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Læknablaðið - nov 2019, Qupperneq 16

Læknablaðið - nov 2019, Qupperneq 16
488 LÆKNAblaðið 2019/105 Introduction: Suicides are number 16 as a cause of death worldwide. Causes are not always known, often associated with depression or trauma. Suicide incidence has decreased world- wide in the past three decades. The economic crisis of 2008 led to an increase in many countries. Many confounding factors make comparisons between countries difficult. This study assesses the possible impact of economic crises in Iceland on suicide incidence. Material and Methods: The work is based on suicide data from 1911 to 2017 and six economic crises from 1918 to 2008. The incidence is calculated five and ten years before and after the index year of each crisis. Possible crisis impact was assessed by app- lying a quasi-Poisson model to the data. Variance can be greater than model shows, so overdispersion was assessed. The evolution over time is assessed by inspection of cumulative sum of squared residuals (CUSUMSQ). Results: Suicide incidence increased from 1930, beginning to decline around 1990. Given a small population size there are wide upwards incidence fluctuations, within and outside the crisis periods. The crises of 1931 and 1948 showed an increase, wheras in the others there is no change or a decrease. The sizes of deviations from expected value are, for the whole period, in compliance with the quasi-poisson model for counts. Conclusion: There is no statistical correlation between the six economic crises and suicide incidence in the Icelandic data. The study is based on population incidence and does not preclude a negative impact of economic crises on individuals. Economic crises and incidence of suicide in Iceland 1911-2017 ENGLISH SUMMARY 1Humus Inc., 2Laekning Inc., 3Forensic Psychiatry and Security unit Landspitali University Hospital, 4Faculty of Economics, University of Iceland. Key words: Economic crisis, Iceland, Suicide, century, quasi-Poisson model, time series. Correspondence: Högni Óskarsson, hogni@humus.is Högni Óskarsson1 Kristinn Tómasson2 Sigurður P. Pálsson3 Helgi Tómasson4 DOI: 10.17992/lbl.2019.11.255 1. worldlifeexpectancy.com/world-rankings-total-deaths - janúar 2019. 2. Preventing suicides: A global imperative. World Health Organization 2014. 3. Titelman D, Oskarsson H, Wahlbeck K, Nordentoft M, Mehlum L, Jiang G-X, et al. Suicide mortality trends in the Nordic countries 1980 – 2009. Nord J Psychiatr 2013; 67: 414-23. 4. Lee L, Roser M, Ortiz-Ospina E. Suicide. Our World in Data. ourworldindata.org/suicide - júlí 2016. 5. National Institute of Mental Health. nimh.nih.gov/health/ statistics/suicide.shtml - desember 2018. 6. Bertolote JM, Fleischmann A. A Global Perspective in the Epidemiology of Suicide. Suicidology 2002; 7: 2. 7. Chang S, Stuckler D, Yip P, Gunnell D. Impact of 2008 global economic crisis on suicide: time trend studies in 54 countries. BMJ 2013; 347: 5239. 8. Kegler SR, Stone DM, Holland KM. Trends in Suicide by Level of Urbanization - United States, 1999-2015. MMWR Morb Mortal Wkly Rep 2017; 66: 270-3. 9. Norström T, Grönquist H. The Great Recession, unemploy- ment and suicides. J Epidemiol Community Health 2015; 69: 110-6. 10. Iglesias-García C, Sáiz PA, Burón P, Sánchez-Lasheras F, Jiménez-Treviño L, Fernández- Artamendi S, et al. Suicide, unemployment, and economic recession in Spain. Rev Psiquiatr Salud Ment 2017; 10: 70-7. 11. Hintikka J, Saarinen PI, Vinamäki H. Suicide mortality in Finland during an economic cycle 1985-1995. Scand J of Public Health 1999; 2: 85-8. 12. De Vogli R, Gimeno D. Changes in income equality ad suicides after „shock therapy“ evidence from Eastern Europe. J Epidemol Community Health 2009; 63: 956. 13. Chang SS, Gunnell D, Sterne JA, Lu TH, Cheng AT. Was the economic crisis 1997-1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Soc Sci Med 2009; 68: 1322-31. 14. Koo J, Cox WM. An economic interpretation of suicide cycles in Japan Research Department Working Paper 0603. Federal Reserve Bank of Dallas, 2006. 15. Harper S, Bruckner TA. Did the Great Recession increase suicides in the USA? Evidence from an interrupted time- -series analysis. Ann Epidemiol 2017; 27; 409-14. 16. Harper S, Charters TJ, Strumpf EC, Galea S, Nandi A. Economic downturns and suicide mortality in the USA 1980-2010: Observational study. Int J Epidemiology 2015; 44; 956-66. 17. Huikari S, Miettunen J, Korhonen M. J. Economic crises and suicides between 1970 and 2011. Time-trend study in 21 developed countries. Epidemiol Community Health 2019; 73: 311-6. 18. Ferrie J., Westerlund H, Oxenstierna G, Theorell T. The impact of moderate and major workplace expansion and downsizing on the psychosocial and physical work environment and income in Sweden. Scand J Public Health 2007; 35: 62-9. 19. Einarsson BG, Gunnlaugsson K, Ólafsson ÞT, Pétursson Þ. The long history of financial boom-bust cycles in Iceland. Part I: Financial crises. Seðlabanki Íslands 2015. 20. hagstofa.is - desember 2018. 21. landlaeknir.is - desember 2018. 22. who.int/classifications/icd/ - desember 2018. 23. McCullagh P, Nelder J. Generalized Linear Models. Chapman and Hall, London 1983. 24. Harvey A. The Econometric Analysis of Time Series. Philip Allan, Hertfortshire 1981. 25. Sigurðsson P, Jónsdóttir G. Sjálfsvíg á Norðurlöndum 1880-1980. Samanburður milli landa og hugsanlegar skráningarskekkjur. Læknablaðið 1985; 71: 86-90. 26. Jónsson G, Magnússon MS, Snorrason H. Hagskinna. Hagstofa Íslands, Reykjavík 1997. 27. Martin-Carrasco M, Evans-Lacko S, Dom G, Christodoulou NG, Samochowiec J, González-Fraile, et al. EPA guidance on mental health and economic crises in Europe 2016. Eur Arch Psych Clin Neurosci 2016; 266; 89-124. 28. Pálsson SP. Sjálfsvígsáhættumat og viðeigandi meðferð. Geðvernd 2018; 47: 6-17. Heimildir Barst til blaðsins 26. mars 2019, samþykkt til birtingar 17. september 2019. R A N N S Ó K N
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