Suicide, unemployment and other socioeconomic factors: evidence from the economic crisis in Greece

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Abstract

Background and Objectives: Economic adverse conditions are acknowledged as having a major impact on the exacerbation of mental disorders and suicides. The severity of current European crisis and the local unrelenting spending is affecting largely the economy of Greece. Methods: The aim of this study was to explore changes in suicides and their possible association with macroeconomic and behavioural factors. Data for the period 1990-2011 were drawn mainly from the Hellenic Statistical Authority and Eurostat. Suicide mortality rates were correlated with economic and behavioural factors. Results: Suicide mortality rates were increased by 55.8% between 2007 and 2011 while the total mortality was increased by 1.1% only. Significantly increasing trends in public debt, unemployment rates, consumption of daily units of antidepressants as well as divorces per 1000, homicides per 100,000 and persons with HIV per 100,000 were also observed. Suicides have been found to bear strong correlation with unemployment (r. 0.64). Significant associations were also found between suicide mortality and the percentage of public debt as percentage of GDP, the incidence of infections from HIV and homicides. Conclusions: People suffering from income and job losses, living in a demoralized social state caused by severe austerity measures and restrictive health policies, are exposed to risks for developing depression or commit suicide.

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Most cited references 73

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Health effects of financial crisis: omens of a Greek tragedy.

Alexander Kentikelenis, Marina Karanikolos, Irene N Papanicolas … (2011)

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Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981-1997.

Preben Mortensen, Esben Agerbo, Ping Qin (2003)

Suicide risk was addressed in relation to the joint effect of factors regarding family structure, socioeconomics, demographics, mental illness, and family history of suicide and mental illness, as well as gender differences in risk factors. Data were drawn from four national Danish longitudinal registers. Subjects were all 21,169 persons who committed suicide in 1981-1997 and 423,128 live comparison subjects matched for age, gender, and calendar time of suicide by using a nested case-control design. The effect of risk factors was estimated through conditional logistic regression. The interaction of gender with the risk factors was examined by using the log likelihood ratio test. The population attributable risk was calculated. Of the risk factors examined in the study, a history of hospitalization for psychiatric disorder was associated with the highest odds ratio and the highest attributable risk for suicide. Cohabiting or single marital status, unemployment, low income, retirement, disability, sickness-related absence from work, and a family history of suicide and/or psychiatric disorders were also significant risk factors for suicide. Moreover, these factors had different effects in male and female subjects. A psychiatric disorder was more likely to increase suicide risk in female than in male subjects. Being single was associated with higher suicide risk in male subjects, and having a young child with lower suicide risk in female subjects. Unemployment and low income had stronger effects on suicide in male subjects. Living in an urban area was associated with higher suicide risk in female subjects and a lower risk in male subjects. A family history of suicide raised suicide risk slightly more in female than in male subjects. Suicide risk is strongly associated with mental illness, unemployment, low income, marital status, and family history of suicide. The effect of most risk factors differs significantly by gender.

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Debt, income and mental disorder in the general population.

T. Brugha, M. Farrell, N. Singleton … (2008)

The association between poor mental health and poverty is well known but its mechanism is not fully understood. This study tests the hypothesis that the association between low income and mental disorder is mediated by debt and its attendant financial hardship. The study is a cross-sectional nationally representative survey of private households in England, Scotland and Wales, which assessed 8580 participants aged 16-74 years living in general households. Psychosis, neurosis, alcohol abuse and drug abuse were identified by the Clinical Interview Schedule--Revised, the Schedule for Assessment in Neuropsychiatry (SCAN), the Alcohol Use Disorder Identification Test (AUDIT) and other measures. Detailed questions were asked about income, debt and financial hardship. Those with low income were more likely to have mental disorder [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.68-2.59] but this relationship was attenuated after adjustment for debt (OR 1.58, 95% CI 1.25-1.97) and vanished when other sociodemographic variables were also controlled (OR 1.07, 95% CI 0.77-1.48). Of those with mental disorder, 23% were in debt (compared with 8% of those without disorder), and 10% had had a utility disconnected (compared with 3%). The more debts people had, the more likely they were to have some form of mental disorder, even after adjustment for income and other sociodemographic variables. People with six or more separate debts had a six-fold increase in mental disorder after adjustment for income (OR 6.0, 95% CI 3.5-10.3). Both low income and debt are associated with mental illness, but the effect of income appears to be mediated largely by debt.