Low income, unemployment, and suicide mortality rates for middle-age persons in Japan

The relationships between age-specific suicide mortality rates and social life factors for all 47 Japanese prefectures in 1980, 1985, and 1990 were assessed by multiple regression analysis after factor analysis on 20 social life indicators. During this period, Japan experienced a secondary oil crisis in 1980-1983 and a bubble economy in 1986-1990. It was concluded that (1) low income was the major determinant which positively affected suicide mortality rate in middle-aged men during a previous 20-yr. period (1970-1990), (2) urbanization was negatively associated with male suicide mortality rates in most of the age classes in the 1980s, (3) unemployment was one of the major determinants of increased suicide mortality rate in middle-age men in the 1980s, and (4) unemployment was the major factor which was inversely associated with suicide mortality rate for elderly women from 1980 to 1990 in Japan.     

Trends and monthly variations in the historical record of suicide in Japan from 1976 to 1994

Monthly suicide rates in Japan were analyzed for the period from 1976 to 1994 to clarify trends and recurring effects. The data were separated by sex, and the least-squares method was used. The major findings were (1) a significant positive correlation between unemployment rate and suicide rate for both sexes, (2) the suicide rate was highest in April for both sexes, and (3) an upsurge in male suicide mortality was noted from 1983 to 1990. These findings may well be associated with socioeconomic factors as well as neurobehavioral variables.     

Soluble interleukin 2 receptor levels, temperament and character in formerly depressed suicide attempters compared with normal controls

An imbalance of the immune system and mixed personality profiles in suicide attempters have been reported. As suicidal behavior is common in patients with psychiatric disorders within the spectrum of depressive features, in this study we measured soluble interleukin-2 receptor concentrations in plasma (sIL-2R) and investigated temperament and character profile and their potential correlation in formerly depressed patients with a history of suicide attempt. We studied sIL-2R levels in plasma and personality characteristics (using Cloninger's Temperament and Character Inventory [TCI]) of formerly depressed patients who had attempted suicide a mean of 3 years previously (n = 25), and age and gender matched normal controls (n = 25). There was no significant difference in sIL-2R levels between formerly depressed suicide attempters and age and gender matched normal controls (0.23 ng/ml +/- 0.25 vs. 0.19 ng/ml +/- 0.16). When compared to normal controls, suicide attempt patients had a significantly higher score on the temperament dimension "harm avoidance" and a lower score on the character dimension "self-directedness." No significant correlation was found between sIL-2R values and TCI dimensions. We propose that the liability to suicidal behavior among suicide attempters susceptible to depressive symptomatology may be related to high harm avoidance and low self-directedness.     

A Durkheimian analysis of youth suicide: Canada, 1971 and 1981.

Durkheim hypothesized that suicide varies inversely with the extent of social integration in family, religious, political, and economic life. In this study I examine the relationship between three of these sources of social integration on young Canadians' (aged 15-29) suicide rate for 1971 and 1981: family integration (as measured by divorce), religious integration (as measured by the percent of the population reporting no religious affiliation), and economic anomie (unemployment). The findings of this research provide confirmation for the hypothesis that religious detachment among the young is associated with increased proneness to commit suicide. The effect of family dissolution was positive and significant for both young men and women in 1981 but not in 1971, giving partial confirmation for the family integration explanation of suicide. These results pertaining to unemployment are not consistent with the American-based literature that calls for a significant and positive impact on the odds of self-destruction.     

Development, gender equality, and suicide rates

A component of the United Nations Development Programme Human Development Index which measures longevity was negatively associated -.55 with suicide rates in 37 nations for men; the correlation with the suicide sex ratio was also negative (r = -.59). Women's access to social, political, and economic power in a subsample of 26 nations, summarized in the UNDP's Gender Empowerment Measure, was positively correlated with suicide rates (r = .36 for both women and men). UNDP measures of attainment in literacy and income showed no individual relationship with suicide rates. In a multiple regression model, life expectancy was negatively related, and the Gender-related Development index was positively related, to suicide rates.     

