Area factors and suicide: 5-year follow-up of the Northern Ireland population

BackgroundSuicide rates vary markedly between areas but it is unclear whether this is due to differences in population composition or to contextual factors operating at an area level.AimsTo determine if area factors are independently related to suicide risk after adjustment for individual and family characteristics.MethodA 5-year record linkage study was conducted of 1 116 748 non-institutionalised individuals aged 16–74 years, enumerated at the 2001 Northern Ireland census.ResultsThe cohort experienced 566 suicides during follow-up. Suicide risks were lowest for women and for those who were married or cohabiting. Indicators of individual and household disadvantage and economic and health status at the time of the census were also strongly related to risk of suicide. The higher rates of suicide in the more deprived and socially fragmented areas disappeared after adjustment for individual and household factors. There was no significant relationship between population density and risk of suicide.ConclusionsDifferences in rates of suicide between areas are predominantly due to population characteristics rather than to area-level factors, which suggests that policies targeted at area-level factors are unlikely to significantly influence suicides rates.

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Are volunteering and caregiving associated with suicide risk? A Census-based longitudinal study

BMC Psychiatry ◽

10.1186/s12888-019-2255-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Michael Rosato ◽

Foteini Tseliou ◽

David M. Wright ◽

Aideen Maguire ◽

Dermot O’Reilly

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Record Linkage ◽

Suicide Risk ◽

Linkage Study ◽

Poor Mental Health ◽

Cox Models ◽

Good Mental Health ◽

Increased Risk

Abstract Background Opposing risks have been identified between different prosocial activities, with volunteering having been linked to better mental health while caregiving has been associated with higher prevalence and incidence of depression. This study explored suicide risk of people engaged in prosocial activities of caregiving and/or volunteering. Methods A Census-based record linkage study of 1,018,000 people aged 25–74 years (130,816 caregivers; 110,467 volunteers; and 42,099 engaged in both) was undertaken. Caregiving (light: 1–19; intense: ≥20 h/week), volunteering and mental health status were derived from 2011 Census records. Suicide risk (45 months follow-up) was assessed using Cox models adjusted for baseline mental health. Results Intense caregiving was associated with worse mental health (ORadj = 1.15: 95%CI = 1.12, 1.18) and volunteering with better mental health (OR = 0.87: 95%CI = 0.84, 0.89). For those engaged in both activities, likelihood of poor mental health was determined by caregiving level. There were 528 suicides during follow-up, with those engaged in both activities having the lowest risk of suicide (HR = 0.34: 95%CI = 0.14, 0.84). Engaging in either volunteering or caregiving was associated with lower suicide risk for those with good mental health at baseline (HR = 0.66: 95%CI = 0.49, 0.88) but not for their peers with baseline poor mental health (HR = 1.02: 95%CI = 0.69, 1.51). Conclusions Although an increased risk of poor mental health was identified amongst caregivers, there was no evidence of an increased risk of suicide.

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Cancer Mortality in Psychiatric Patients: The IOWA Record-Linkage Study

The International Journal of Psychiatry in Medicine ◽

10.2190/47qd-dr04-nr5q-8d16 ◽

1987 ◽

Vol 16 (3) ◽

pp. 189-197 ◽

Cited By ~ 6

Author(s):

Donald W. Black ◽

George Winokur

Keyword(s):

Record Linkage ◽

Excess Mortality ◽

Psychiatric Patients ◽

Relevant Literature ◽

Linkage Study ◽

Significant Excess ◽

University Of Iowa ◽

Organic Mental Disorders ◽

The University

Of 5,412 patients admitted to the University of Iowa Psychiatric Hospital over a ten-year period, forty-six died of cancer during follow-up, which did not differ significantly from expected. Significant excess mortality from cancer was present within the first two years of follow-up. At risk during this period were women and patients with organic mental disorders. A review of relevant literature is presented.

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Correction: Investigating the population characteristics, processes and outcomes of pre-hospital psychiatric and self-harm emergencies in Scotland: a national record linkage study

Emergency Medicine Journal ◽

10.1136/emermed-2017-207114.1corr1 ◽

2017 ◽

Vol 34 (11) ◽

pp. e12-e12

Keyword(s):

Record Linkage ◽

Linkage Study ◽

Population Characteristics ◽

Self Harm

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29 Investigating the population characteristics, processes and outcomes of pre-hospital psychiatric and self-harm emergencies in scotland: a national record linkage study

10.1136/bmjopen-2017-emsabstracts.29 ◽

2017 ◽

Author(s):

E Duncan ◽

C Best ◽

N Dougall ◽

S Skar ◽

D Fitzpatrick ◽

...

Keyword(s):

Record Linkage ◽

Linkage Study ◽

Population Characteristics ◽

Self Harm

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01 Investigating the population characteristics, processes and outcomes of pre-hospital psychiatric and self-harm emergencies in scotland: a national record linkage study

Emergency Medicine Journal ◽

10.1136/emermed-2017-207114.1 ◽

2017 ◽

Vol 34 (10) ◽

pp. 695.1-695

Author(s):

Catherine Best ◽

Nadine Dougall ◽

Silje Skar ◽

David Fitzpatrick ◽

Josie Evans ◽

...

