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Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences

Published online by Cambridge University Press:  20 April 2007

ESBEN AGERBO ,
DAVID GUNNELL ,
JENS PETER BONDE ,
PREBEN BO MORTENSEN  and
MERETE NORDENTOFT
ESBEN AGERBO*
Affiliation:
National Centre for Register-based Research, University of Aarhus, Aarhus C, Denmark
DAVID GUNNELL
Affiliation:
Department of Social Medicine, University of Bristol, Bristol, UK
JENS PETER BONDE
Affiliation:
Department of Occupational Medicine, Aarhus University Hospital, Aarhus C, Denmark
PREBEN BO MORTENSEN
Affiliation:
National Centre for Register-based Research, University of Aarhus, Aarhus C, Denmark
MERETE NORDENTOFT
Affiliation:
Bispebjerg Hospital, Department of Psychiatry, Copenhagen NV, Denmark
*
*Address for correspondence: Esben Agerbo, M.Sc., National Centre for Register-based Research, University of Aarhus, Taasingegade1, DK-8000 Aarhus C, Denmark. (Email: ea@ncrr.dk)
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Abstract

Background

To explore the risk of suicide associated with occupation while evaluating the impact of socio-economic, demographic and psychiatric differences.

Method

A nested case–control study with 3195 suicides and 63 900 matched controls. Information on causes of death, occupation, psychiatric admission, marital status and socio-economic factors was obtained from routine registers.

Results

Across the 55 occupations investigated, the risk of suicide ranged from 2·73 [95% confidence interval (CI) 1·77–4·22] among doctors to 0·44 (95% CI 0·27–0·72) among architects and engineers compared with primary school teachers. With the exception of doctors and nurses, most of the excess risk of suicide associated with particular occupations is explained by the social and economic characteristics of people in those occupations. Much, but not all, of the excess risk in doctors and nurses is due to their increased use of self-poisoning, a method for which they have the knowledge to use effectively. Occupation has little association with suicide among people who suffer from a psychiatric illness, except for doctors, where the excess risk is 3·62 (p=0·007).

Conclusions

Most of the considerable variation in suicide risk across occupations is explained by socio-economic factors, except for doctors and nurses. Apart from in doctors, the risk of suicide has little association with occupation among people who suffer from a psychiatric illness. Restriction of access to lethal means is an important strategy in suicide prevention.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 8 , August 2007 , pp. 1131 - 1140
Copyright
Copyright © Cambridge University Press 2007

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