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Radeloff D, Papsdorf R, White L, Genuneit J. Suicide trends in Germany during the COVID-19 pandemic and the war in Ukraine. Psychiatry Res 2023; 330:115555. [PMID: 38149554 DOI: 10.1016/j.psychres.2023.115555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 12/28/2023]
Abstract
AIMS The later phase of the COVID-19 pandemic overlaps with geopolitical and economic consequences from the Ukraine war. Financial hardship and concerns about gas supply may add to pandemic factors and lead to increased suicide rates in Germany. METHODS Age- and sex-stratified suicide data from police crime statistics covering 35 % of the German population were used for an interrupted time-series analysis and for a projection of total German suicides in 2022. RESULTS For both sexes, a trend reversal from constant or declining suicide rates to an increase was observed. This increase is particularly pronounced in 2022 and mainly relates to the 60+ age group that is highly vulnerable to suicide. The projection of the overall German suicide rate is at a level last observed in 2015. CONCLUSIONS The key challenge now is to combat potential causes of this rise in suicide rates to avert the emerging upward trend.
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Affiliation(s)
- Daniel Radeloff
- Department of Child- and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany.
| | - Rainer Papsdorf
- Department of Child- and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany
| | - Lars White
- Department of Child- and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
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Godoy-Bermúdez A, Rojo-Gallego-Burin A, Delgado-Márquez L, Martín-Martín JJ, Sánchez-Martínez MT, López del Amo-González MP. Variation in perceived health across gender, working status, educational level, and regional health care expenditure in Spain (2014-2017). PLoS One 2023; 18:e0269613. [PMID: 37450459 PMCID: PMC10348579 DOI: 10.1371/journal.pone.0269613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
A gender perspective was used to analyze whether and how education, unemployment, and per capita public health expenditure were associated with perceived health among the Spanish population between the years 2014 and 2017. Using multilevel methodologies (looking at year, individual, and region) and linear and logistic specifications, we analyzed longitudinal microdata files from the Survey on Living Conditions. The results suggest that women with lower educational levels tend to report worse health than their more educated counterparts. On the other hand, women's bad health was not associated with unemployment, unlike men's. Regional per capita public health expenditure was not associated with perceived health in either men or women.
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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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Castillo-Sánchez G, Acosta MJ, Garcia-Zapirain B, De la Torre I, Franco-Martín M. Application of Machine Learning Techniques to Help in the Feature Selection Related to Hospital Readmissions of Suicidal Behavior. Int J Ment Health Addict 2022:1-22. [PMID: 35873865 PMCID: PMC9294773 DOI: 10.1007/s11469-022-00868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/02/2022] Open
Abstract
Suicide was the main source of death from external causes in Spain in 2020, with 3,941 cases. The importance of identifying those mental disorders that influenced hospital readmissions will allow us to manage the health care of suicidal behavior. The feature selection of each hospital in this region was carried out by applying Machine learning (ML) and traditional statistical methods. The results of the characteristics that best explain the readmissions of each hospital after assessment by the psychiatry specialist are presented. Adjustment disorder, alcohol abuse, depressive syndrome, personality disorder, and dysthymic disorder were selected for this region. The most influential methods or characteristics associated with suicide were benzodiazepine poisoning, suicidal ideation, medication poisoning, antipsychotic poisoning, and suicide and/or self-harm by jumping. Suicidal behavior is a concern in our society, so the results are relevant for hospital management and decision-making for its prevention.
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Affiliation(s)
- Gema Castillo-Sánchez
- Department of Signal Theory and Communications, and Telematics Engineering, Universidad de Valladolid, Paseo de Belén 15, 47011 Valladolid, Spain
| | | | | | - Isabel De la Torre
- Department of Signal Theory and Communications, and Telematics Engineering, Universidad de Valladolid, Paseo de Belén 15, 47011 Valladolid, Spain
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Mathieu S, Treloar A, Hawgood J, Ross V, Kõlves K. The Role of Unemployment, Financial Hardship, and Economic Recession on Suicidal Behaviors and Interventions to Mitigate Their Impact: A Review. Front Public Health 2022; 10:907052. [PMID: 35875017 PMCID: PMC9298506 DOI: 10.3389/fpubh.2022.907052] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 12/02/2022] Open
Abstract
Understanding the social determinants and risk factors for suicidal behaviors underlies the development of effective suicide prevention interventions. This review focused on recently published literature (2010 onwards), with the aim to determine the role of economic factors (at the individual and population level) on suicidal behaviors and ideation as well as the effectiveness of interventions addressing these factors in reducing suicidal behaviors and ideation. Where available, literature examining the economic impact of COVID-19 was highlighted. Economic recession and unemployment are associated with increased risk of suicidal behavior at the population and individual level. Additionally, personal financial problems such as debt and financial strain are associated with increased risk of suicidal behavior and ideation at the individual level. Regarding interventions, unemployment benefits, employment protection legislation, higher minimum wage and active labor market programs may reduce suicide at the population level. However, it is not clear what impact they have at the individual level, nor in relation to suicide attempts, self-harm, or suicidal ideation. There was a lack of evidence as to the effectiveness of financially focused suicide prevention interventions at either level. Current findings were contextualized within, and advance, prominent social theoretical models. Recommendations focused on future areas of research, including the unfolding economic impact of COVID-19, as well as the co-design and evaluation of tailored interventions and/or gatekeeper training for those in the financial and welfare sector, and enhanced early education aimed at increasing financial literacy in young people before onset or exacerbation of financial hardship.
