Occupation-specific suicide risk in England: 2011–2015

BackgroundPrevious research has documented marked occupational differences in suicide risk, but these estimates are 10 years old and based on potentially biased risk assessments.AimsTo investigate occupation-specific suicide mortality in England, 2011–2015.MethodEstimation of indirectly standardised mortality rates for occupations/occupational groups based on national data.ResultsAmong males the highest risks were seen in low-skilled occupations, particularly construction workers (standardised mortality ratio [SMR] 369, 95% CI 333–409); low-skilled workers comprised 17% (1784/10 688) of all male suicides (SMR 144, 95% CI 137–151). High risks were also seen among skilled trade occupations (SMR 135 95% CI 130–139; 29% of male suicides). There was no evidence of increased risk among some occupations previously causing concern: male healthcare professionals and farmers. Among females the highest risks were seen in artists (SMR 399, 95% CI 244–616) and bar staff (SMR 182, 95% CI 123–260); nurses also had an increased risk (SMR 123, 95% CI 104–145). People in creative occupations and the entertainment industry – artists (both genders), musicians (males) and actors (males) – were at increased risk, although the absolute numbers of deaths in these occupations were low. In males (SMR 192, 95% CI 165–221) and females (SMR 170, 95% CI 149–194), care workers were at increased risk and had a considerable number of suicide deaths.ConclusionsSpecific contributors to suicide in high-risk occupations should be identified and measures – such as workplace-based interventions – put in place to mitigate this risk. The construction industry seems to be an important target for preventive interventions.Declaration of interestNone.

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Suicide as an outcome for mental disorders

The British Journal of Psychiatry ◽

10.1192/bjp.170.3.205 ◽

1997 ◽

Vol 170 (3) ◽

pp. 205-228 ◽

Cited By ~ 1585

Author(s):

E. Clare Harris ◽

Brian Barraclough

Keyword(s):

Mental Disorders ◽

Suicide Risk ◽

English Language ◽

Common Mental Disorders ◽

Meta Analysis ◽

Strong Association ◽

Search Terms ◽

Increased Risk ◽

Mortality Ratio

BackgroundMental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders.MethodWe searched the medical literature to find reports on the mortality of mental disorders. English language reports were located on MEDLINE (1966–1993) with the search terms mental disorders', ‘brain injury’, ‘eating disorders’, ‘epilepsy’, ‘suicide attempt’, ‘psychosurgery’, with ‘mortality’ and ‘follow-up studies’, and from the reference lists of these reports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suicides with those expected. A standardised mortality ratio (SMR) was calculated for each disorder.ResultsOf 44 disorders considered, 36 have a significantly raised SMR for suicide, five have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated.ConclusionsIf these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide risk is highest for functional and lowest for organic disorders with substance misuse disorders lying between. However, within these broad groupings the suicide risk varies widely.

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Personality and suicide risk: the impact of economic crisis in Japan

Psychological Medicine ◽

10.1017/s0033291714001688 ◽

2014 ◽

Vol 45 (3) ◽

pp. 559-573 ◽

Cited By ~ 12

Author(s):

F. Tanji ◽

M. Kakizaki ◽

Y. Sugawara ◽

I. Watanabe ◽

N. Nakaya ◽

...

Keyword(s):

Cohort Study ◽

Personality Traits ◽

Economic Crisis ◽

Suicide Risk ◽

Short Form ◽

Suicide Mortality ◽

Eysenck Personality Questionnaire ◽

Personal Factors ◽

Increased Risk ◽

The Impact

BackgroundThe interactive effect of personal factors and social factors upon suicide risk is unclear. We conducted prospective cohort study to investigate whether the impact of the economic crisis in 1997–1998 upon suicide risk differed according to Neuroticism and Psychoticism personality traits.MethodsThe Miyagi Cohort Study in Japan with a follow-up for 19 years from 1990 to 2008 has 29 432 subjects aged 40–64 years at baseline who completed a questionnaire about various health habits and the Japanese version of the Eysenck Personality Questionnaire – Revised Short Form in 1990.ResultsThe suicide mortality rate increased from 4.6 per 100 000 person-years before 1998 to 27.8 after 1998. Although both Neuroticism and Psychoticism were significantly associated with an increased risk of mortality during the whole period from 1990 to 2008, the impact of the economic crisis upon suicide risk differed between the Neuroticism and Psychoticism personality traits. Compared with the lowest category, the hazard ratios (HRs) for the highest Neuroticism increased from 0.66 before 1998 to 2.45 after 1998. On the other hand, the HRs for the highest Psychoticism decreased from 7.85 before 1998 to 2.05 after 1998.ConclusionsThe impact of the 1997–1998 economic crisis upon suicide risk differed according to personality. Suicide risk increased among these with higher Neuroticism after the economic crisis, but this was not the case for other personality subscales.

