Inequality in Addiction and Mental Disorders in 6818 Suicide Attempts: Determine of Positive Contribution of Determinants by Decomposition Method
,
Abstract
Background: Unpleasant health outcomes are common in deprived communities and have been shown a direct connection between socioeconomic status and wellbeing but, the effect of the socioeconomic status on suicide is currently controversial. This study explored the relationship of the socioeconomic status and addiction and mental disorders in suicide attempts and decomposed inequalities into its determinants to calculating share of contribution to the inequality.
Methods: This cross-sectional study recognized 546 suicide deaths and 6818 attempted suicides from 1 Jan 2010 to 31 Dec 2014 in Ilam Province, West of Iran. Inequality measured by concentration index (CI) and decomposing contribution in inequality. All analysis was performed by standard statistical software, Stata (Ver. 11.2).
Results: The pooled rate of death in people with suicide attempts was 8.0% and that of having a history of suicide was 5.2%. The overall CI for addiction was -0.233 (95% CI= -0.383 to -0.084), and the CI for mental disorders was 0.0006 (95% CI = -0.009 to 0.010). The more amount of contribution to socioeconomic inequality in suicide attempts because of age group of < 25 yr (26%), socioeconomic level (23%), and marital status (22%).
Conclusion: Addiction and mental disorders were distributed among suicide attempters unequally and gap between advantaged and disadvantaged attempted suicide confirmed by our results. Addiction prevention-related policies and programmers’ should be focus on disadvantaged groups.
Kessler RC, Berglund P, Borges G, Nock M, Wang PS (2005). Trends in suicide ideation, plans, gestures, and attempts in the united states, 1990-1992 to 2001-2003. JAMA ,293(20):2487-95.
Shirazi HR, Hosseini M, Zoladl M et al (2012). Suicide in the Islamic Republic of Iran: an integrated analysis from 1981 to 2007. East Mediterr Health J, 18(6):607-13.
Welch SS (2001). A review of the literature on the epidemiology of parasuicide in the general population. Psychiatr Serv, 52(3):368-75.
Malakouti SK, Davoudi F, Khalid S et al (2015). The Epidemiology of Suicide Behaviors among the Countries of the Eastern Mediterranean Region of WHO: a Systematic Review. Acta Med Iran,53(5):257-65.
Suokas J, Suominen K, Isometsä E, Ostamo A, Lönnqvist J (2001). Long-term risk factors for suicide mortality after attempted suicide - Findings of a 14-year follow-up study. Acta Psychiatr Scand,104(2):117-21.
Evans E, Hawton K, Rodham K (2004). Factors associated with suicidal phenomena in adolescents: A systematic review of population-based studies. Clin Psychol Rev, 24(8):957-79.
Sokero TP, Melartin TK, Rytsala HJ, Leskela US, Lestela-Mielonen PS, Isometsa ET (2003). Suicidal ideation and attempts among psychiatric patients with major depressive disorder. J Clin Psychiatry,64(9):1094-100.
Morden NE, Lai Z, Goodrich DE et al (2012). Eight-Year Trends of Cardiometabolic Morbidity and Mortality in Patients with Schizophrenia. Gen Hosp Psychiatry, 34(4):368-79.
Shakeri J, Farnia V, Abdoli N, Akrami MR, Arman F, Shakeri H (2015). The Risk of Repetition of Attempted Suicide Among Iranian Women with Psychiatric Disorders as Quantified by the Suicide Behaviors Questionnaire. Oman Med J, 30(3):173-80.
Mohammadi MR, Ghanizadeh A, Rahgozart M et al (2005). Suicidal attempt and psychiatric disorders in Iran. Suicide Life Threat Behav, 35(3):309-16.
Afghah S, Aghahasani M, Noori-Khajavi M, Tavakoli E (2014). Survey of Suicide Attempts in Sari. Iran J Psychiatry, 9(2):89-95.
Stirbu I, Kunst AE, Mielck A, Mackenbach JP (2011). Inequalities in utilisation of general practitioner and specialist services in 9 European countries. BMC Health Services Research,11(1):288.
Burrows S, Laflamme L (2010). Socioeconomic disparities and attempted suicide: state of knowledge and implications for research and prevention. Int J Inj Contr Saf Promot, 17(1):23-40.
Yoder KA, Hoyt DR (2005). Family economic pressure and adolescent suicidal ideation: application of the family stress model. Suicide Life Threat Behav, 35(3):251-64.
Chan WC, Law C, Liu K, Wong PC, Law Y, Yip PF (2009). Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences. Soc Psychiatry Psychiatr Epidemiol, 44(4):278-84.
Vyas S, Kumaranayake L (2006). Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan,21:459 - 68.
Wagstaff A, Paci P, Van Doorslaer E (1991). On the measurement of inequalities in health. Soc Sci Med, 33:545 - 57.
Wagstaff A, Van Doorslaer E, Paci P (1989). Equity in the finance and delivery of health care: some tentative cross-country comparisons. Oxford Rev Econ Policy, 5:89 - 112.
Wagstaff A, Van Doorslaer E, Watanabe N (2003). On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J Econom, 112:207 - 23.
Speybroeck N, Konings P, Lynch J et al (2010). Decomposing socioeconomic health inequalities. Int J Public Health, 55:347 - 51.
Dragisic T, Dickov A, Dickov V, Mijatovic V (2015). Drug Addiction as Risk for Suicide Attempts. Mater Sociomed, 27(3):188-91.
Taylor R, Morrell S, Slaytor E, Ford P (1998). Suicide in urban New South Wales, Australia 1985–1994: socio-economic and migrant interactions. Soc Sci Med, 47(11):1677-86.
Kposowa AJ (2001). Unemployment and suicide: a cohort analysis of social factors predicting suicide in the US National Longitudinal Mortality Study. Psychol Med, 31(1):127-38.
Congdon P (2013). Assessing the Impact of Socioeconomic Variables on Small Area Variations in Suicide Outcomes in England. Int J Environ Res Public Health, 10(1):158-77.
Gunnell DJ, Peters TJ, Kammerling RM, Brooks J (1995). Relation between parasuicide, suicide, psychiatric admissions, and socioeconomic deprivation. BMJ, 311(6999):226-30.
Phillips AC, Batty GD, Gale CR et al (2009). Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: the Vietnam experience study. Psychosom Med, 71(4):395-403.
Sharma R1, Markar HR (1994). Mortality in affective disorders. J Affect Disord, 31(2):91-6.
| Files | ||
| Issue | Vol 46 No 6 (2017) | |
| Section | Original Article(s) | |
| Keywords | ||
| Inequality Addiction Decomposition Suicide attempts Mental disorders | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