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Affiliation(s)
| | | | | | | | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention and WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
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Mayer S, Berger M, Konnopka A, Brodszky V, Evers SMAA, Hakkaart-van Roijen L, Guitérrez-Colosia MR, Salvador-Carulla L, Park AL, Hollingworth W, García-Pérez L, Simon J. In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3500. [PMID: 35329189 PMCID: PMC8948969 DOI: 10.3390/ijerph19063500] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022]
Abstract
Improving the efficiency of mental healthcare service delivery by learning from international best-practice examples requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) aimed to harmonize the international unit cost development. This article presents the methodology and set of 36 externally validated, standardized reference unit costs (RUCs) for five health and social care services (general practitioner, dentist, help-line, day-care center, nursing home) in Austria, England, Germany, Hungary, The Netherlands, and Spain based on unambiguous service definitions using the extended DESDE PECUNIA coding framework. The resulting PECUNIA RUCs are largely comparable across countries, with any causes for deviations (e.g., country-specific scope of services) transparently documented. Even under standardized methods, notable limitations due to data-driven divergences in key costing parameters remain. Increased cross-country comparability by adopting a uniform methodology and definitions can advance the quality of evidence-based policy guidance derived from health economic evaluations. The PECUNIA RUCs are available free of charge and aim to significantly improve the quality and feasibility of future economic evaluations and their transferability across mental health systems.
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Affiliation(s)
- Susanne Mayer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria; (S.M.); (M.B.)
| | - Michael Berger
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria; (S.M.); (M.B.)
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg, 20246 Hamburg, Germany;
- Department Psychology, MSH Medical School Hamburg, 20457 Hamburg, Germany
| | - Valentin Brodszky
- Department of Health Economics, Institute of Economic and Public Policy, Corvinus University of Budapest, 1093 Budapest, Hungary;
| | - Silvia M. A. A. Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands;
- Centre of Economic Evaluation & Machine Learning, Trimbos Institute, 3521 VS Utrecht, The Netherlands
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands;
| | - Mencia R. Guitérrez-Colosia
- Department of Psychology, Universidad Loyola Andalucía, 41704 Dos Hermanas, Spain;
- Asociación Científica Psicost, 41704 Dos Hermanas, Spain
| | - Luis Salvador-Carulla
- Health Research Institute, Faculty of Health, University of Canberra, Canberra 2617, Australia;
- Menzies Centre for Health Policy and Economics, School of Public Health, University of Sydney, Sydney 2006, Australia
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, UK;
| | - William Hollingworth
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Rd, Bristol BS8 1NU, UK;
| | - Lidia García-Pérez
- Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Camino Candelaria Nº 44, 1ª Planta, El Rosario, 38109 Santa Cruz De Tenerife, Spain;
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria; (S.M.); (M.B.)
