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Inoue K, Apbassova M, Seksenbayev N, Toleuov E, Akkuzinova K, Karimova Z, Moldagaliyev T, Ospanova N, Apbassova S, Chaizhunusova N, Shabdarbayeva D, Dyussupov A, Takeshita H, Kawano N. The relationship between a comprehensive index of prosperity and suicide rates in former Soviet countries, including a comparison with European and Asian countries: Discussion from a new perspective. Leg Med (Tokyo) 2024; 69:102460. [PMID: 38739974 DOI: 10.1016/j.legalmed.2024.102460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 05/05/2024] [Accepted: 05/09/2024] [Indexed: 05/16/2024]
Abstract
Investigations of suicide in countries of the former Soviet Union, which broke into 15 different countries in the early 1990s, require examinations of a combination of economic, social, and health factors. It is important to address these factors individually and to examine the various composite indicators for each. Moreover, it would be worthwhile to explore the potential applicability of a comprehensive worldwide index. We analyzed data from nine of the former Soviet countries for which both the annual suicide rate and the Global Competitiveness Index (GCI) were available for the years 2006-2017. We determined the precise relationships between the suicide rate and the GCI during this period in these nine countries as well as in nine countries with high suicide rates in Europe and Asia. The results indicated the following: (i) In six of the nine former Soviet countries with complete data, the suicide rate showed a relationship with the GCI. Notably, this relationship was inverse in all but one country. (ii) Among the nine European and Asian countries with high suicide rates, three exhibited a correlation between the suicide rate and the GCI. Measures to prevent suicide should be devised especially in countries of the former Soviet Union through collaboration among multiple fields and organizations, as necessary, with particular attention paid to countries with worse or worsening GCI values.
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Affiliation(s)
- Ken Inoue
- Research and Education Faculty, Medical Sciences Cluster, Health Service Center, Kochi University, Kochi, Japan; The Center for Peace, Hiroshima University, Hiroshima, Japan.
| | - Madina Apbassova
- Department of Pathological Anatomy and Forensic Medicine, Semey Medical University, Semey, Kazakhstan
| | | | - Elaman Toleuov
- Department of Psychiatry and Narcology, Semey Medical University, Semey, Kazakhstan
| | - Kamila Akkuzinova
- Department of Psychiatry and Narcology, Semey Medical University, Semey, Kazakhstan
| | - Zhanna Karimova
- Department of Psychiatry and Narcology, Semey Medical University, Semey, Kazakhstan
| | - Timur Moldagaliyev
- Department of Psychiatry and Narcology, Semey Medical University, Semey, Kazakhstan
| | - Nargul Ospanova
- Department of Psychiatry and Narcology, Semey Medical University, Semey, Kazakhstan
| | - Saulesh Apbassova
- Department of Pathological Anatomy and Forensic Medicine, Semey Medical University, Semey, Kazakhstan
| | | | - Dariya Shabdarbayeva
- Department of Pathological Anatomy and Forensic Medicine, Semey Medical University, Semey, Kazakhstan
| | - Altay Dyussupov
- Chairman of the Board-Rector, Semey Medical University, Semey, Kazakhstan
| | - Haruo Takeshita
- Department of Legal Medicine, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Noriyuki Kawano
- The Center for Peace, Hiroshima University, Hiroshima, Japan
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Balbuena LD, Baetz M, Sexton JA, Harder D, Feng CX, Boctor K, LaPointe C, Letwiniuk E, Shamloo A, Ishwaran H, John A, Brantsæter AL. Identifying long-term and imminent suicide predictors in a general population and a clinical sample with machine learning. BMC Psychiatry 2022; 22:120. [PMID: 35168594 PMCID: PMC8848909 DOI: 10.1186/s12888-022-03702-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 01/12/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Machine learning (ML) is increasingly used to predict suicide deaths but their value for suicide prevention has not been established. Our first objective was to identify risk and protective factors in a general population. Our second objective was to identify factors indicating imminent suicide risk. METHODS We used survival and ML models to identify lifetime predictors using the Cohort of Norway (n=173,275) and hospital diagnoses in a Saskatoon clinical sample (n=12,614). The mean follow-up times were 17 years and 3 years for the Cohort of Norway and Saskatoon respectively. People in the clinical sample had a longitudinal record of hospital visits grouped in six-month intervals. We developed models in a training set and these models predicted survival probabilities in held-out test data. RESULTS In the general population, we found that a higher proportion of low-income residents in a county, mood symptoms, and daily smoking increased the risk of dying from suicide in both genders. In the clinical sample, the only predictors identified were male gender and older age. CONCLUSION Suicide prevention probably requires individual actions with governmental incentives. The prediction of imminent suicide remains highly challenging, but machine learning can identify early prevention targets.
