Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences
Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences
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DOI：
10.1017/s0033291707000487
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发表时间：
2007-08-01
影响因子：
6.9
通讯作者：
Nordentoft, Merete
中科院分区：
文献类型：
--
作者：
Ager, Esben;Gunnell, David;Nordentoft, Merete
背景探讨自杀风险与职业的关系，同时评估社会经济、人口统计学和精神病学差异的影响。3195例自杀者和63900例对照者的巢式病例对照研究。死因、职业、精神病入院、婚姻状况和社会经济因素等信息均来自常规登记。在调查的55个职业中，与小学教师相比，医生的自杀风险为2.73 [95%置信区间（CI）1.77-4.22]，建筑师和工程师为0.44（95% CI 0.27-0.72）。除了医生和护士之外，大多数与特定职业相关的自杀风险过高都是由这些职业的社会和经济特征所解释的。医生和护士中的大部分（但不是全部）过度风险是由于他们越来越多地使用自我中毒，这是一种他们有知识有效使用的方法。职业与精神病患者自杀的相关性很小，但医生除外，其超额风险为3.62（p = 0.007）。除了医生和护士之外，不同职业之间自杀风险的显著差异大多可以用社会经济因素来解释。除了医生之外，精神病患者的自杀风险与职业几乎没有联系。限制获得致命手段是预防自杀的一项重要战略。
Background. To explore the risk of suicide associated with occupation while evaluating the impact of socio-economic, demographic and psychiatric differences.Method. A nested case-control study with 3195 suicides and 63 900 matched controls. Information on causes of death, occupation, psychiatric admission, marital status and socio-economic factors was obtained from routine registers.Results. Across the 55 occupations investigated, the risk of suicide ranged from 2.73 [95 % confidence interval (CI) 1.77-4.22] among doctors to 0.44 (95 % CI 0.27-0.72) among architects and engineers compared with primary school teachers. With the exception of doctors and nurses, most of the excess risk of suicide associated with particular occupations is explained by the social and economic characteristics of people in those occupations. Much, but not all, of the excess risk in doctors and nurses is due to their increased use of self-poisoning, a method for which they have the knowledge to use effectively. Occupation has little association with suicide among people who suffer from a psychiatric illness, except for doctors, where the excess risk is 3.62 (p = 0.007).Conclusions. Most of the considerable variation in suicide risk across occupations is explained by socio-economic factors, except for doctors and nurses. Apart from in doctors, the risk of suicide has little association with occupation among people who suffer from a psychiatric illness. Restriction of access to lethal means is an important strategy in suicide prevention.