Social fragmentation, severe mental illness and suicide
Social fragmentation, severe mental illness and suicide
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DOI：
10.1007/s00127-004-0733-9
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发表时间：
2004-03-01
影响因子：
4.4
通讯作者：
Gunnell, D
中科院分区：
文献类型：
--
作者：
Evans, J;Middleton, N;Gunnell, D
背景自杀的地理模式与社会碎片化的地区水平有关。目前尚不清楚这是否反映了社会支离破碎地区严重精神疾病的水平更高。方法将1991年至1992年布里斯托尔市15岁的精神病住院和自杀的数据与该市34个选区的邮政编码进行匹配。使用负二项回归模型研究了精神病院入院(作为严重精神疾病患病率的替代指标)和自杀率与社会分裂程度的生态关联。结果社会经济贫困程度高的地区精神科住院率高于社会碎片化程度高的地区。相比之下，自杀与社会分裂的关系比社会经济上的剥夺更强。在控制精神科入院率和社会经济剥夺的模型中，自杀与社会分裂的联系仅适度减弱，社会分裂每四分位数增加的RR为1.23(95%C.I.1.09-1.38)，而调整前为1.29(95%C.I.1.16-1.44)。结论社会分裂与自杀之间的联系不能用社会经济剥夺或社会分裂地区严重精神疾病的患病率来解释。
Background Geographic patterns of suicide are associated with area levels of social fragmentation. It is unknown whether this reflects higher levels of severe mental illness in socially fragmented areas. Method Data on psychiatric inpatient admissions and suicides amongst people aged 15-64 living in the City of Bristol [1991-1992] were postcode matched to the city's 34 electoral wards. Ecological associations of psychiatric admission (used as a 'proxy' measure of prevalence of severe mental illness) and suicide rates with levels of social fragmentation were investigated using negative binomial regression models. Results Psychiatric hospital admission rates were higher in areas with high levels of socioeconomic deprivation than in areas with high levels of social fragmentation. In contrast, associations with suicide were stronger in relation to social fragmentation than socioeconomic deprivation. Association of suicide with social fragmentation was only moderately attenuated in models controlling for psychiatric admission rate and socio-economic deprivation, RR 1.23 (95% C.I. 1.09-1.38) per quartile increase in social fragmentation, compared to 1.29 (95% C.I. 1.16-1.44) before adjustment. Conclusion The association between social fragmentation and suicide is not explained by socioeconomic deprivation or the prevalence of severe mental illness within socially fragmented areas as measured by psychiatric admission rate.