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Suicide Trends over Time by Occupation in Korea and Their Relationship to Economic Downturns

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16112007 ◽

2019 ◽

Vol 16 (11) ◽

pp. 2007 ◽

Cited By ~ 3

Author(s):

Jin-Ha Yoon ◽

Sun Jae Jung ◽

Jaesung Choi ◽

Mo-Yeol Kang

Keyword(s):

Age Groups ◽

Suicide Mortality ◽

Standardized Mortality Ratio ◽

Service Trade ◽

Occupational Groups ◽

Economic Downturns ◽

Suicidal Death ◽

Mortality Ratio ◽

Self Harm ◽

And Gender

We analyzed suicide mortality by occupation using administrative data from 1993 to 2016. Methods: National death records from 1993 to 2016 of the Korea National Statistical Office (KNSO) were used. Suicidal death was taken from Korean Classification of Disease codes as intentional self-harm (X60–X84) and sequelae of intentional self-harm (Y870). Occupational groups were categorized into “Manager,” “Officer,” ”Service-Trade,” “Agricultural-Fishery-Forestry” (AFF), “Skilled Manual,” and “Unskilled Manual.” Direct standardized mortality (DSM) and standardized mortality ratio (SMR) with 95% confidence interval (95% CI) were calculated. Overall, suicide rates increased during economic downturns, especially among lower socio-economic occupation classes. Both DSM and SMR were highest in AFF, followed by Unskilled Manual, Service-Trade, Officer, Skilled Manual, and Manager categories among men, whereas women showed the highest DSM and SMR in AFF, followed by Service-Trade, Officer, Unskilled Manual, Manager, and Skilled Manual categories. The age-stratified analysis showed that age groups with increasing trends in suicide differed according to occupation and gender. In certain occupational groups, the time-point prevalence fluctuated with socio-economic background in suicidal mortality and differed by age and gender.

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Ethical Issues Relevant to the Assessment of Suicide Risk in Nonclinical Research Settings

Crisis ◽

10.1027/0227-5910/a000110 ◽

2012 ◽

Vol 33 (1) ◽

pp. 54-59 ◽

Cited By ~ 4

Author(s):

Carolyn M. Wilson ◽

Bruce K. Christensen

Keyword(s):

Undergraduate Students ◽

Suicide Risk ◽

Ethical Issues ◽

Current Paper ◽

Self Report ◽

Ethical Guidelines ◽

Schizotypal Personality ◽

Increased Risk ◽

Genetic Features ◽

Conducting Research

Background: Our laboratory recently confronted this issue while conducting research with undergraduate students at the University of Waterloo (UW). Although our main objective was to examine cognitive and genetic features of individuals with schizotypal personality disorder (SPD), the study protocol also entailed the completion of various self-report measures to identify participants deemed at increased risk for suicide. Aims and Methods: This paper seeks to review and discuss the relevant ethical guidelines and legislation that bear upon a psychologist’s obligation to further assess and intervene when research participants reveal that they are at increased risk for suicide. Results and Conclusions: In the current paper we argue that psychologists are ethically impelled to assess and appropriately intervene in cases of suicide risk, even when such risk is revealed within a research context. We also discuss how any such obligation may potentially be modulated by the research participant’s expectations of the role of a psychologist, within such a context. Although the focus of the current paper is on the ethical obligations of psychologists, specifically those practicing within Canada, the relevance of this paper extends to all regulated health professionals conducting research in nonclinical settings.

