinical characteristics. Results: Seventy-seven of 281 suicides (28%) had psychiatric records. Most common diagnoses were mood disorders (44%), followed by schizophrenia (27%), anxiety disorders (10%), substance use disorders (9%) and organic conditions (8%). Male gender, single/divorced marital status, early illness onset, co-occurring substance misuse and lower educational attainment (for patients aged below 70) were significantly associated with earlier age of suicide whereas past suicide attempts and psychiatric hospitalizations, comorbid somatic conditions and unemployment showed insignificant association. Substantial proportion of patients (60%) had contacted psychiatric service in the year preceding suicide, with nearly half of these encounters being within 30 days of the accident. Conclusion: Severe mental disorders are major suicide risk factor with additional contribution of certain socio-demographic and illness-related characteristics. Monitoring for suicidality must be constant in chronic psychiatric patients. Registration of suicide cases in Bulgaria needs improvement in terms of information concerning mental health. More studies with larger samples and longitudinal design are needed to further elucidate distal and proximal suicide risk factors.
Collapse
Affiliation(s)
- Kalyan Stoychev
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Emilia Dimitrova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Vladimir Nakov
- Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Maya Stoimenova-Popova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Petranka Chumpalova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Ivanka Veleva
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | | | - Dancho Dekov
- Deparment of General Medicine, Forensic Medicine, and Deontology, Medical University Pleven, Pleven, Bulgaria
| |
Collapse
|
3
|
Ahn J, Kim NS, Lee BK, Park J, Kim Y. Comparison of the physical and mental health problems of unemployed with employees in South Korea. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:163-172. [PMID: 32576100 DOI: 10.1080/19338244.2020.1783503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study compared the physical and mental health problems of adults with standard and nonstandard employment with those who were unemployed. We used data from the Korean National Health and Nutrition Examination Survey to compare adult males and females with standard and nonstandard employment with those who were unemployed. Relative to adults with standard employment, higher proportions of unemployed individuals were women, older, had low monthly incomes, and had mental health problems. Compared to men and women with standard employment, unemployed men and women had greater risk of reporting depressive feelings (OR = 1.683, 95% CI = 1.298-2.183; OR = 1.419, 95% CI = 1.179-1.709) and suicidal ideation (OR = 2.218, 95% CI = 1.682-2.928; OR = 1.250, 95% CI = 1.020-1.530). Among workers with nonstandard employment, there were gender differences in the risk for arthritis. Unemployed individuals also had a higher risk of mental health problems than nonstandard workers. In conclusion, the unemployed were more vulnerable to mental health problems.
Collapse
Affiliation(s)
- Jaeouk Ahn
- Department of Medical IT Engineering, College of Medical Sciences, Soonchunhyang University, Asan, South Korea
| | - Nam-Soo Kim
- Institute of Occupational and Environmental Medicine, Soonchunhyang University, Asan, South Korea
| | - Byung-Kook Lee
- Department of Preventive Medicine, Soonchunhyang University, South Korea
| | - Jungsun Park
- Department of Occupational Health, Daegu Catholic University, Gyeongsan, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| |
Collapse
|
4
|
Thibodeau L, Lachaud J. Impact of economic fluctuations on suicide mortality in Canada (1926-2008): Testing the Durkheim, Ginsberg, and Henry and Short theories. DEATH STUDIES 2016; 40:305-315. [PMID: 26765836 DOI: 10.1080/07481187.2015.1133727] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Three theories have been proposed to explain the relationship between suicide and economic fluctuations, including the Durkheim (nonlinear), Ginsberg (procyclical), and Henry and Short (countercyclical) theories. This study tested the effect of economic fluctuations, measured by unemployment rate, on suicide rates in Canada from 1926 to 2008. Autoregressive integrated moving average time-series models were used. The results showed a significant relationship between suicide and economic fluctuation; this association was positive during the contraction period (1926-1950) and negative in the period of economic expansion (1951-1973). Males and females showed differential effects in the period of moderate unemployment (1974-2008). In addition, the suicide rate of mid-adults (45-64) was most impacted by economic fluctuations. Our study tends to support Durkheim's theory and suggests the need for public health responses in times of economic contraction and expansion.