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Affiliation(s)
- Lloyd D Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada.
| | - Marilyn Baetz
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Douglas Harder
- Mental Health & Addictions Services, Saskatchewan Health Authority, Saskatoon, Canada
| | - Cindy Xin Feng
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Kerstina Boctor
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | - Candace LaPointe
- Mental Health & Addictions Services, Saskatchewan Health Authority, Saskatoon, Canada
| | - Elizabeth Letwiniuk
- Mental Health & Addictions Services, Saskatchewan Health Authority, Saskatoon, Canada
| | - Arash Shamloo
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | | | - Ann John
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Anne Lise Brantsæter
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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Næss EO, Mehlum L, Qin P. Marital status and suicide risk: Temporal effect of marital breakdown and contextual difference by socioeconomic status. SSM Popul Health 2021; 15:100853. [PMID: 34222610 PMCID: PMC8242039 DOI: 10.1016/j.ssmph.2021.100853] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/03/2021] [Accepted: 06/18/2021] [Indexed: 11/18/2022] Open
Abstract
Research has shown that people who have never been married, divorced, or widowed are at an increased risk of suicide compared with those who are married, but we have little knowledge as to how this elevated risk is modified by socioeconomic factors, and little research has studied the risk among persons enduring a marital separation. This study addressed these issues with individual-level data from Norwegian national registers. All suicide cases in people above 18 years that took place in the period 1992–2012 (n = 11 051) were compared with living controls (185 685) matched on sex and age via a nested case control design, and suicide risk associated with marital status was assessed with conditional logistic regression. The results showed that, compared with a status of being married, suicide risk was highly associated with a status of being never married, separated, divorced, or widowed, even after adjustment for income-level, educational attainment, centrality of residence, and immigration status. The strongest effect was seen for a separated status; compared to the married, separated persons were fully 6.06 times more apt to die by suicide, and the effect was strongest in the 30 days following a separation. The observed significant associations remained but differed in strength by sex and age, and there were significant deviations by personal socioeconomic status. Most notably, the increased risk was higher for never-married persons with low educational attainment or income. However, most interaction effects (10/16) did not yield significant results. In conclusion, suicide risk is strongly associated with a single status of any form with the highest risk during a marital separation, but the increased risk varies in strength according to individual-level factors. The stress and loss of support induced by marital dissolution are important contributing risk factors for suicide, and persons with low income may be especially vulnerable. Single status of any form was associated with increased risk of suicide. The risk was highest during the first month of a marital separation. A separated status had the strongest effect in middle-aged adults of both sexes. The risk for individuals who had never married differed by income and education.
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Affiliation(s)
- Erik Oftedahl Næss
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway
| | - Lars Mehlum
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway
| | - Ping Qin
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway
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Wu S, Adamsk K. Intervention effect of cognitive behaviour therapy under suicidology on psychological stress and emotional depression of college students. Work 2021; 69:697-709. [PMID: 34120946 DOI: 10.3233/wor-213510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The suicide of college students had been a social topic attracting people's attention, and the generation of suicidal ideation was an inevitable link in the psychological process of suicidal behavior. It was the focus of many researches whether the pressure of college students with suicidal ideation can be detected and relieved in time. OBJECTIVE The study aimed to analyze the therapeutic effect of cognitive behaviour therapy on psychological stress, depression, and other negative emotions of college students with suicide ideation. METHODS 114 people from 1,158 college students with suicide ideation in the Wuhan area were divided into an experimental group and a control group in this study. Students in the experimental group were given with the cognitive behaviour therapy, and students in the control group were not intervened in any way. The suicide ideation scale (despair, optimism, and sleep), psychological stress test rating, and self-reporting inventory (somatization, compulsion, interpersonal relationship, depression, anxiety, hostility, terror, delusion, and psychosis) were used to evaluate the objects in the pre-test stage, intermediate-test stage, and the tracking-test stage. The multivariate logistic regression was adopted to analyze the influencing factors of the suicide ideation of the college student. RESULTS The suicide ideation of the college student was significantly positively correlated with the psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis (P > 0.05); the total score of suicide ideation, despair, optimism, and sleep in the experimental group were lower than those in the control group (P < 0.05) in the intermediate-test stage and the tracking-test stage (P < 0.05); the psychological stress, depression, and anxiety of the college students in the experimental group in the intermediate-test and tracking-test stage were slighter than those in the control group (P < 0.05); the somatization, compulsion, and interpersonal relationship of students in the experimental group were significantly lower than those in the control group (P < 0.05). CONCLUSIONS The psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis were all risk factors for the college student to have suicide ideation. Negative emotions such as psychological stress, emotional depression, and anxiety of the college student with suicide ideation could be improved effectively by cognitive behaviour therapy, and the level of suicide ideation could be reduced finally.
