Suicide in married couples in Sweden: Is the risk greater in same-sex couples?
Suicide in married couples in Sweden: Is the risk greater in same-sex couples?
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DOI：
10.1007/s10654-016-0154-6
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发表时间：
2016-07-01
影响因子：
13.6
通讯作者：
Kosidou, Kyriaki
中科院分区：
文献类型：
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作者：
Bjorkenstam, Charlotte;Andersson, Gunnar;Kosidou, Kyriaki
少数族裔的性取向是自杀意念和企图的预测指标，尽管它与自杀死亡率的关系不太清楚。我们利用瑞典广泛链接的数据库，调查在已婚人士中，同性婚姻是否与自杀有关。使用基于人群的登记设计，我们分析了瑞典同性已婚女性和男性(n=6456)和不同性别已婚女性和男性(n=1181723)的自杀风险。我们选择了1996年1月1日至2009年12月31日之间的所有新伴侣或已婚人士，并跟踪他们的自杀情况，直到2011年12月31日。采用多元Poisson回归计算调整后的发病风险比(IRR)，可信区间(CI)为95%。在调整了危险时间和社会经济混杂因素后，同性已婚个体的自杀风险高于异性已婚个体(IRR 2.7，95%CI 1.5-4.8)。性别分层分析显示，与不同性别的已婚妇女相比，同性已婚妇女的风险暂时增加(IRR 2.5，95%可信区间0.8-7.7)。在同性已婚男性中，自杀风险几乎是异性已婚男性的三倍(内部收益率2.895%，可信区间1.5-5.5%)。在对艾滋病毒状况进行调整后，这一点也适用。即使在瑞典这样一个对同性恋态度相对宽容的国家，同性已婚人士的自杀风险也比其他已婚人士高。
Minority sexual orientation is a predictor of suicide ideation and attempts, though its association with suicide mortality is less clear. We capitalize on Sweden's extensively linked databases, to investigate whether, among married individuals, same-sex marriage is associated with suicide. Using a population-based register design, we analyzed suicide risk among same-sex married women and men (n = 6456), as compared to different-sex married women and men (n = 1181723) in Sweden. We selected all newly partnered or married individuals in the intervening time between 1/1/1996 and 12/31/2009 and followed them with regard to suicide until 12/31/2011. Multivariate Poisson regression was used to calculate adjusted incidence risk ratios (IRR) with 95 % confidence intervals (CI). The risk of suicide was higher among same-sex married individuals as compared to different-sex married individuals (IRR 2.7, 95 % CI 1.5-4.8), after adjustment for time at risk and socioeconomic confounding. Sex-stratified analyses showed a tentatively elevated risk for same-sex married women (IRR 2.5, 95 % CI 0.8-7.7) as compared to different-sex married women. Among same-sex married men the suicide risk was nearly three-fold greater as compared to different-sex married (IRR 2.895 % CI 1.5-5.5). This holds true also after adjustment for HIV status. Even in a country with a comparatively tolerant climate regarding homosexuality such as Sweden, same-sex married individuals evidence a higher risk for suicide than other married individuals.