State IQ and suicide rates in the United States

Previous findings pertaining to the direction (positive or negative) of the ecological correlation between intelligence and suicide rates in the USA have been conflicting. Using novel state IQ estimates, derived from the Scholastic Assessment Test, the American College Test, these tests combined, or the National Assessment of Educational Progress state scores, these estimates were not consistently associated to state suicide rates. Whereas ACT-derived state IQ was significantly positively correlated with suicide rates, the correlation with composite ACT-SAT-derived state IQ was significantly negative and with both SAT-derived and NAEP-derived state IQ also negative but not significant. Validity checks pointed to possible methodological problems with the state IQ estimates. Currently available estimates of state IQ, therefore, seem not appropriate to resolve the question of the direction of the ecological correlation of intelligence and suicide mortality across the USA.     

Lesbian,gay, and bisexual suicidal behavior: testing a constructivist model

The present investigation surveyed 162 self-identified lesbian, gay, and bisexual individuals recruited from LGB-related social organizations or contacted through networking procedures with regard to suicidal behaviors, suicide risk factors, and reasons for living. Approximately 41% of the respondents indicated a serious consideration of suicide including the identification of a specific suicide plan (23%) or a past suicide attempt (36%) with significant intent to die (13%). Forty-six percent of the sample indicated at least some degree of chance of attempting suicide in the future. Grounded in the existential-constructivist theory of suicide (Rogers, 2001), empirically and theoretically identified suicide risk factors were found as a group to predict suicidal ideation (R2 = .16) and attempts (R2 = .17), with abuse-related items independently predicting both suicidal ideation (R2 = .03) and attempts (R2 = .08). Items related to self-identity issues and social acceptance were predictive of suicidal ideation (R2 = .04), while substance abuse was predictive of suicidal ideation (R2 = .05) and attempts (R2 = .13) for males only. The established factor structure of the Reasons for Living Inventory (Linehan et al., 1983) was not supported in the current data, suggesting that it may not be an appropriate measure of reasons for living with LGB individuals.     

Mortality of geriatric and younger patients with schizophrenia in the community

Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age > or = 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a Chinese rural community were compared. A 10 year follow-up investigation among a 1994 cohort (n = 510) of patients with schizophrenia was conducted in Xinjin County, Chengdu, China. Compared with young subjects, geriatric subjects with schizophrenia were more likely to be female, have more previous physical illness, never accepted treatment, and practice religious (p < or = 0.01). There were no significant differences of suicide attempts among the three groups. Young subjects had a higher rate of suicide (1,033.8 per 100,000 person-years), and geriatric subjects had a higher rate of deaths due to other causes (accident and natural causes) (4,314.2 per 100,000 person-years). Standardized mortality ratios for both suicide and deaths due to other causes were highest in young subjects and the lowest in geriatric subjects. Patients with schizophrenia in all age groups had a marked increase in mortality and suicide. Specific intervention strategies for decreasing mortality and suicide should be developed for patients with schizophrenia in different age groups.     

The Media and Suicide: A Nonadditive Model, 1968–1980

Unlike previous work, the present investigation tests a nonadditive model of the suggestion/imitation. Suicide stories are predicted to have the greatest effect on suicide in times of high suicidogenic conditions. The latter are measured in terms of unemployment. Data on the American monthly suicide rate are analyzed using Cochrane Orcutt techniques. While support was found for the nonadditive model based on an interaction effect between media stories and the rate of unemployment, it did not prove more powerful than an additive model. Future work is needed, however, for a systematic testing of the nonadditive thesis.     

Relationships of suicide ideation with cause-specific mortality in a longitudinal study of South Koreans

Using 7-year mortality follow-up data (n = 341) from the 1998 National Health and Nutrition Examination Surveys of South Korean individuals (N = 5,414), the authors found that survey participants with suicide ideation were at increased risk of suicide mortality during the follow-up period compared with those without suicide ideation. The cause-specific analyses showed that, in men, suicide ideation was significantly associated with mortality due to cardiovascular disease, external causes, and other causes. However, there was no significant association between suicide ideation and cause-specific mortality in women. The relationship between suicide ideation and cause-specific mortality in men was not fully explained by baseline health status, socioeconomic status, health behavior, or psychosocial factors.     