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Cardiovascular hospitalisation before and during the financial crisis among occupations in Taiwan

European Journal of Public Health ◽

10.1093/eurpub/ckz185.362 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Y Chang

Keyword(s):

Financial Crisis ◽

Sex Education ◽

Negative Binomial ◽

Random Effect ◽

Unskilled Worker ◽

Research Database ◽

Skilled Workers ◽

Occupational Groups ◽

2008 Financial Crisis ◽

The 2008 Financial Crisis

Abstract Background Cardiovascular diseases (CVD) were related to financial stress. Little was known about the effects of financial crisis on cardiovascular health by occupations. This study examined CVD hospitalisations before and during the 2008 financial crisis among five occupational groups in Taiwan. Methods Data were collected from the Taiwan Survey on Hypertension, Hyperglycemia and Hyperlipidaemia 2007, including 4,673 participants aged 20 and above, categorized into five types of occupations, i.e., professional & manager (PM), office clerk & administrative staff (OA), skilled work (SW), unskilled worker (UW) and non-worker (NW). We abstracted their CVD hospitalisation records in the three years before (September 2005 to August 2008) and during the 2008 financial crisis (September 2008 to August 2011) from the National Health Insurance Research Database. Using incidence rate ratios (IRRs), we compared CVD hospitalisation of the first, second, third year from September 2008 to the three-year average before September 2008 for five occupational groups. Random effect negative binomial models were performed to estimate IRRs. Results After adjusting for covariates including age, sex, education, smoking, alcohol drinking, exercise and body mass index, there was an increase of CVD hospitalisation incidence for NW in the first year of the financial crisis (IRR=1.46, 95% Confidence Interval [95% CI]=1.19-1.77); in the second year, SW had a raised risk of CVD hospitalisation (IRR= 2.71, 95% CI = 1.59-4.60). For all occupational groups, the incidence rates of CVD hospitalisation reached the peak in the third year (PM: IRR=2.68, 95% CI = 1.05-6.83; OA: IRR=2.70, 95% CI = 1.18-6.19; SW: IRR=5.13, 95% CI = 2.89-9.09; UW: IRR=2.12, 95% CI = 1.02-4.41; NW: IRR=1.85, 95% CI = 1.18-2.67). Conclusions CVD hospitalisation of all occupations were affected by the financial crisis; when non-workers were the early victims, skilled workers may be the most vulnerable in the 2008 financial crisis. Key messages This study investigated the effects of the 2008 financial crisis on cardiovascular disease hospitalization by five occupational types in Taiwan. All occupations, particularly skilled workers, were affected by the financial crisis.

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Prevalence, Persistence, and Factors Associated with SARS-CoV-2 IgG Seropositivity in a Large Cohort of Healthcare Workers in a Tertiary Care University Hospital in Northern Italy

Viruses ◽

10.3390/v13061064 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1064

Author(s):

Gitana Scozzari ◽

Cristina Costa ◽

Enrica Migliore ◽

Maurizio Coggiola ◽

Giovannino Ciccone ◽

...

Keyword(s):

Tertiary Care ◽

Multivariable Analysis ◽

Northern Italy ◽

University Hospital ◽

Care Workers ◽

Increased Risk ◽

Never Smokers ◽

The University ◽

Job Profile ◽

Pandemic Wave

This observational study evaluated SARS-CoV-2 IgG seroprevalence and related clinical, demographic, and occupational factors among workers at the largest tertiary care University-Hospital of Northwestern Italy and the University of Turin after the first pandemic wave of March–April 2020. Overall, about 10,000 individuals were tested; seropositive subjects were retested after 5 months to evaluate antibodies waning. Among 8769 hospital workers, seroprevalence was 7.6%, without significant differences related to job profile; among 1185 University workers, 3.3%. Self-reporting of COVID-19 suspected symptoms was significantly associated with positivity (Odds Ratio (OR) 2.07, 95%CI: 1.76–2.44), although 27% of seropositive subjects reported no previous symptom. At multivariable analysis, contacts at work resulted in an increased risk of 69%, or 24% for working in a COVID ward; contacts in the household evidenced the highest risk, up to more than five-fold (OR 5.31, 95%CI: 4.12–6.85). Compared to never smokers, being active smokers was inversely associated with seroprevalence (OR 0.60, 95%CI: 0.48–0.76). After 5 months, 85% of previously positive subjects still tested positive. The frequency of SARS-COV-2 infection among Health Care Workers was comparable with that observed in surveys performed in Northern Italy and Europe after the first pandemic wave. This study confirms that infection frequently occurred as asymptomatic and underlines the importance of household exposure, seroprevalence (OR 0.60, 95%CI: 0.48–0.76).

