Suicide in young adults: psychiatric and socio-economic factors from a case–control study
1 School of Science and Health, University of Western Sydney, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
2 School of Public Health and Community Medicine, University of New South Wales, Samuels Building, Botany Street, Randwick, NSW 2052, Australia
3 Sydney School of Public Health, University of Sydney, Edward Ford Building, Camperdown, NSW 2006, Australia
4 Centre for Translational Neuroscience and Mental Health (CTNMH), University of Newcastle, Locked Bag 7, Hunter Region Mail Centre, Newcastle, New South Wales NSW 2310, Australia
5 Department of Consultation-Liaison Psychiatry, Calvary Mater Newcastle Hospital, Locked Bag 7, Hunter Region Mail Centre, Newcastle, New South Wales NSW 2310, Australia
6 School of Psychiatry, University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick NSW 2031, Australia
7 Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
8 Department of Forensic Medicine, New South Wales Health Pathology, PO Box 90, Glebe, NSW 2037, Australia
BMC Psychiatry 2014, 14:68 doi:10.1186/1471-244X-14-68Published: 6 March 2014
Suicide in young adults remains an important public health issue in Australia. The attributable risks associated with broader socioeconomic factors, compared to more proximal psychiatric disorders, have not been considered previously in individual-level studies of young adults. This study compared the relative contributions of psychiatric disorder and socio-economic disadvantage associated with suicide in terms of relative and attributable risk in young adults.
A population-based case–control study of young adults (18–34 years) compared cases of suicide (n = 84) with randomly selected controls (n = 250) from population catchments in New South Wales (Australia), with exposure information collected from key informant interviews (for both cases and controls). The relative and attributable risk of suicide associated with ICD-10 defined substance use, affective, and anxiety disorder was compared with educational achievement and household income, adjusting for key confounders. Prevalence of exposures from the control group was used to estimate population attributable fractions (PAF).
Strong associations were evident between mental disorders and suicide for both males and females (ORs 3.1 to 18.7). The strongest association was for anxiety disorders (both males and females), followed by affective disorders and substance use disorders. Associations for socio-economic status were smaller in magnitude than for mental disorders for both males and females (ORs 1.1 to 4.8 for lower compared to high SES groups). The combined PAF% for all mental disorders (48% for males and 52% for females) was similar in magnitude to socio-economic status (46% for males and 58% for females).
Socio-economic status had a similar magnitude of population attributable risk for suicide as mental disorders. Public health interventions to reduce suicide should incorporate socio-economic disadvantage in addition to mental illness as a potential target for intervention.