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
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Zerbinati L, Palagini L, Balestrieri M, Belvederi Murri M, Caruso R, D'Agostino A, Ferrara M, Ferrari S, Minervino A, Milia P, Nanni MG, Pini S, Politi P, Porcellana M, Rocchetti M, Taddei I, Toffanin T, Grassi L, Bellucci J, Bergamelli E, Attilio Campagna V, Cherubini M, Folesani F, Gancitano M, Giannetti F, Giovanna G, Gullotta B, Massa L, Montardi G. Changes of consultation-liaison psychiatry practice in Italian general hospitals: A comparative 20-year multicenter study. Front Psychiatry 2022; 13:959399. [PMID: 36311528 PMCID: PMC9614237 DOI: 10.3389/fpsyt.2022.959399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Conducted under the auspices of the Italian Society of Consultation Liaison Psychiatry (SIPC) the aim of this study was to describe the characteristics of Consultation Liaison Psychiatry (CLP) activity in Italy (SIPC-2-2018) over the past 20 years by comparing with data from the first Italian nation-wide study (SIPC-1-1998). METHODS We collected data on CLP visits of 3,943 patients from 10 Italian hospitals over a period of 1 year. Data were compared with those from the SIPC-1 1998 study (4,183 participants). Patients were assessed with the same ad hoc 60-item Patient Registration Form recording information from five different areas: Sociodemographic, hospitalization-related, consultation-related, interventions and outcome. RESULTS Compared with participants from the previous study, SIPC-2-2018 participants were significantly older (d = 0.54) and hospitalized for a longer duration (d = 0.20). The current study detected an increase in the proportion of referrals from surgical wards and for individuals affected by onco-hematologic diseases. Depressive disorders still represented the most frequent psychiatric diagnosis, followed by adjustment and stress disorders and delirium/dementia. Also, CLP psychiatrists prescribed more often antidepressants (Φ = 0.13), antipsychotics (Φ = 0.09), mood stabilizers (Φ = 0.24), and less often benzodiazepines (Φ = 0.07). CONCLUSION CLP workload has increased considerably in the past 20 years in Italy, with changes in patient demographic and clinical characteristics. A trend toward increase in medication-based patient management was observed. These findings suggest that the psychiatric needs of patients admitted to the general hospital are more frequently addressed by referring physicians, although Italian CLP services still deserve better organization and autonomy.
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Affiliation(s)
- Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Laura Palagini
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Matteo Balestrieri
- Psychiatric Clinic, Department of Medicine, University of Udine, Udine, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Armando D'Agostino
- Department of Health Sciences, Università Degli Studi di Milano, Milano, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Silvia Ferrari
- Section of Psychiatry, Department of Diagnostic-Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Paolo Milia
- Italian Society of Psychosomatic Medicine, Parma, Italy
| | - Maria Giulia Nanni
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.,Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Matteo Porcellana
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Matteo Rocchetti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ines Taddei
- Department of Psychiatric Sciences and Psychological Medicine, University La Sapienza, 3rd Psychiatric Clinic, Rome, Italy
| | - Tommaso Toffanin
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | | | - Jessica Bellucci
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Emilio Bergamelli
- Psychiatric Clinic, Department of Medicine, University of Udine, Udine, Italy
| | | | - Melissa Cherubini
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Federica Folesani
- Department of Health Sciences, Università Degli Studi di Milano, Milano, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Marta Gancitano
- Department of Health Sciences, Università Degli Studi di Milano, Milano, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Francesca Giannetti
- Section of Psychiatry, Department of Diagnostic-Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Giovanna
- Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Benedetta Gullotta
- Department of Health Sciences, Università Degli Studi di Milano, Milano, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Lucia Massa
- Italian Society of Psychosomatic Medicine, Parma, Italy
| | - Giulia Montardi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
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Relationships between Expenditure of Regional Governments and Suicide Mortalities Caused by Six Major Motives in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010084. [PMID: 35010343 PMCID: PMC8751063 DOI: 10.3390/ijerph19010084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/02/2023]
Abstract
Suicide mortality in Japan reduced in the period of 2009-2018. A number of studies identified the impact of financial governmental support for social welfare systems on suicide mortality; however, the detailed effects of specific regional policies, designed according to regional cultural, economic, education and welfare situations, on suicide mortality remain to be clarified. Therefore, the present study analyses the associations between the regional governmental expenditure of six major divisions, "public health", "public works", "police", "ambulance/fire services", "welfare" and "education", and suicide mortalities caused by six major suicidal motives, related to "family", "health", "economy", "employment", "romance" and "school", across the 47 prefectures in Japan during the period of 2009-2018, using fixed-effect analysis of hierarchal linear regression with robust standard error. The expenditure of "public works" displayed a positive relationship with suicide mortality of females caused by family-related motives but was not related to other suicide mortalities, whereas the expenditures in "public health", "police", "ambulance/fire services", "welfare" and "education" contributed to a reduction in suicide mortality, at least in some statistical indicators. The expenditures of both "ambulance/fire" and "education" were predominantly effective among the six major divisions of regional governmental expenditure in reducing suicide mortalities. In the education subdivisions, the expenditure of "kindergarten" was related to a reduction in suicide mortalities caused by a wide spectrum of motives. The amount of expenditure of welfare indicated the limited possibility of facilitating a reduction in suicide mortalities caused by only motives associated with economy or employment. However, in the welfare subdivisions, the expenditure of "child welfare" and "social welfare" was effective in reducing suicide mortalities, but the expenditure of "elderly welfare" was unexpectedly related to an increase in suicide mortalities. These results suggest that most Japanese people are struggling to bring up children even in the situation of an increasing elderly population with a decreasing birth rate. Therefore, it is important to enhance the investment welfare policy for the future to improve the childcare environment. Although the issue of an increasing elderly population and a decreasing birth rate in Japan has not yet improved, the obtained results suggest that evidence-based welfare expenditure redistributions of prefectures and municipalities could improve Japanese society and welfare systems.