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Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

The British Journal of Psychiatry ◽

10.1192/bjp.185.1.70 ◽

2004 ◽

Vol 185 (1) ◽

pp. 70-75 ◽

Cited By ~ 264

Author(s):

Daniel Louis Zahl ◽

Keith Hawton

Keyword(s):

Relative Risk ◽

Suicide Risk ◽

Single Episode ◽

Deliberate Self Harm ◽

Young Females ◽

Follow Up Study ◽

Increased Risk ◽

Self Harm

BackgroundRepetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.AimsTo investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.MethodA mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.ResultsThirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.ConclusionsRepetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

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Association between acute psychiatric bed availability in the Veterans Health Administration and veteran suicide risk: a retrospective cohort study

BMJ Quality & Safety ◽

10.1136/bmjqs-2020-012975 ◽

2021 ◽

pp. bmjqs-2020-012975

Author(s):

Peter J Kaboli ◽

Matthew R Augustine ◽

Bjarni Haraldsson ◽

Nicholas M Mohr ◽

M Bryant Howren ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Suicide Risk ◽

Veterans Health Administration ◽

Veterans Health ◽

Health Administration ◽

Bed Occupancy ◽

Increased Risk

BackgroundVeteran suicides have increased despite mental health investments by the Veterans Health Administration (VHA).ObjectiveTo examine relationships between suicide and acute inpatient psychiatric bed occupancy and other community, hospital and patient factors.MethodsRetrospective cohort study using administrative and publicly available data for contextual community factors. The study sample included all veterans enrolled in VHA primary care in 2011–2016 associated with 111 VHA hospitals with acute inpatient psychiatric units. Acute psychiatric bed occupancy, as a measure of access to care, was the main exposure of interest and was categorised by quarter as per cent occupied using thresholds of ≤85%, 85.1%–90%, 90.1%–95% and >95%. Hospital-level analyses were conducted using generalised linear mixed models with random intercepts for hospital, modelling number of suicides by quarter with a negative binomial distribution.ResultsFrom 2011 to 2016, the national incidence of suicide among enrolled veterans increased from 39.7 to 41.6 per 100 000 person-years. VHA psychiatric bed occupancy decreased from a mean of 68.2% (IQR 56.5%–82.2%) to 65.4% (IQR 53.9%–79.9%). VHA hospitals with the highest occupancy (>95%) in a quarter compared with ≤85% had an adjusted incident rate ratio (IRR) for suicide of 1.10 (95% CI 1.01 to 1.19); no increased risk was observed for 85.1%–90% (IRR 0.96; 95% CI 0.89 to 1.03) or 90.1%–95% (IRR 0.96; 95% CI 0.89 to 1.04) compared with ≤85% occupancy. Of hospital and community variables, suicide risk was not associated with number of VHA or non-VHA psychiatric beds or amount spent on community mental health. Suicide risk increased by age categories, seasons, geographic regions and over time.ConclusionsHigh VHA hospital occupancy (>95%) was associated with a 10% increased suicide risk for veterans whereas absolute number of beds was not, suggesting occupancy is an important access measure. Future work should clarify optimal bed occupancy to meet acute psychiatric needs and ensure adequate bed distribution.

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The Recent Rise of Suicide Mortality in the United States

Annual Review of Public Health ◽

10.1146/annurev-publhealth-051920-123206 ◽

2021 ◽

Vol 43 (1) ◽

Author(s):

Gonzalo Martínez-Alés ◽

Tammy Jiang ◽

Katherine M. Keyes ◽

Jaimie L. Gradus

Keyword(s):

Public Health ◽

United States ◽

Suicide Risk ◽

The United States ◽

Health Concern ◽

Suicide Mortality ◽

Annual Review ◽

Publication Date ◽

Suicide Rates ◽

Subsequent Decrease

Suicide is a major public health concern in the United States. Between 2000 and 2018, US suicide rates increased by 35%, contributing to the stagnation and subsequent decrease in US life expectancy. During 2019, suicide declined modestly, mostly owing to slight reductions in suicides among Whites. Suicide rates, however, continued to increase or remained stable among all other racial/ethnic groups, and little is known about recent suicide trends among other vulnerable groups. This article ( a) summarizes US suicide mortality trends over the twentieth and early twenty-first centuries, ( b) reviews potential group-level causes of increased suicide risk among subpopulations characterized by markers of vulnerability to suicide, and ( c) advocates for combining recent advances in population-based suicide prevention with a socially conscious perspective that captures the social, economic, and political contexts in which suicide risk unfolds over the life course of vulnerable individuals. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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