High Altitude Remains Associated with Elevated Suicide Rates after Adjusting for Socioeconomic Status: A Study from South Korea

Abstract

There have been several studies supporting a possible relationship between high suicide rate and high altitude. However socioeconomic status may confound this association because low socioeconomic status, which is known to be related to a high suicide rate, is also associated with living at high altitude. This study aims to explore whether the relationship between high altitude and high suicide rate remains after adjusting for socioeconomic status in South Korea. We collected demographic data of completed suicides, the mean altitude of the district where each suicide took place, and the mean income of each district. We analyzed the data using regression analysis before and after adjustment for mean income. We found that there is a positive correlation between altitude and suicide rate, even after adjustment for mean income. Thus, altitude appears to be an independent risk factor for suicide.

Cerebral bioenergetic differences measured by phosphorus‐31 magnetic resonance spectroscopy between bipolar disorder and healthy subjects living in two different regions suggesting possible effects of altitude

“…The results of the present study are also consistent with the published evidence that increased suicide rates are associated with mountainous areas of the USA, an association that, notably, has been replicated by investigators working in multiple other countries, which may be plausibly linked with altered brain bioenergetics in the cerebral cortex of both BD and healthy subjects, possibly reflecting altitude‐related changes in the brain. These changes in brain chemistry may serve as biomarkers relevant to altitude that may contribute to the vulnerability of individuals who suffer from, or are at risk for the development of, BD.…”

“…Rates of suicide are increased in higher‐altitude regions of the USA as well as other countries . Increasing altitude has also been associated with altered local rates of illicit drug use, attention‐deficit hyperactivity disorder, and depressive episodes .…”

“…Rates of suicide are increased in higher-altitude regions of the USA as well as other countries. [1][2][3][4] Increasing altitude has also been associated with altered local rates of illicit drug use, attention-deficit hyperactivity disorder, and depressive episodes. [5][6][7] Although this observation was not replicated in some countries, 8,9 it is intriguing that altitude may be a crucial factor affecting complex human behaviors, such as suicidal behavior, 10 in line with reported alterations of various neurotransmitters due to hypobaric hypoxia.…”

Sightings edited by Erik Swenson and Peter Bärtsch

“…With respect to the latter, two recent reports find a greater rate of suicide with higher altitude residence (Kim et al, 2014a) and greater methamphetamine use (Kim et al, 2014b). An altitude correlation with suicide has already been noted in the Rocky Mountains of North America.…”

“…An altitude correlation with suicide has already been noted in the Rocky Mountains of North America. The study of Kim et al (2014a) examined suicide rates in South Korea. They found a progressive age and socioeconomic adjusted rate of suicide that was apparent from sea level to 1000 m, the highest altitude of permanent residence in South Korea.…”