Why are suicide rates rising in young men but falling in the elderly? a time-series analysis of trends in England and Wales 1950-1998
Why are suicide rates rising in young men but falling in the elderly? a time-series analysis of trends in England and Wales 1950-1998
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DOI：
10.1016/s0277-9536(02)00408-2
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发表时间：
2003-08-01
影响因子：
5.4
通讯作者：
Frankel, S
中科院分区：
文献类型：
--
作者：
Gunnell, D;Middleton, N;Frankel, S
1950 年至 1998 年间，英格兰和威尔士 45 岁以下男性的自杀率翻了一番，相比之下，所有年龄段的老年男性和女性的自杀率均有所下降。对这些不同趋势的解释很大程度上是推测性的，但社会变化可能发挥了重要作用。我们使用常规可用的特定年龄和性别的自杀、社会、经济和健康数据进行了时间序列分析，重点关注趋势差异最大的两个年龄组——25-34 岁和 60 岁以上。 1950 年至 1998 年间，许多自杀危险因素出现了不利的趋势：离婚、失业和药物滥用的上升，以及出生和结婚的下降。在经济繁荣加剧的同时，收入不平等也在加剧。两个年龄性别组的自杀危险因素趋势总体相似，尽管离婚率和药物滥用标志物的上升在 25-34 岁人群中最为显着，而年轻男性的抗抑郁药物处方增幅最低。统计模型表明，没有任何单一因素可以被确定为近期趋势的潜在因素。与年轻男性自杀率上升最相关的因素是离婚率上升、结婚率下降和收入不平等加剧。这些变化对年轻女性的自杀影响不大。这可能是因为通常过量服用的药物（他们最喜欢的自杀方法）的毒性已经降低，或者因为它们受男性自杀率上升的潜在因素的影响较小。在老年人中，自杀率的下降与国内生产总值、女性劳动力规模、婚姻和抗抑郁药处方的增加有关。最近的人口自杀趋势似乎与一系列社会和健康相关因素有关。观察到的某些模式可能是由于社会融合水平下降造成的，但这种影响似乎并未对老一代人的模式产生不利影响。 (C) 2002 Elsevier Science Ltd. 保留所有权利。
Suicide rates doubled in males aged < 45 in England and Wales between 1950 and 1998, in contrast rates declined in older males and females of all ages. Explanations for these divergent trends are largely speculative, but social changes are likely to have played an important role. We undertook a time-series analysis using routinely available age- and sex-specific suicide, social, economic and health data, focussing on the two age groups in which trends have diverged most-25-34 and 60 + year olds. Between 1950 and 1998 there were unfavourable trends in many of the risk factors for suicide: rises in divorce, unemployment and substance misuse and declines in births and marriage. Whilst economic prosperity has increased, so too has income inequality. Trends in suicide risk factors were generally similar in both age-sex groups, although the rises in divorce and markers of substance misuse were most marked in 25-34 year olds and young males experienced the lowest rise in antidepressant prescribing. Statistical modelling indicates that no single factor can be identified as underlying recent trends. The factors most consistently associated with the rises in young male suicide are increases in divorce, declines in marriage and increases in income inequality. These changes have had little effect on suicide in young females. This may be because the drugs commonly used in overdose-their favoured method of suicide-have become less toxic or because they are less affected by the factors underlying the rise in male suicide. In older people declines in suicide were associated with increases in gross domestic product, the size of the female workforce, marriage and the prescribing of antidepressants. Recent population trends in suicide appear to be associated with by a range of social and health related factors. It is possible that some of the patterns observed are due to declining levels of social integration, but such effects do not appear to have adversely influenced patterns in older generations. (C) 2002 Elsevier Science Ltd. All rights reserved.