Economic correlates of violent death rates in forty countries, 1962–2008: A cross-typological analysis

ObjectivesOur goal was to identify if there might be advantages to combining two major public health concerns, i.e., homicides and suicides, in an analysis with well-established macro-level economic determinants, i.e., unemployment and inequality.MethodsMortality data, unemployment statistics, and inequality measures were obtained for 40 countries for the years 1962–2008. Rates of combined homicide and suicide, ratio of suicide to combined violent death, and ratio between homicide and suicide were graphed and analyzed. A fixed effects regression model was then performed for unemployment rates and Gini coefficients on homicide, suicide, and combined death rates.ResultsFor a majority of nation states, suicide comprised a substantial proportion (mean 75.51%; range 0–99%) of the combined rate of homicide and suicide. When combined, a small but significant relationship emerged between logged Gini coefficient and combined death rates (0.0066, p < 0.05), suggesting that the combined rate improves the ability to detect a significant relationship when compared to either rate measurement alone. Results were duplicated by age group, whereby combining death rates into a single measure improved statistical power, provided that the association was strong.ConclusionsViolent deaths, when combined, were associated with an increase in unemployment and an increase in Gini coefficient, creating a more robust variable. As the effects of macro-level factors (e.g., social and economic policies) on violent death rates in a population are shown to be more significant than those of micro-level influences (e.g., individual characteristics), these associations may be useful to discover. An expansion of socioeconomic variables and the inclusion of other forms of violence in future research could help elucidate long-term trends.     

Deliberate Self-Poisoning,Unemployment, and Public Health

The purpose of the present investigation was to explore further the known relationship between deliberate self-poisoning and social deprivation. Each individual who attended one of Cork city's three casualty departments following an act of deliberate self-poisoning in 1988 was examined. The place of residence (ward) of each city resident patient was established. The social status of the city's 34 wards was estimated using a number of indices obtained from the 1981 and 1986 census reports and social service records. A comparison was made between the 1988 self-poisoning rate for each ward and the rate found in a 1982 study of the city. Correlations between self-poisoning rate and seven social deprivation indices were found to be significant. Multiple regression, factor, and partial correlation analyses were carried out to examine more closely the interrelationships between the social deprivation indices. With respect to explaining the variation in the self-poisoning rate, unemployment alone performed almost as well as all of the indices together and as well as the factors derived using factor analysis. The correlation between unemployment and self-poisoning rate remained highly significant when the other related variables were controlled for. However, at fixed levels of unemployment, these variables were found to be independent of the self-poisoning rate. It is suggested that whereas clinical intervention may benefit the individual, deliberate self-poisoning as an issue requires a public health approach for its resolution.     

Positive mental health,positive affect and suicide ideation

Background/ObjectivePositive mental health (PMH) has been shown to confer resilience against suicide ideation. However, the mechanisms underlying the positive effect of PMH on suicide ideation/behavior are largely unknown. The current study aimed to determine whether positive affect mediates the association between PMH and suicide ideation.MethodA total of 150 adult outpatients (65.3%; female; age: M(SD)=37.79(13.50), range:18–77) completed measures on PMH, positive and negative affect, as well as suicide ideation. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive affect was considered to mediate the association between positive mental health and suicide ideation.ResultsWhile positive affect fully mediated the significant negative association between PMH and suicide ideation, negative affect did not reveal to be a significant mediator of this relationship.ConclusionsThe protective influence of PMH against suicide ideation is due to heightened positive affect: If positive mental health translates into positive affect, then suicide ideation becomes less likely.     