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Analysing the Impacts of Financial Expenditure of Prefectures on Methods of Suicide Completion in Japan. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint3010001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recently, several studies reported that the governmental financial expenditures play important roles in the prevention of increasing suicide mortalities; however, the specific regional policies, designed dependent on regional cultural, economic, education and welfare backgrounds, affect suicide mortality by a specific suicidal means. Therefore, the present study determined the impacts of the regional governmental expenditure of six major divisions, “public health”, “public works”, “police”, “ambulance/fire services”, “welfare” and “education” on suicide mortalities by five major suicidal means, “hanging”, “poisoning”, “charcoal burning”, “jumping” and “throwing”, across the 47 prefectures in Japan during 2009–2018 using fixed-effect analysis of hierarchal linear regression with robust standard error. The expenditures of “ambulance/fire services” and “education” indicated the negative relation to suicide mortalities by wide-spectrum suicidal means, whereas expenditures of “public works” did not affect suicide mortalities. In the education subdivisions, expenditure of “kindergarten” and “elementary school” indicated the impacts of reduction of suicide mortalities, whereas the expenditures of “special school” for individuals with disabilities unexpectedly contribute to increasing suicide mortalities by poisoning, charcoal burning and throwing of females. Regarding subdivisions of welfare, expenditure of “child welfare” and “social welfare” contributed to a reduction in suicide mortalities, but expenditure of “elderly welfare” surprisingly contributed to increasing suicide mortalities. Furthermore, expenditures of welfare subdivision abolished the negative impacts of the expenditures of educational subdivisions, kindergarten and elementary school, but the positive impact of expenditure of special school on female suicide mortalities was not affected. These results suggest that most Japanese people are struggling to care for children even in the situation of an increasing elderly population with a decreasing birthrate. Therefore, it is important to enhance the investment welfare policy for the future to improve the childcare environment. The results demonstrated by this study suggest that the scientifically evidence-based redistributions of welfare expenditure in regional government, at least partially, provide improvement of Japanese society and welfare systems, under the continuous severe Japanese social concerns associated with increasing elderly population with a decreasing birthrate.
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Chen YY, Cai Z, Chang Q, Canetto SS, Yip PSF. Caregiving as suicide-prevention: an ecological 20-country study of the association between men's family carework, unemployment, and suicide. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2185-2198. [PMID: 33948679 DOI: 10.1007/s00127-021-02095-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 04/07/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Suicide rates are generally higher in men than in women. Men's higher suicide mortality is often attributed to public-life adversities, such as unemployment. Building on the theory that men's suicide vulnerability is also related to their private-life behaviors, particularly men's low engagement in family carework, this ecological study explored the association between men's family carework, unemployment, and suicide. METHODS Family-carework data for twenty Organization for Economic Co-operation and Development (OECD) countries were obtained from the OECD Family Database. Sex-specific age-standardized suicide rates came from the Global Burden of Disease dataset. The association between men's engagement in family carework and suicide rates by sex was estimated, with OECD's unemployment-benefits index and United-Nations' Human Development-Index (HDI) evaluated as controls. The moderation of men's carework on the unemployment-suicide relationship was also assessed. RESULTS Overall and sex-specific suicide rates were lower in countries where men reported more family carework. In these countries, higher unemployment rates were not associated with higher male suicide rates. In countries where men reported less family carework, higher unemployment was associated with higher male suicide rates, independent of country's HDI. Unemployment benefits were not associated with suicide rates. Men's family carework moderated the association between unemployment and suicide rates. CONCLUSION This study's findings that higher levels of men's family carework were associated with lower suicide mortality, especially among men and under high-unemployment conditions, point to the suicide-protective potential of men's family carework. They are consistent with evidence that where gender equality is greater, men's and women's well-being, health, and longevity are greater.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan
- Department of Public Health, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - ZiYi Cai
- Department of Social Work and Social Administration, Faculty of Social Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Xiamen, China
| | | | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong.
- Hong Kong Jockey Club Center for Suicide Research and Prevention, University of Hong Kong, Pok Fu Lam, Hong Kong.