Collapse
Affiliation(s)
- Lise Thibodeau
- a Division of Clinical Epidemiology, Department of Medicine , McGill University, and Research Institute of the McGill University Health Centre (RI-MUHC) , Montreal , Quebec , Canada
| | - James Lachaud
- b Dalla Lana School of Public Health , University of Toronto , Toronto , Ontario , Canada
| |
Collapse
|
5
|
Encrenaz G, Miras A, Contrand B, Séguin M, Moulki M, Queinec R, René JS, Fériot A, Mougin M, Bonfils M, Marien P, Michel G, Lagarde E. [Suicide among the French National Police forces: Implication of life events and life trajectories]. Encephale 2015; 42:304-13. [PMID: 26452434 DOI: 10.1016/j.encep.2015.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/20/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Research indicates that suicide rates are high among members of law enforcement. Our objectives were: (1) to determine life events implicated in suicide mortality among French law enforcement; and (2) to describe the different life trajectories of police officers who deceased by suicide. METHODS All suicides of police officers which occurred during 2008 (n=49) were explored using the psychological autopsy method. Key informants were: a supervisor, a colleague and a member of the family or a close friend. Each of them were interviewed by trained psychologists using standardized questionnaires exploring: sociodemographic characteristics, life events, social integration and support, health service use, mental health with the Composite International Diagnostic Interview short form (CIDI-SF), occupational stress with the Spielberger Inventory, impulsiveness with the Barratt Impulsiveness Scale and aggressiveness with the Brown-Goodwin Lifetime Aggression Scale. Information was then summarized in a timetable life trajectory of all life areas. All cases were finally appraised by at least two experts in order to identify the determinants of the suicide and to determine psychiatric diagnoses. For each period of time, a burdensomeness score was determined, from 6 (no adversity) to 1 (adversities in each sphere of life). RESULTS Of the 49 cases of suicide, two were excluded and 39 were investigated and appraised (response rate: 39/47=83%). Eighty-two percent of the suicide cases were men and the mean age at death was 35years. In more than half of the cases, police officers used their service weapon to commit suicide. All deceased police officers were suffering from mental health symptoms (primarily depression). Of them, two thirds had used healthcare for this distress. The main other cause of suicide was problems in the married life (70% of the cases). Four distinct types of life trajectories of adversities could be identified by a qualitative analysis. DISCUSSION It is the first time such a study was performed in France, and results are concordant with those of the literature. This study showed that all deceased police officers were suffering from mental disorders and that there was not one single profile of life trajectory: screening and support of police officers in distress need to be prioritized. Moreover, results suggested that the availability of the service weapon during off-duty periods should be reconsidered. This study helped the Home ministry to elaborate and improve strategies to prevent suicide among police officers.
Collapse
Affiliation(s)
- G Encrenaz
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France; COMPTRASEC UMR 5114 CNRS, université de Bordeaux, avenue Léon-Duguit, 33608 Pessac, France.
| | - A Miras
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - B Contrand
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - M Séguin
- Université du Québec en Outaouais et groupe McGill d'étude sur le suicide, institut universitaire Douglas, Canada
| | - M Moulki
- Pôle 347, unité Régis, centre hospitalier Charles-Perrens, 33000 Bordeaux, France
| | - R Queinec
- Centre hospitalier de Cadillac, 33410 Cadillac, France
| | - J-S René
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - A Fériot
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - M Mougin
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - M Bonfils
- Association Entr'Actes, 92700 Colombes, France
| | - P Marien
- Laboratoire EA psychologie, santé et qualité de vie, université de Bordeaux, 33000 Bordeaux, France
| | - G Michel
- Laboratoire EA psychologie, santé et qualité de vie, université de Bordeaux, 33000 Bordeaux, France
| | - E Lagarde
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| |
Collapse
|
6
|
Extremera N, Rey L. Health-related quality of life and cognitive emotion regulation strategies in the unemployed: a cross-sectional survey. Health Qual Life Outcomes 2014; 12:172. [PMID: 25432102 PMCID: PMC4263041 DOI: 10.1186/s12955-014-0172-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 11/14/2014] [Indexed: 11/13/2022] Open
Abstract
Background The loss of one’s job has been conceptualized as a major stressful life event in an adult’s life and has consistently been associated with lower health-related quality of life (HRQoL). The role of cognitive emotion regulation strategies after the experience of stressful events has emerged as an important predictor of adverse psychological and health outcomes. However, the effect of these coping strategies on the HRQoL of unemployed people has not been examined until now. We aimed to study the associations of these cognitive emotion regulation strategies on HRQoL of unemployed people. Methods Using cross-sectional data, 1,125 unemployed adults were assessed using a Cognitive Emotion Regulation Questionnaire for cognitive coping and SF-12 to assess HRQoL. We studied the effect of cognitive emotion regulation strategies on mental and physical health composite separately, adjusting for gender, age, educational level and length of unemployment, using hierarchical regression analyses. Results Results showed unemployed men tended to express greater use of self-blame, other-blame, and catastrophizing, and lower use of perspective taking strategies when confronted with unemployment. Moreover, self-blame (for mental health composite only), blaming others, rumination, and catastrophizing negatively correlated, while positive reappraisal, putting into perspective, planning, and positive refocusing positively correlated with both mental and physical health composite in unemployed people. Further hierarchical regression analyses indicate that five strategies (a lower reported use of self-blame, rumination, and catastrophizing, as well as higher scores of positive reappraisal and positive refocusing) and three strategies (lower scores of catastrophizing and rumination and high scores in planning) have significant and independent contributions, beyond gender, age, educational level and length of unemployment, to the prediction of mental health and physical health composite, respectively. Conclusions Cognitive emotion regulation strategies appeared to be significantly correlated with HRQoL in unemployed people. Our findings suggest the potential value of including assistance programs focused on cognitive emotion regulation strategies to complement current psychosocial and health approaches aimed at preserving or improving unemployed people’s HRQoL.