Suicide mortality of suicide attempt patients discharged from emergency room, nonsuicidal psychiatric patients discharged from emergency room, admitted suicide attempt patients, and admitted nonsuicidal psychiatric patients

The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients admitted for suicide attempt, and psychiatric inpatients admitted for other reasons were examined. The records of 3,897 patients who were treated at a general hospital in Seoul, Korea, from July 2003 to December 2006 were reviewed. Forty-three of the 3,897 subjects died by suicide during the 2.5-year observation period. Compared to the general Korean population, the suicide mortality rate was 82-fold higher for suicide attempt patients, admitted; 54-fold higher for suicide attempt patients, discharged; 21-fold higher for nonsuicidal patients, admitted; and 11-fold higher for nonsuicidal patients, discharged. In all four groups, diagnosis of a depressive disorder and suicide attempt at presentation were each significant independent risk factors for suicide completion. These results highlight the need for suicide prevention strategies for depressed patients who present to the ER or are admitted to a psychiatric ward after a suicide attempt.     

Possible relationship of elderly suicide rates with unemployment in society: a cross-national study

Analyses of individual and aggregated data have yielded an association between suicide and unemployment, particularly for men in younger age groups. Examination of the relationship of elderly suicide rates with measures of unemployment in a cross-national study of 27 countries did not produce any statistically significant association between these two variables. Also, the magnitude of the actual correlations was small. One reason for low magnitude of correlations may be better welfare systems in the studied countries which mainly reported medium and high income.     

Questions of culture,age and gender in the epidemiology of suicide

Cultural values were examined as predictors of suicide incidence rates compiled for men and women in six age groups for 33 nations for the years 1965, 1970, 1975, 1980, and 1985. Hofstede's cultural values of Power-Distance, Uncertainty Avoidance, and Masculinity (i.e., social indifference) were negative correlates of reported suicide, and Individualism was a strong positive correlate. The proportion of variance in suicide reports generally related to these four cultural values was R2 = 0.25. Suicide by women and by middle-aged people was most related to cultural values, even though international variance in suicide is greater for men and for the elderly. Suicide incidence for girls and young women showed unique negative correlations with Individualism. For all age groups, Individualism predicted a greater preponderance of male suicides, and Power-Distance predicted more similar male and female suicide rates. Social alienation and Gilligan's feminist theory of moral judgment were hypothesized to explain some gender differences.     

Prison suicides in Austria, 1975-1997

Suicide prevention in custody is hampered by the lack of funds and professional staff. In order to evaluate the prison suicide phenomenon, a study was conducted evaluating all suicides that occurred in Austrian prisons between 1975 and 1997 (n = 220). In addition to evaluating the number of male versus female suicides, the preferred suicide methods were studied, as well as suicide risk of different circumstances of custody. Suicide rates of distinguishable, important subgroups of prisoners were calculated. The suicide rate for prisoners on remand was 236.0 per 100,000, and for offenders classified as mentally ill it was 205.4 per 100,000. That is about 8 times higher than the suicide rate in Austria's general population (1975-1997: 24.6 per 100,000). The suicide rate for sentenced offenders was 81.3 per 100,000, about twice the suicide rate in Austria's general male population. We recommend that psychologists or psychiatrists concentrate on the suicide prevention of high-risk offenders after screening the newly admitted offenders for their propensity to suicide.     

The economy and suicide in Japan, 1985-2000

From 1985-2000, unemployment was the strongest correlate of Japanese suicide rates.     

The effects of changes in the World Health Organization's International Classification of Diseases on suicide rates in 71 countries, 1950-1999

The World Health Organization (WHO) provides annual mortality statistics from 1950 onward based on the International Classification of Diseases (ICD). In this paper we evaluate the effects of ICD form revisions on suicide rates for 71 countries. The changes between ICD-6, ICD-7, ICD-8, and ICD-9 did not have an overall effect on reported suicide rates. The transitions to ICD-8 and ICD-9 were, however, associated with country-specific changes in the suicide rate in some countries. The change from ICD-9 to ICD-10 was associated with an overall change of -.73 suicides per 100,000 inhabitants. It is recommended that researchers using the WHO mortality data for longitudinal cross-national studies control for the ICD form used at different time points.