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11
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Hasegawa T, Matsumoto R, Yamamoto Y, Okada M. Analysing effects of financial support for regional suicide prevention programmes on methods of suicide completion in Japan between 2009 and 2018 using governmental statistical data. BMJ Open 2021; 11:e049538. [PMID: 34475170 PMCID: PMC8413950 DOI: 10.1136/bmjopen-2021-049538] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To explore the mechanisms of reduction of suicide mortality in Japan (from 25.7 to 16.5 per 100 000 population) between 2009 and 2018, the present study determined the effects of execution amounts of regional suicide prevention programmes (Emergency Fund to Enhance Community-Based Suicide Countermeasure: EFECBSC) on gender-specific trends of suicide mortality by disaggregated methods. DESIGN AND SETTING Stepwise multiple regression analysis was used to determine the effects of execution amounts of 10 subdivisions of execution amounts of financial support for regional suicide prevention programmes (EFECBSC) on suicide methods and gender disaggregated suicide mortalities in Japan between 2009 and 2018 using the statistical data obtained from national governmental database. RESULTS The suicide mortalities by the most common/frequent suicide methods, hanging, charcoal burning and jumping were significantly decreased between 2009 and 2018. Male hanging suicide was decreased by prefectural enlightenment, municipal development programmes, but female hanging suicide was decreased by municipal personal consultation programmes. Municipal development and enlightenment programmes decreased male and female charcoal-burning suicide mortalities, respectively. Jumping suicide was decreased by prefectural telephone consultation programmes but was unexpectedly increased by municipal personal consultation and enlightenment programmes. CONCLUSIONS This study revealed the contribution of ECEFBSC on reduction of suicide mortalities, especially hanging, charcoal-burning and jumping suicides, via enhancement of regional suicide prevention programmes in Japan; however, notably, the 'means substitution' from parts of hanging and charcoal burning to jumping is probably generated by EFECBSC. Therefore, these findings provide important aspects for planning evidence-based and cost-effective regional suicide prevention programmes.
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Affiliation(s)
- Toshiki Hasegawa
- Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Ryusuke Matsumoto
- Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Yoshimasa Yamamoto
- Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Motohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
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12
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Effects of Financial Expenditure of Prefectures/Municipalities on Regional Suicide Mortality in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168639. [PMID: 34444387 PMCID: PMC8394344 DOI: 10.3390/ijerph18168639] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/08/2021] [Accepted: 08/13/2021] [Indexed: 12/16/2022]
Abstract
In Japan, suicide mortality has been improving from 2009; however, suicide remains one of the leading causes of death. Although previous studies identified solid relationships between governmental financial support for social welfare systems and suicide mortality, little attention is paid to how specific regional policies, designed according to regional cultural, economic, and social welfare situations, affect suicide mortality. Therefore, the present study analyses the relationships between the regional governmental expenditure of six major divisions and suicide mortality across the 47 prefectures in Japan from 2009 to 2018 using fixed-effect analysis of hierarchal linear regression with robust standard error. The expenditure in “public health”, “police”, “ambulance/fire services”, “welfare” and “education” is associated with reduction in suicide mortality, at least in some statistical indicators, whereas expenditure of “public works” indicated the influence of increasing suicide mortality or had no effect. Welfare expenditure was the most predominantly effective among the six major divisions of regional governmental expenditure. In the welfare subdivisions, expenditure of “child welfare” and “social welfare” was effective in a reduction in suicide mortality, but expenditure of “elderly welfare” surprisingly contributed to increasing suicide mortality. Child welfare expenditure negatively impacted suicide mortality in wide-ranging generations of both males and females; the positive effects of elderly welfare expenditure reached were limited as working-age populations increased, but unexpectedly did not affect the suicide mortality of elderly populations. The relatively increasing expenditure of elderly welfare with the relatively decreasing child welfare are unavoidable due to the Japanese social issues associated with a declining birth rate and ageing population. Furthermore, the budget of that regional government that can modify its expenditure structure by making its own policies is limited since most regional governmental expenditure is composed of essential expenditure for maintaining and operating regional social welfare systems. Although severe social situations in Japan are still unoptimised, the present results suggest that scientific-evidence-based redistributions of welfare expenditure in regional governments can at least partially improve Japanese society and welfare systems.
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13
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Sacchi V, Mattei G, Musetti L, Galeazzi GM. Impact of Antidepressant Prescriptions on Suicidal Behavior in Times of Severe Financial Strain. J Nerv Ment Dis 2021; 209:558-563. [PMID: 34009863 DOI: 10.1097/nmd.0000000000001336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This descriptive study observes the relationship between antidepressant prescriptions and the suicide rate in Italy in the 2000s to the mid-2010s, which includes a period of severe economic crisis. The observation period was from 2000 to 2015. Suicide and unemployment rates disaggregated by age and sex were collected from the Italian Institute of Statistics. Statistical analyses were performed using correlations between suicide rates and the defined daily dose, with reference to selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other types of antidepressants. Fixed-effects panel regressions were also run. Increases in SSRIs prescriptions were associated with decreases in suicide rates among both men and women. However, when the analyses were adjusted for the rate of growth of the unemployment rate and for gross domestic product, the associations were weaker. The potential protective factor of SSRIs with respect to suicidal behavior may be reduced by severe recessions, especially when unemployment increases.
