Completed Suicide and Marital Status According to the Italian Region of Origin

Abstract

Completed suicide is associated with marital status; being unmarried is associated with a higher suicide rate as compared with being married or living with a partner. Moreover, the region of origin may be particularly important when trying to explain major inequalities in suicide rates across a country. Data were obtained from the Italian Database on Mortality, collected by the Italian Census Bureau (ISTAT) and processed by the Italian National Institute of Health-Statistics Unit. The Italian population in the last Italian census (October 2001) was used to estimate age-standardized mortality rates from suicide by marital status (ICD-9 revision: E950-959) and "natural" causes (ICD-9 revision: 0-280; 320-799). Rate Ratios and 95% confidence intervals were calculated using married individuals as a reference. All analyses were conducted separately for men and women for 2000-2002, the most recent years with data available. Logistic regression analysis was used to compare differences by marital status for suicide versus death from natural causes. There are major inequalities in suicide rates in Italy. The North region has the highest suicide rates both for married and non-married individuals. Sardinia Island has the highest male suicide rate in Italy-23.07 per 100,000 per year-compared with the average national male suicide rate of 13.80, a difference which is significantly higher by 67% (RR: 1.67; 95%CI = 1.40-1.99). In contrast, Sardinia has one of the lowest female suicide rates among the Italian regions, close to that of the South and the Center regions. The North-East is the only region where the suicide rate among divorced men is significantly higher than that of married men. In the South, widowers have the highest suicide rate, with a rate 6-times that of married men (RR = 5.66; 95%CI = 4.46-7.18). Major inequalities in suicide rates by region may derive from different socio-cultural backgrounds, confirming the notion that suicide is a multifaceted phenomenon. The results of the present study indicate that suicide prevention must take into account the social and cultural characteristics of different communities. Moreover, these findings support the notion that marital status may play a central role in influencing suicide.

Social-Environmental Factors and Suicide Mortality: A Narrative Review of over 200 Articles

“…Findings from studies at both the aggregate and individual level show that divorce (Andres & Halicioglu, 2010;Chang et al, 2011;Corcoran & Nagar, 2010;Denney, Rogers, Krueger, & Wadsworth, 2009;Gunnell et al, 2003;Kposowa, 2000;Leenaars & Lester, 1999;Masocco et al, 2010;Masocco et al, 2008;Wu & Bond, 2006), separation (Barstad, 2008;Ide, Wyder, Kolves, & De Leo, 2011;Wyder, Ward, & De Leo, 2009) and widowhood (Ajdacic-Gross et al, 2007;Corcoran, 2009;Denney et al, 2009;Luoma & Pearson, 2002;Masocco et al, 2010;Masocco et al, 2008) result in a higher likelihood of suicide. In comparison, marriage is commonly found to be negatively related to suicide (Cutright & Fernquist, 2007;Cutright, Stack, & Ferquist, 2007;Griffiths, Ladva, Brock, & Baker, 2008;Masocco et al, 2008;O'Reilly, Rosato, Connolly, & Cardwell, 2008;Qin, Agerbo, & Mortensen, 2003).…”

“…Research also suggests that the association between relationship status and suicide is sensitive to social change, as well as age, gender and the time period under analysis (Messner, Bjarnason, Raffalovich, & Robinson, 2006;Pampel, 1998;Trovato, 1987). Other individual and contextual factors also considered to be important to the association between relationship status and suicide include stigma towards help-seeking, social isolation, unemployment, and alcohol and drug use (Masocco et al, 2010). Therefore, it appears that the protective effects of relationships on suicide are related to social and cultural norms and individual factors.…”

Unmasking depression in persons attempting suicide

“…Similar socio-demographic characteristics were found in other community-based studies. 5,10,[27][28][29] A minority of participants reported chronic illnesses such as lifestyle diseases. This may be due to the fact that the majority of our study objective screening and effective early management of depression in all patients presenting with any form of suicidal behaviour.…”

Prevalence and risk factors of suicide in a rural area of Shandong province in mainland China: a case control study

“…In India, Pakistan, and Iran, being married appeared to a risk factor for suicide, especially for women [21][22][23] . However, most studies from Asia, Europe, New Zealand, and the United States have shown that married status had some protective effect against suicide, especially for men [6,[16][17][18][19][28][29][30][31] . In Denmark, marital status had a comparable protective influence on suicide risk in both sexes [20] .…”

“…In India, the rate for suicide was nearly equal to men and women [23][24] . Similarly, being unmarried has also been identified as a risk factor for suicide in the majority of previous studies [1,[16][17][18][19][26][27][28][29][30][31] . However, in India, Pakistan, and Iran, majority of suicide victims were married and being married was even a risk factor for suicide, especially in women [21][22][23] .…”