Mental health and socio-economic variations in Australian suicide
Mental health and socio-economic variations in Australian suicide
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DOI：
10.1016/j.socscimed.2005.02.009
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发表时间：
2005-10-01
影响因子：
5.4
通讯作者：
Carter, G
中科院分区：
文献类型：
--
作者：
Taylor, R;Page, A;Carter, G
本文调查了自杀率与精神障碍和自杀企图患病率之间的关系，基于居住地区的社会经济地位（SES）组。对澳大利亚自杀数据（1996-1998年）进行了分析，并结合全国心理健康和福祉调查（1997年）得出的基于地区的精神障碍患病率。自杀风险的泊松回归模型包括年龄、基于地区的SES的五分位数、城乡居住地和出生国（COB），男性和女性分别进行分析。分析的重点是自杀和（ICD-10）情感障碍，焦虑症，物质使用障碍和自杀未遂的SES组的患病率之间的关联。其他精神疾病的患病率，物质使用问题，卫生服务的利用，紧张的生活事件和personality.Significant增加梯度明显从高到低SES组的情感障碍，焦虑症（女性），物质使用障碍（男性）的患病率;阈下药物和酒精问题和抑郁症;和自杀企图和自杀（男性）。精神障碍的患病率，其他阈值以下的心理健康项目和自杀企图与自杀显着相关，但在大多数情况下，相关性的幅度降低，并成为统计学上不显着调整后的COB，城乡居住，和SES。对于男性自杀，SES最低组与SES最高组相比，所有年龄段的相对风险（RR）为1.40（95%CI 1.29-1.52，p < 0.001），男性青年（20-34岁）为1.46（95%CI 1.27-1.67，p < 0.001）。当回归模型包括情感障碍的患病率和其他选定的心理健康变量和人口统计学factors.From一个人口的角度来看，这种关系并没有实质性的修改在男性中，SES仍然显着相关的自杀后，控制精神障碍和其他精神疾病的患病率。精神状况和自杀行为可能在SES和自杀之间起中介作用，但本研究表明，自杀和SES之间也存在独立的关系。(c)2005爱思唯尔有限公司保留所有权利。
This paper investigates the relationship between suicide rates and prevalence of mental disorder and suicide attempts, across socio-economic status (SES) groups based on area of residence. Australian suicide data (1996-1998) were analysed in conjunction with area-based prevalences of mental disorder derived from the National Survey of Mental Health and Well-Being (1997). Poisson regression models of suicide risk included age, quintile of area-based SES, urban-rural residence, and country of birth (COB), with males and females analysed separately. Analysis focussed on the association between suicide and prevalences of (ICD-10) affective disorders, anxiety disorders, substance use disorders and suicide attempts by SES group. Prevalences of other psychiatric symptomatology, substance use problems, health service utilisation, stressful life-events and personality were also investigated.Significant increasing gradients were evident from high to low SES groups for prevalences of affective disorders, anxiety disorders (females only), and substance use disorders (males only); sub-threshold drug and alcohol problems and depression; and suicide attempts and suicide (males only). Prevalences of mental disorder, other sub-threshold mental health items and suicide attempts were significantly associated with suicide, but in most cases associations were reduced in magnitude and became statistically non-significant after adjustment for COB, urban-rural residence, and SES. For male suicide the relative risk (RR) in the lowest SES group compared to the highest was 1.40 (95% CI 1.29-1.52, p < 0.001) for all ages, and 1.46 (95% CI 1.27-1.67, p < 0.001) for male youth (20-34 years). This relationship was not substantially modified in males when regression models included prevalences of affective disorders, and other selected mental health variables and demographic factors.From a population perspective, SES remained significantly associated with suicide after controlling for the prevalence of mental disorders and other psychiatric symptomatology. Mental conditions and previous suicidal behaviour may play an intermediary role between SES and suicide, but this study suggests that an independent relationship between suicide and SES also exists. (c) 2005 Elsevier Ltd. All rights reserved.