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Affiliation(s)
| | | | - Laura Musetti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa
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14
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Mattei G, Russo T, Addabbo T, Galeazzi GM. The COVID-19 recession might increase discriminating attitudes toward LGBT people and mental health problems due to minority stress. Int J Soc Psychiatry 2021; 67:400-401. [PMID: 32985293 DOI: 10.1177/0020764020960770] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giorgio Mattei
- Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy.,Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Association for Research in Psychiatry, Castelnuovo Rangone, Modena, Italy
| | - Tullia Russo
- Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy
| | - Tindara Addabbo
- Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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15
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Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115670. [PMID: 34070685 PMCID: PMC8199206 DOI: 10.3390/ijerph18115670] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.
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16
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Nakano T, Hasegawa T, Okada M. Analysing the Impacts of Financial Support for Regional Suicide Prevention Programmes on Suicide Mortality Caused by Major Suicide Motives in Japan Using Statistical Government Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073414. [PMID: 33806105 PMCID: PMC8036759 DOI: 10.3390/ijerph18073414] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/17/2021] [Accepted: 03/21/2021] [Indexed: 11/24/2022]
Abstract
To improve and plan regional suicide prevention programmes that utilise more cost-effective governmental financial support compared with previous programmes, the present study determined the effects of the amount of financial support provided for regional suicide prevention programmes, such as the Emergency Fund to Enhance Community-Based Suicide Countermeasures (EFECBSC), on the trends of suicide mortalities caused by six major suicide motives between 2009 and 2018, using forward multiple regression analysis. The ranking order of motives for male suicide was health, economy, family, employment, romance and school (in that order), whereas the ranking order for females was health, family, economy, romance, employment and school. Male suicide mortality caused by economy-related motives was significantly/inversely related to prefectural intervention programmes, whereas mortality caused by health-related motives was also significantly/inversely related to prefectural intervention programmes, but significantly/positively related to prefectural personal consultation support programmes. Contrary to males, female suicide mortality caused by health-related motives was significantly/inversely related to the municipal development programmes of leaders/listeners, whereas mortality caused by family- and school-related motives was significantly/positively related to prefectural and municipal telephone consultation support programmes, respectively. Contrary to our expectations, school-aged female suicide mortality caused by school-related motives was significantly/positively related to prefectural personal consultation support, enlightenment and municipal telephone consultation support programmes. These results indicate that Japanese regional suicide prevention programmes probably affect the suppression of male suicide mortality. However, these programmes are possibly ineffective, or at least partially, have an adverse effect, in regard to the suicide mortalities of female and school-aged populations. Therefore, we should work to improve regional suicide prevention programmes, making them more cost-effective and targeted towards female and school-aged populations in the future.
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17
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Mattei G, Venturi G, Alfieri S, Colombini N, Ferrari S, Rigatelli M, Starace F, Galeazzi GM. Clinical and Socio-demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community-Based Italian Study. Community Ment Health J 2020; 56:1380-1390. [PMID: 32086675 DOI: 10.1007/s10597-020-00577-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
Abstract
This study aims to identify clinical and socio-demographic variables associated with the outcome of vocational rehabilitation programs (VRPs). All users of an Italian Community Mental Health Centre (CMHC) included in VRPs delivered according to the model of Supported Employment in years 2011-2016 were retrospectively enrolled. Fifty users who ended the program with employment were compared with fifty users who dropped out, with respect to clinical and socio-demographic variables. VRPs lasting less than 6 months and oriented toward the competitive labor market had a higher probability of employment. Among users who successfully ended the VRP, the median of health interventions significantly decreased after employment. In the same group of users, less non-health interventions strictly linked to the VRP were required, when compared with users who dropped out. We conclude that employment is associated with improvement of users' clinical conditions and reduced workload for the CMHC.
