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Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review

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  • Li, Zhuoyang
  • Page, Andrew
  • Martin, Graham
  • Taylor, Richard

Abstract

The overall importance of a risk factor for suicide in a population is determined not only by the relative risk (RR) of suicide but also the prevalence of the risk factor in the population, which can be combined with the RR to calculate the population attributable risk (PAR). This study compares risk factors from two well studied domains of suicide research - socio-economic deprivation (relatively low RR, but high population prevalence) and mental disorders (relatively high RR risk, but low population prevalence). RR and PAR associated with suicide was estimated for high prevalence ICD-10/DSM-IV psychiatric disorders and measures of socio-economic status (SES) from individual-level, population-based studies. A systematic review and meta-analysis was conducted of population-based case-control and cohort studies of suicide where relative risk estimates for males and females could be extracted. RR for any mental disorder was 7.5 (6.2-9.0) for males and 11.7 (9.7-14.1) for females, compared to RR for the lowest SES groups of 2.1 (1.5-2.8) for males and 1.5 (1.2-1.9) for females. PAR in males for low educational achievement (41%, range 19-47%) and low occupational status (33%, range 21-42%) was of a similar magnitude to affective disorders (26%, range 7-45%) and substance use disorders (9%, range 5-24%). Similarly in females the PAR for low educational achievement (20%, range 19-22%) was of a similar magnitude to affective disorders (32%, range 19-67%), substance use disorder (25%, range 5-32%) and anxiety disorder (12%, range 6-22%). The findings of the present study suggest that prevention strategies which focus on lower socio-economic strata (more distal risk factors) have the potential to have similar population-level effects as strategies which target more proximal psychiatric risk factors in the prevention and control of suicide.

Suggested Citation

  • Li, Zhuoyang & Page, Andrew & Martin, Graham & Taylor, Richard, 2011. "Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review," Social Science & Medicine, Elsevier, vol. 72(4), pages 608-616, February.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:4:p:608-616
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    References listed on IDEAS

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    1. Taylor, Richard & Page, Andrew & Morrell, Stephen & Harrison, James & Carter, Greg, 2005. "Mental health and socio-economic variations in Australian suicide," Social Science & Medicine, Elsevier, vol. 61(7), pages 1551-1559, October.
    2. Cubbin, C. & LeClere, F.B. & Smith, G.S., 2000. "Socioeconomic status and the occurrence of fatal and nonfatal injury in the United States," American Journal of Public Health, American Public Health Association, vol. 90(1), pages 70-77.
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    1. Wen-Chao Zhang & Cun-Xian Jia & Ji-Yu Zhang & Lin-Lin Wang & Xian-Chen Liu, 2015. "Negative Life Events and Attempted Suicide in Rural China," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-12, January.
    2. Liu, Juncai & Zhang, Xuanyu & Chen, Qi & Li, Shixian & Lu, Xuehua & Ran, Guangming & Zhang, Qi, 2024. "The association between family socioeconomic status and suicide ideation among adolescent: A conditional process model," Children and Youth Services Review, Elsevier, vol. 160(C).
    3. Jakobsen, Andreas Lindegaard & Lund, Rolf Lyneborg, 2022. "Neighborhood social context and suicide mortality: A multilevel register-based 5-year follow-up study of 2.7 million individuals," Social Science & Medicine, Elsevier, vol. 311(C).
    4. Justin T. Denney & Tim Wadsworth & Richard G. Rogers & Fred C. Pampel, 2015. "Suicide in the City: Do Characteristics of Place Really Influence Risk?," Social Science Quarterly, Southwestern Social Science Association, vol. 96(2), pages 313-329, June.
    5. Daiane Borges Machado & Davide Rasella & Darci Neves dos Santos, 2015. "Impact of Income Inequality and Other Social Determinants on Suicide Rate in Brazil," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-12, April.
    6. Hagedoorn, Paulien & Helbich, Marco, 2022. "Longitudinal effects of physical and social neighbourhood change on suicide mortality: A full population cohort study among movers and non-movers in the Netherlands," Social Science & Medicine, Elsevier, vol. 294(C).
    7. Li Ping Wong & Haridah Alias & Afiqah Alyaa Md Fuzi & Intan Sofia Omar & Azmawaty Mohamad Nor & Maw Pin Tan & Diana Lea Baranovich & Che Zarrina Saari & Sareena Hanim Hamzah & Ku Wing Cheong & Chiew H, 2021. "Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-14, March.
    8. Allison Milner & Andrew Page & Anthony D LaMontagne, 2013. "Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-6, January.
    9. Lorena Cecilia López Steinmetz & Romina Lucrecia López Steinmetz & Juan Carlos Godoy, 2020. "Is unemployment less important than expected for suicide attempted in developing regions? Occupational profile of suicide attempts in Jujuy, north westernmost Argentina," International Journal of Social Psychiatry, , vol. 66(1), pages 67-75, February.
    10. Anna Oksuzyan & Sven Drefahl & Jennifer Caputo & Siddartha Aradhya, 2023. "Is it Better to Intermarry? Immigration Background of Married Couples and Suicide Risk Among Native-Born and Migrant Persons in Sweden," European Journal of Population, Springer;European Association for Population Studies, vol. 39(1), pages 1-26, December.
    11. Saito, Masashige & Watanabe, Ryota & Tamada, Yudai & Takeuchi, Kenji & Tani, Yukako & Kondo, Katsunori & Ojima, Toshiyuki, 2024. "Social disconnection and suicide mortality among Japanese older adults: A seven-year follow-up study," Social Science & Medicine, Elsevier, vol. 347(C).

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