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Affiliation(s)
- Shaofei Wu
- Hubei Province Key Laboratory of Intelligent Robots, Wuhan Institute of Technology, Wuhan, P.R. China.,School of Computer Science and Engineering, Wuhan Institute of Technology, Wuhan, P.R. China
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Saunders NR, Chiu M, Lebenbaum M, Chen S, Kurdyak P, Guttmann A, Vigod S. Suicide and Self-Harm in Recent Immigrants in Ontario, Canada: A Population-Based Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:777-788. [PMID: 31234643 PMCID: PMC6882076 DOI: 10.1177/0706743719856851] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To estimate the rates of suicide and self-harm among recent immigrants and to determine which immigrant-specific risk factors are associated with these outcomes. METHODS Population-based cohort study using linked health administrative data sets (2003 to 2017) in Ontario, Canada which included adults ≥18 years, living in Ontario (N = 9,055,079). The main exposure was immigrant status (long-term resident vs. recent immigrant). Immigrant-specific exposures included visa class and country of origin. Outcome measures were death by suicide or emergency department visit for self-harm. Cox proportional hazards estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). RESULTS We included 590,289 recent immigrants and 8,464,790 long-term residents. Suicide rates were lower among immigrants (n = 130 suicides, 3.3/100,000) than long-term residents (n = 6,354 suicides, 11.8/100,000) with aHR 0.3, 95% CI, 0.2 to 0.3. Male-female ratios in suicide rates were attenuated in immigrants. Refugees had 2.1 (95% CI, 1.3 to 3.6; rate 6.1/100,000) and 2.8 (95% CI, 2.5 to 3.2) times the likelihood of suicide and self-harm, respectively, compared with nonrefugee immigrants. Self-harm rate was lower among immigrants (n = 2,256 events, 4.4/10,000) than long-term residents (n = 68,039 events, 9.7/10,000 person-years; aHR 0.3; 95% CI, 0.3 to 0.3). Unlike long-term residents, where low income was associated with high suicide rates, income was not associated with suicide among immigrants and there was an attenuated income gradient for self-harm. Country of origin-specific analyses showed wide ranges in suicide rates (1.4 to 9.9/100,000) and self-harm (1.8 to 14.9/10,000). CONCLUSION Recent immigrants have lower rates of suicide and self-harm and different sociodemographic predictors compared with long-term residents. Analysis of contextual factors including immigrant class, origin, and destination should be considered for all immigrant suicide risk assessment.
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Affiliation(s)
- Natasha Ruth Saunders
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada.,These authors contributed equally, acting as co-first authors
| | - Maria Chiu
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada.,These authors contributed equally, acting as co-first authors
| | - Michael Lebenbaum
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada
| | | | - Paul Kurdyak
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Astrid Guttmann
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada
| | - Simone Vigod
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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Giammusso I, Casadei F, Catania N, Foddai E, Monti MC, Savoja G, Tosto C. Immigrants Psychopathology: Emerging Phenomena and Adaptation of Mental Health Care Setting by Native Language. Clin Pract Epidemiol Ment Health 2018; 14:312-322. [PMID: 30972131 PMCID: PMC6407656 DOI: 10.2174/1745017901814010312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/18/2018] [Accepted: 10/29/2018] [Indexed: 11/22/2022]
Abstract
Mental health of immigrants is an important social and clinical issue. Immigrants may report higher rates of mental disorders and lower levels of use of mental health service with respect to natives. The aim of the present work is to review recent findings of the psychopathology of immigrants and analyze how to adapt the mental care settings through the use of mother tongues. We searched the literature to individuate and review the most recent scientific articles focused on the psychopathology of immigrants realized in Europe. Moreover, we summarized the guidelines about immigrants mental health care and we focused on the barriers caused by language. We individuated 15 papers reporting data about mental disorders among immigrants and the related risk and protective factors. The articles reported information about psychosis, depression, anxiety, post-traumatic stress disorder, somatization and suicide rates. Risk and protective factors are individuated mainly among social factors (e.g. ethnic density effect, hosting countries' policies). Furthermore, immigrants encounter language barriers in the use of mental care services. The realization of cross-cultural training and the development of a working alliance between clinicians and interpreters resulted to be effective solutions even if these interventions are not frequently implemented. The extent of migratory flows and the related difficulties experienced by immigrants require attention and well-informed interventions. The high rates of incidence of mental disorder and the strict number of services who implement interventions taking into accounts fundamental aspect as language show that there is still a lot to do.