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Affiliation(s)
- G Mattei
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy. .,Ph.D. School in Labor, Development and Innovation, "Marco Biagi" Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy. .,Association for Research in Psychiatry, Castelnuovo Rangone, Modena, Italy.
| | - G Venturi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - S Alfieri
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - N Colombini
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - S Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - M Rigatelli
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Starace
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - G M Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
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18
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Brennecke G, Stoeber FS, Kettner M, Keil J, White L, Vasilache A, von Klitzing K, Radeloff D. Suicide among immigrants in Germany. J Affect Disord 2020; 274:435-443. [PMID: 32663973 DOI: 10.1016/j.jad.2020.05.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/29/2020] [Accepted: 05/10/2020] [Indexed: 01/23/2023]
Abstract
AIMS The identification of high-risk groups is crucial in public health suicide prevention approaches. This study aims to compare suicide risks of Germans with nine of the largest immigrant populations living in Germany. METHODS Based on a German national database of mortality statistics, the number of suicides in Germans and immigrants was available for the study period (2000 - 2017), stratified for gender and age groups. Standard mortality ratios (SMR) for suicide were computed since age distributions differed between populations. Moreover, SMR of immigrant populations were correlated with potential risk and resilience factors. RESULTS The analysed dataset covers a period of 18 years, which translates to over 1.47 billion life years (LY) and 206,056 recorded suicides. 134,971,779 LY (10.1%) and 8,936 (4.3%) suicides were assigned to non-German citizens. SMR, calculated for nine of the largest immigrant populations, were lower compared with the German reference population ranging from 0.24 (Greek nationality) to 0.86 (Russian nationality). SMR in immigrants was highest in adolescents and declined with age. SMR was associated with country of origin (CO) suicide rates as well as with socio-economic factors of immigrant groups in Germany. With the global financial crisis, suicide risk of immigrants from the most affected countries decreased more strongly compared to immigrants from other CO. CONCLUSIONS The suicide risk strongly differs between the individual immigrant groups and is associated with risk factors of the respective CO. Therefore, future suicide prevention approaches in immigrants should take CO-specific vulnerabilities into account as well as age-related risk factors.
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Affiliation(s)
- G Brennecke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - F S Stoeber
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - M Kettner
- Institute of Forensic Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - J Keil
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - L White
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - A Vasilache
- Center for German and European Studies (CGES), Faculty of Sociology, Bielefeld University, Bielefeld, Germany
| | - K von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - D Radeloff
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany.
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Okada M, Hasegawa T, Kato R, Shiroyama T. Analysing regional unemployment rates, GDP per capita and financial support for regional suicide prevention programme on suicide mortality in Japan using governmental statistical data. BMJ Open 2020; 10:e037537. [PMID: 32859665 PMCID: PMC7454243 DOI: 10.1136/bmjopen-2020-037537] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To explore the mechanisms of reduced suicide mortality in Japan, which decreased from 25.7 to 16.5 per 100 000 people following the comprehensive suicide prevention programme from 2009 to 2018, the present study determined the relationship between regional suicide mortality, socioeconomic data (GDP per capita, unemployment rates) and financial support for regional suicide prevention programmes. DESIGN AND SETTING Stepwise multiple regression analysis was used to determine the effects of regional GDP per capita, unemployment rates and implementation amount of financial support for regional suicide prevention programmes (Emergency Fund to Enhance Community-Based Suicide Countermeasures-EFECBSC) on age and gender disaggregated suicide mortalities in Japan between 2009 and 2018. Data on each prefecture's complete unemployment rates, GDP per capita and implementation amount of EFECBSC sub-divisions were derived from an official Japanese governmental database. RESULTS Both prefectural enlightenment and intervention model programmes were found to lead to a decrease in male suicide mortality, but were less effective in reducing female suicide mortality. Municipal enlightenment and intervention model programmes were also less effective in reducing suicide mortality. Municipal development programmes for listener and leader led to a greater decrease in suicide mortality for both men and women compared with such programmes at the prefectural level. Contrary to our expectations, reduced complete unemployment rate only reduced suicide mortality in the older male population without affecting female suicide mortality. CONCLUSION The study findings suggest an inverse relationship between financial support and suicide mortality in Japan. Furthermore, independent factors in the reduction of suicide mortality rates provide important information for planning evidence-based and cost-effective regional suicide prevention programmes.
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Affiliation(s)
- Motohiro Okada
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Toshiki Hasegawa
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Ryo Kato
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Takashi Shiroyama
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
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20
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Cavicchioli M, Pistoresi B. Unfolding the relationship between mortality, economic fluctuations, and health in Italy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:351-362. [PMID: 31749025 DOI: 10.1007/s10198-019-01135-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023]
Abstract
Despite the long-run strong negative association between economic development and mortality, their short-run relationship remains controversial. In the present work, we study co-movement between mortality growth (overall, gender- and cause-specific) and economic fluctuations in Italy over the period 1862-2013. To this aim, we use Johansen (Econometrica 59:1551-1580, 1991) procedure to jointly estimate the short- and long-run dynamics of the two variables, avoiding omitted variable bias in the cyclical co-movement extraction or spurious association attributable to trends. We also take into account possible asymmetric responses of mortality growth to shocks in GDP. We find that an increase of 1% in real GDP per capita induces a reduction in mortality rate of 0.27% for total population. Moreover, we observe that business cycle fluctuations do not affect mortality in the pre-wars era, where only the long run decreases matters driven by reduction in infections and accidents mortality. On the contrary, in the post-wars period, expansive phases of business cycle are associated with reduction in mortality growth and periods of recession generate an ever-deeper decrease. However, in this period, mortality for cancer is procyclical and significantly increasing in expansion: this reinforces the debate for controlling environmental factors.
