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Suicide mortality trends in Galicia, Spain and their relationship with economic indicators

Published online by Cambridge University Press:  02 September 2015

P. Fernández-Navarro ,
M. L. Barrigón ,
J. Lopez-Castroman ,
M. Sanchez-Alonso ,
M. Páramo ,
M. Serrano ,
M. Arrojo  and
E. Baca-García
P. Fernández-Navarro
Affiliation:
Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública – CIBERESP), Spain
M. L. Barrigón
Affiliation:
Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain
J. Lopez-Castroman
Affiliation:
Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier and INSERM U1061, Montpellier, France
M. Sanchez-Alonso
Affiliation:
Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain
M. Páramo
Affiliation:
Servicio de Psiquiatría, EOXI de Santiago, Servicio Gallego de Salud, Spain
M. Serrano
Affiliation:
Servicio de Psiquiatría, EOXI de Coruña, Servicio Gallego de Salud, Spain
M. Arrojo
Affiliation:
Servicio de Salud Mental y Asistencia a Drogodependencias, Dirección General de Asistencia Sanitaria, Servicio Gallego de Salud, Spain
E. Baca-García*
Affiliation:
Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA
*
*Address for correspondence: E. Baca-García, Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain. (Email: ebacgar2@yahoo.es)
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Abstract

Background.

Recent research has shown an association between unemployment and suicide, but the mediating factors in this relationship are still unknown. In this study, we investigated the effect of unemployment and economic recession on suicide rates in the Spanish region of Galicia between 1975 and 2012

Method.

We analysed age-standardised suicide rates in men and women and in four age groups: less than 25 years, 25–45 years, 45–65 years and more than 65 years and performed a joinpoint analysis to determine trend changes throughout 1975–2012 period. Also we analysed the association between suicide, recession and unemployment by means of a temporal trend model with a Generalised Additive Model.

Results.

Suicide rates increased from 145 suicides in 1975 to a high in 1993, with 377 deaths by suicide, representing 1.38% of all causes of death, and thereafter they tend to decrease to 335 suicides in 2012. Joinpoint analyses revealed that suicide rates changed differently across sex and age groups. For men, the annual percentage of change (APC) between 1975 and 1988 (CI 95% 1986–1994) was 5.45 (CI 95% = 3.5, −7.2) but from 1988 the APC became negative [−0.66 (CI 95% = −1.3, −0.1)]. For women, APC between 1974 and 1990 (CI 95% 1986–1992) was 4.86 (CI 95% = 3.2, −6.4) and −1.46 subsequently (CI 95% = −2.2, −0.5). Women aged 24 years or less showed stable suicide rates while men from 45–65 years showed two incidence peaks. When we studied the independent correlation between unemployment, recession and suicide, we found a significant association between unemployment and suicide, but not between recession and suicide for both sexes together and for men while for women there was no significant correlation between suicide and unemployment or recession. Finally, when we studied the effect of the interaction between unemployment and recession on suicide we found economic recession and unemployment interacted with regards to suicide rates (F = 5.902; df = 4.167; p = 0.00098) and after adjusting by sex, the effect was confirmed among men (F = 4.827; df = 2.823; p = 0.0087), but not among women (F = 0.001; df = 1.000; p = 0.979).

Conclusions.

Although suicide rates in Galicia are gradually decreasing in the last decades, there are important sex and age differences. Unemployment was related with suicide during economic recession periods according to our results.

Keywords

Economic recessionjoinpoint analysessuicideunemployment
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 5 , October 2016 , pp. 475 - 484
Copyright
Copyright © Cambridge University Press 2015 

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