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Affiliation(s)
- Isabella Giammusso
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.,Associazione PLP, Psicologi Liberi Professionisti, Via Pasteur, 65, 00144, Rome, Italy
| | - Filippo Casadei
- Associazione PLP, Psicologi Liberi Professionisti, Via Pasteur, 65, 00144, Rome, Italy
| | - Nicolay Catania
- Associazione PLP, Psicologi Liberi Professionisti, Via Pasteur, 65, 00144, Rome, Italy
| | - Elena Foddai
- Associazione PLP, Psicologi Liberi Professionisti, Via Pasteur, 65, 00144, Rome, Italy
| | - Maria Chiara Monti
- Associazione PLP, Psicologi Liberi Professionisti, Via Pasteur, 65, 00144, Rome, Italy
| | - Giorgia Savoja
- Associazione PLP, Psicologi Liberi Professionisti, Via Pasteur, 65, 00144, Rome, Italy
| | - Crispino Tosto
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
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7
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Puzo Q, Mehlum L, Qin P. Rates and characteristics of suicide by immigration background in Norway. PLoS One 2018; 13:e0205035. [PMID: 30265720 PMCID: PMC6161913 DOI: 10.1371/journal.pone.0205035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/18/2018] [Indexed: 11/30/2022] Open
Abstract
Suicide mortality among immigrant groups is an important health issue, particularly in countries with growing segments of immigrant populations such as Norway. Through linkage of Norwegian national registers we wanted to estimate suicide rates (per 100,000 population) in immigrant groups and to profile characteristics of suicide by immigration background with respect to sex, age, method and seasonality of suicide as well as time since immigrating to Norway. Among all 11,409 suicides during 1992-2012, 1,139 (10%) were individuals with an immigration background. Suicide rate was lower in first-generation immigrants (foreign-born persons to two foreign-born parents) than native Norwegians (9.53 vs 12.22, P < 0.01), with a significant difference confined to male rates only. Foreign-born persons with at least one Norwegian-born parent had significantly higher suicide rates than natives in both sexes (22.42 vs 18.03 in males, 11.67 vs 6.54 in females, P < 0.01). The most frequently used suicide method in all the population groups was hanging; this method accounted for 44.0% of all suicides of first-generation immigrants, 45.2% of all suicides of foreign-born persons with at least one Norwegian-born parent, and 35.4% of all suicides of natives. Suicide by firearms accounted for a much smaller proportion of cases of first-generation immigrants (6.7%) and foreign-born persons with at least one Norwegian-born parent (6.8%) than cases of native Norwegians (20.7%). In terms of monthly distribution, suicides of first-generation immigrants displayed two peaks, in May and in November (P = 0.01). More than 25% of all first-generation immigrant suicides occurred in the first five years after immigration; but differences in time since immigration were observed by sex and country group of origin, in particular among those aged 35 years or less when moving to Norway. In conclusion, there are notable differences in characteristics of suicides by immigration background. Knowledge of immigrant mortality according to suicide method, seasonality of suicide, and time since immigration may be useful when planning suicide preventive measures.
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Affiliation(s)
- Quirino Puzo
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Kazemi-Galougahi MH, Mansouri A, Akbarpour S, Bakhtiyari M, Sartipi M, Moradzadeh R. Income-related inequality in completed suicide across the provinces of Iran. Epidemiol Health 2018; 40:e2018012. [PMID: 29642654 PMCID: PMC6004429 DOI: 10.4178/epih.e2018012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/31/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran. METHODS This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran. RESULTS The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06). CONCLUSIONS This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.
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Affiliation(s)
| | - Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samaneh Akbarpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Bakhtiyari
- Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Majid Sartipi
- Department of Epidemiology and Biostatistics, School of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
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