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Affiliation(s)
- Maddalena Cavicchioli
- Department of Economics "Marco Biagi", University of Modena and Reggio Emilia, Viale Berengario 51, 41121, Modena, Italy.
- RECent, Center for Economic Research, University of Modena and Reggio, Emilia, Modena, Italy.
| | - Barbara Pistoresi
- Department of Economics "Marco Biagi", University of Modena and Reggio Emilia, Viale Berengario 51, 41121, Modena, Italy
- RECent, Center for Economic Research, University of Modena and Reggio, Emilia, Modena, Italy
- Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy
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21
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De Leo D, Vichi M, Kolves K, Pompili M. Late life suicide in Italy, 1980-2015. Aging Clin Exp Res 2020; 32:465-474. [PMID: 31792764 DOI: 10.1007/s40520-019-01431-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/21/2019] [Indexed: 11/24/2022]
Abstract
AIM Suicide trends in older adults were examined in Italy from 1980 to 2015. Age groups considered were 65-74 years, 75-84 and 85 + years. METHODS Data on suicide deaths were obtained from the Italian Mortality Database (IMDB) collected by the Italian National Institute of Statistics (ISTAT) and processed by the Statistics Unit of the Italian National Institute of Health (Istituto Superiore di Sanità). Joinpoint regression analyses were carried out for age subgroups by sex. In addition, data related to four main macro-areas of Italy were considered: North-West, North-East, Centre, and South with Islands (Sicily and Sardinia). RESULTS Starting by 1985, declines were noted in all age groups with more noticeable decreases in older adults aged 75-84 and 85 + years. Female subjects demonstrated more ample falls in rates than male individuals. Declines were detected in all macro-areas of Italy. CONCLUSION Improved health assistance and quality of life of older individuals have probably contributed to the decline of suicide rates of senior citizens, who also showed improved poverty indices in the country, differently from all other age groups.
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Affiliation(s)
- Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt Campus, Brisbane, 4122, Australia.
- Slovenian Centre for Suicide Research, Primorska University, Koper, Slovenia.
| | | | - Kairi Kolves
- Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt Campus, Brisbane, 4122, Australia
| | - Maurizio Pompili
- Psychiatric Clinic, University of Rome 'La Sapienza', Rome, Italy
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22
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Mattei G, Pistoresi B. Unemployment and suicide in Italy: evidence of a long-run association mitigated by public unemployment spending. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:569-577. [PMID: 30542937 DOI: 10.1007/s10198-018-1018-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/04/2018] [Indexed: 05/28/2023]
Abstract
From the mid-1990s on, the suicide rate in Italy declined steadily, then apparently rose again after the onset of the Great Recession, along with a sharp increase in unemployment. The aim of this study is to test the association between the suicide rate and unemployment (i.e., the unemployment rate for males and females in the period 1977-2015, and the long-term unemployment rate in the period 1983-2012) in Italy, by means of cointegration techniques. The analysis was adjusted for public unemployment spending (referring to the period 1980-2012). The study identified a long-run relationship between the suicide rate and long-term unemployment. On the other hand, an association between suicide and unemployment rate emerged, though statistically weaker. A 1% increase in long-term unemployment increases the suicide rate by 0.83%, with a long-term effect lasting up to 18 years. Public unemployment spending (as percentage of the Italian gross domestic product) may mitigate this association: when its annual growth rate is higher than 0.18%, no impact of unemployment on suicide in detectable. A decrease in the suicide rate is expected for higher amounts of social spending, which may be able to compensate for the reduced level of social integration resulting from unemployment, helping the individual to continue to integrate into society. A corollary of this is that austerity in times of economic recession may exacerbate the impact of the economic downturn on mental health. However, a specific "flexicurity" system (intended as a combination of high employment protection, job satisfaction and labour-market policies) may have a positive impact on health.
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Affiliation(s)
- Giorgio Mattei
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi, 287, 41125, Modena, Italy.
- Department of Economics and Marco Biagi Foundation, University of Modena and Reggio Emilia, Via J. Berengario, 51, 41121, Modena, Italy.
| | - Barbara Pistoresi
- Department of Economics and ReCent, University of Modena and Reggio Emilia, Viale Berengario 51, Modena, Italy
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