Keyword(s):

Record Linkage ◽

Linkage Study ◽

Population Characteristics ◽

Self Harm

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RF10 Hidden harms of hypnotics: a population based record linkage study of psychotropic medication and suicide risk

10.1136/jech-2019-ssmabstracts.125 ◽

2019 ◽

Author(s):

IN Onyeka ◽

A Maguire ◽

D O’Reilly

Keyword(s):

Psychotropic Medication ◽

Record Linkage ◽

Suicide Risk ◽

Population Based ◽

Linkage Study

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Does physical ill-health increase the risk of suicide? A Census-based follow-up study of over 1 million people

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1223 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Ifeoma Onyeka ◽

Emma Ross ◽

Aideen Maguire ◽

Dermot O’Reilly

Keyword(s):

Mental Health ◽

Risk Factor ◽

Health Status ◽

Physical Health ◽

Suicide Risk ◽

Health Conditions ◽

Logistic Regression Models ◽

Physical Conditions ◽

The Relationship

Background/Main Aim Prior poor mental ill-health is a recognised risk factor for suicide but the relationship between multiple physical health conditions and suicide risk is less clear. Methods Data of 1,196,364 adults (18-90years+) enumerated in Northern Ireland’s 2011 Census records were linked to death registrations until the end of 2015. Logistic regression models were generated to determine association between physical health status and both all-cause mortality and death from suicide, with adjustment for census-based attributes including the presence of mental health status. Physical health conditions severity was assessed using limiting long-term illness (LLTI: none, a little, a lot) and number of physical health conditions. Results About 14% of the cohort (n=164,473) had physical multimorbidity (two or more conditions) and 51,672 individuals died during follow-up; 877 due to suicide. A dose-response relationship was evident between number of physical conditions and all-cause death reaching an adjusted odds ratio (AOR) of 3.79 (95%CI: 3.65–3.94) in those with 4-or-more conditions (compared to those with no physical condition), but the association between number of physical conditions and suicide risk disappeared with adjustment for mental health. LLTI however, was an independent risk factor for suicide even after adjustment for mental health (AOR 1.52, 95%CI: 1.25–1.87 for those with daily activities limited a lot). The relationship between LLTI and suicide risk was only evident at younger ages (people aged less than 60). Conclusion This study demonstrates that the number of physical conditions is not an independent risk for suicide but that activity limitation is, though only at younger ages.

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The Unmet Need for Psychotropic Medication within the Migrant Population of Northern Ireland - A Record Linkage Study

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1309 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Kishan Patel

Keyword(s):

Mental Health ◽

Northern Ireland ◽

Psychotropic Medication ◽

Record Linkage ◽

Unmet Need ◽

Linkage Study ◽

Poor Mental Health ◽

Migrant Population ◽

Migrant Group ◽

Migrant Groups

BackgroundA large proportion of people with mental ill-health do not receive the care that they require - constituting unmet need. Migrant populations are particularly at risk of not receiving necessary care for a range of reasons including perceptual differences and multiple barriers to health service. Main AimThis record linkage study compares the likelihood of people with poor mental health receiving psychotropic medication between migrant and settled communities and amongst different migrant groups in Northern Ireland. MethodsA cohort of 78,267 people aged 16-64 who reported chronic poor mental health in the 2011 Census records was generated and followed for the next 12 months by linkage to a centralised prescribing dataset to determine rates of treatment. All individual and household attributes were derived from Census forms. Absence of a psychotropic medication prescription from the beginning of 2011 represented unmet need. Logistic regression analyses quantified the relationship between psychotropic medication and migrant status, while accounting for relevant demographic and socio-economic factors. ResultsOverall, 86% of the settled population with chronic poor mental health received at least one psychotropic medication during the study period, compared to 67% of the equivalent population of 1,736 migrants. Although migrants were 61% less likely than the settled community to report poor mental health (OR 0.39 (95% CI 0.37 - 0.41)), those reporting poor mental health were less than one-third as likely as to be on psychotropic medication in fully adjusted models. There also existed considerable variation between individual migrant groups, with uptake of medication lowest amongst the Lithuanian migrant group (OR 0.09 (95% CI 0.05 – 0.14)), and highest amongst German migrant group (OR 1.30 (95% CI 0.87 – 1.94)). ConclusionAlthough this study suggests substantial unmet need for treatment of poor mental health amongst the migrant population of Northern Ireland this may not represent the whole story. Differences between individual migrant groups suggest that other factors may also be at play including differing approaches to treatment, or alternative routes to treatment. The implications of the study will be discussed in the paper.

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Unmet need for mental health medication within the migrant population of Northern Ireland: a record linkage study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-212774 ◽

2020 ◽

pp. jech-2019-212774

Author(s):

Kishan Patel ◽

Tania Bosqui ◽

Anne Kouvonen ◽

Michael Donnelly ◽

Ari Väänänen ◽

...

Keyword(s):

Mental Health ◽

Northern Ireland ◽

Psychotropic Medication ◽

Record Linkage ◽

Unmet Need ◽

Linkage Study ◽

Poor Mental Health ◽

Migrant Population ◽

Data Set ◽

Migrant Groups

BackgroundMigrant populations are particularly at risk of not receiving the care for mental ill-health that they require for a range of reasons, including language and other barriers to health service access. This record linkage study compares, for migrant and settled communities, the likelihood that a person in Northern Ireland with poor mental health will receive psychotropic medication.MethodsA cohort of 78 267 people aged 16–64 years (including 1736 migrants) who reported chronic poor mental health in the 2011 Census records was followed for 15 months by linkage to a centralised prescribing data set to determine the rates of pharmacological treatment. Logistic regression analyses quantified the relationship between psychotropic medication uptake and migrant status, while accounting for relevant demographic and socioeconomic factors.ResultsOverall, 67% of the migrants with chronic poor mental health received at least one psychotropic medication during the study period, compared to 86% for the settled population; this equates to an OR of 0.32 (95% CI 0.29 to 0.36) in the fully adjusted models. Adjustment for English proficiency did not significantly alter these models. There was also considerable variation between individual migrant groups.ConclusionAlthough this study suggests substantial unmet need for treatment of poor mental health among the migrant population of Northern Ireland, further qualitative studies are required to better understand how different migrant groups respond to mental ill-health.

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