Collapse
Affiliation(s)
- Natalio Extremera
- Department of Social Psychology, Faculty of Psychology, University of Malaga, Campus de Teatinos s/n. Málaga, 29071, Malaga, Spain.
| | - Lourdes Rey
- Department of Personality, Evaluation and Psychological Treatment, University of Malaga, Malaga, Spain.
| |
Collapse
|
7
|
Bando DH, Lester D. An ecological study on suicide and homicide in Brazil. CIENCIA & SAUDE COLETIVA 2014; 19:1179-89. [DOI: 10.1590/1413-81232014194.00472013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 07/27/2013] [Indexed: 08/30/2023] Open
Abstract
The objective was to evaluate correlations between suicide, homicide and socio-demographic variables by an ecological study. Mortality and socio-demographic data were collected from official records of the Ministry of Health and IBGE (2010), aggregated by state (27). The data were analyzed using correlation techniques, factor analysis, principal component analysis with a varimax rotation and multiple linear regression. Suicide age-adjusted rates for the total population, men and women were 5.0, 8.0, and 2.2 per 100,000 inhabitants respectively. The suicide rates ranged from 2.7 in Pará to 9.1 in Rio Grande do Sul. Homicide for the total population, men and women were 27.2, 50.8, and 4.5 per 100,000, respectively. The homicide rates ranged from 13.0 in Santa Catarina to 68.9 in Alagoas. Suicide and homicide were negatively associated, the significance persisted among men. Unemployment was negatively correlated with suicide and positively with homicide. Different socio-demographic variables were found to correlate with suicide and homicide in the regressions. Suicide showed a pattern suggesting that, in Brazil, it is related to high socioeconomic status. Homicide seemed to follow the pattern found in other countries, associated with lower social and economic status.
Collapse
|
8
|
Gallagher LM, Kliem C, Beautrais AL, Stallones L. Suicide and Occupation in New Zealand, 2001–2005. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 14:45-50. [DOI: 10.1179/oeh.2008.14.1.45] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
9
|
Economic fluctuations and suicide: A comparison of Taiwan and Hong Kong. Soc Sci Med 2010; 71:2083-90. [DOI: 10.1016/j.socscimed.2010.09.043] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 07/05/2010] [Accepted: 09/28/2010] [Indexed: 11/21/2022]
|
10
|
Andersson L, Allebeck P, Gustafsson JE, Gunnell D. Association of IQ scores and school achievement with suicide in a 40-year follow-up of a Swedish cohort. Acta Psychiatr Scand 2008; 118:99-105. [PMID: 18331576 DOI: 10.1111/j.1600-0447.2008.01171.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Few studies have investigated the association of childhood IQ and school achievement with suicide. The aim of this study was to investigate the association of childhood IQ with suicide in a cohort of Swedish women and men. METHOD 21 809 subjects born in 1948 and 1953 who completed IQ and school tests at age 13 years have been followed until 2003. Information on paternal education and in-patient care for psychosis was linked using the Swedish personal identification number. RESULTS There were 180 suicides amongst subjects with measured IQ. High IQ was associated with reduced suicide risk among men (OR per unit increase in age-adjusted model 0.90, 95% CI 0.83-0.99), while there was no statistical evidence of an association in women (OR 1.04, 95% CI 0.90-1.20). Among men with a history of psychosis, high IQ was associated with an increased risk of suicide. CONCLUSION Low childhood IQ at age 13 years is associated with an increased risk of suicide in men but not in women; however, amongst those with psychosis, low IQ appears to be protective.
Collapse
Affiliation(s)
- L Andersson
- Department of Public Health and Community Medicine, Social Medicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
| | | | | | | |
Collapse
|
11
|
Abstract
OBJECTIVE To compare well established antecedents and correlates of completed suicide with the motives and the mechanics reported in Greek mythology. METHOD A well-known collection of Greek myths, the Book of fables by Hyginus, was explored to investigate the mechanics driving an individual to imagine, design and carry out a suicide attempt. RESULTS Females outnumber males in the mythographer's list, their favourite methods to die being drowning, hanging, self-burning and throwing themselves down from on high. Some kind of familial recurrence of suicide was accounted for, and a large percentage of these suicides was connected to incest. Shame, sense of guilt and grief for the death of a loved one are the most frequently reported psychological correlates of the act, whereas defeat, failure or a catastrophic change in living conditions and, among females, an unfortunate love affair figure as the main antecedents of suicide. CONCLUSION Negative life events and emotional reactions to the severing of social ties frequently occur as antecedents of suicide in Greek mythology.
Collapse
Affiliation(s)
- A Preti
- Department of Psychology, University of Cagliari, Italy
| | | |
Collapse
|