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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

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Abstract

In 1997-1998 a widespread economic crisis hit the economies of many East/Southeast Asian countries; its impact on suicide rates across the region has not been systematically documented. We investigated the impact of the Asian economic crisis (1997-1998) on suicide in Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Suicide and population data for the period 1985-2006 were extracted from the World Health Organisation's mortality database and Taiwanese mortality statistics. Sex-specific age-standardised suicide rates for people aged 15years or above were analysed using joinpoint regression. Trends in divorce, marriage, unemployment, gross domestic product (GDP) per capita and alcohol consumption were compared with trends in suicide rates graphically and using time-series analysis. Suicide mortality decreased in the late 1980s and early 1990s but subsequently increased markedly in all countries except Singapore, which had steadily declining suicide rates throughout the study period. Compared to 1997, male rates in 1998 rose by 39% in Japan, 44% in Hong Kong and 45% in Korea; rises in female rates were less marked. Male rates also rose in Thailand, but accurate data were incomplete. The economic crisis was associated with 10,400 more suicides in 1998 compared to 1997 in Japan, Hong Kong and Korea. Similar increases in suicide rates were not seen in Taiwan and Singapore, the two countries where the economic crisis had a smaller impact on GDP and unemployment. Time-series analyses indicated that some of the crisis's impact on male suicides was attributable to increases in unemployment. These findings suggest an association of the Asian economic crisis with a sharp increase in suicide mortality in some, but not all, East/Southeast Asian countries, and that these increases were most closely associated with rises in unemployment.

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... Korea was one of the countries most affected during the 1997 Asian Financial Crisis and, as ultimately life-saving assistance, the International Monetary Fund provided an emergency rescue loan in December 1997. Korea suffered a steep rise in unemployment, declining household income and rising financial inequality (Chang, Gunnell, Sterne, Lu & Cheng, 2009). During that decade, a sharp increase in suicide rates overwhelmed a number of East/Southeast Asian countries and coincided with the Asian Economic crisis in 1997-1998 20 . ...
... Research has proved the correlation between unemployment and financial problems as triggers for depression, and depression as a pattern for suicidal thoughts. The Asian Crisis was associated with in excess of 10,000 suicides in Japan, Hong Kong and Korea, painting a picture of the strong affinity between socio-economic variables during this event (Chang et al., 2009). Despite its major economic success, Korea's system is showing some cracks. ...
... Despite a well-edu-20 The Asian Economic Crisis of 1997-1998 began with a stressed depreciation in the Thai currency that quickly spread to neighbouring countries such as Indonesia, Singapore, Korea among others. This crisis was followed by a massive capital outflows, bankruptcies and rising unemployment (Chang et al., 2009). 21 Youth unemployment is understood as the number of unemployed between 15 and 24 years of age expressed as a percentage of the youth labour force (OECD, 2019). ...
Article
This paper examines the role of the educational system in modern South Korea and its effects on young students. It takes a threefold approach: Starting off with a historical background about education as the backbone for South Korea’s rapid economic growth during the 70s and 80s, followed by an in-detail approach to the current educational system and its high-pressure context. Afterwards, the effects on youth deriving from this particular background are 24 MAP | REVISTA MUNDO ASIA PACÍFICO | Vol. 10, No. 18 explored from a social, cultural, and demographic standpoint, closing up with the actions taken by the government to tackle this national issue. Last, but not least, based on the quantitative and qualitative work of previous authors, this paper concludes with an insight of recommendations and the importance of addressing limitations and acknowledging gaps, as a step to effective measures that offer social welfare for future generations.
... This trend is pronounced in Western nations with extended family structures and in Asian countries where older adults are culturally venerated [6,23]. During the Asian economic crisis of 1997-1998, the suicide rate in Asia rose substantially, especially among older adults [24]. Suicide rates of older adults in this study are similar to that of previous results. ...
... A recent South Korean study reported that there were no statistically significant associations between income level and suicidal ideation in older adults; however, there was significantly higher suicidal ideation among young people with lower incomes [25]. Young and middle-aged adults are more likely to be directly influenced by changes in economic circumstances, such as income level, than older adults [24]. After adjusting for socioeconomic variables, the positive association between age and suicidal ideation was not observed. ...
Article
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Whether older adults can more likely commit suicide than those in other age groups, after adjusting for other possible causes, remains unknown. We aimed to examine why elderly individuals are more likely to develop first-onset suicidal ideation than individuals in other age groups. We identified 2018 young, 3329 middle-aged, and 2714 elderly individuals without a history of suicidal ideation, from the Korean Welfare Panel Study 2011–2021. To determine key stressors that can induce suicidal ideation, selected groups of variables were adjusted progressively in a generalized estimating equation (GEE) model. Incidence rates of the elderly, middle-aged, and young individuals were 15.9, 22.0, and 11.3 per 1000 person-years, respectively. In GEE analysis, a positive association was not noted between age group and suicidal ideation after adjusting for stressor variables. Furthermore, the overly adjusted model (Full model) showed a strong negative association with aging; young [odds ratio (OR): 1.68, 95% confidence interval (CI): 1.35–2.11] and middle-aged (OR: 1.94, 95% CI: 1.38–2.73) individuals were more likely to develop first-onset suicidal ideation than the elderly. We found that full models, particularly assessing wealth rather than income, can explain why the elderly have higher suicide rates than those in other age groups.
... Marriage, divorce, and alcohol consumption are other important determinants of suicide. 47 The geriatric population is increasing globally, including in South-East Asian countries. 48 It has been anticipated that the geriatric population of South-East Asia will rise exponentially by 2050, and thus the suicide rate and total number of suicides in the geriatric population will also increase. ...
... 48 Research evidence suggest that during the period of economic crisis (1997)(1998), there was an increase in suicide rates in most South East Asian countries. 47 The increase in suicides cannot be exclusively attributed to the financial crisis, however. Evidence suggests that in South East Asia, affluent countries have a higher suicide rate, 49 which indicates that there may be other attributing factors, specific to countries and regions, which are associated with suicide. ...
Article
Suicide in the geriatric population is a significant problem. Increasing age, living alone, having a psychiatric illness and medical comorbidities have been identified as risk factors for suicide among the elderly population. The elderly population in South East Asia is rapidly growing and the number of elderly people with mental illness and/or medical comorbidities is also increasing. The factors and attributes of suicide may vary from region to region due to socio-cultural and geographic diversities. Understanding these factors may help in planning suicide prevention strategies for the elderly population. There is a dearth of studies assessing the demography, risk factors for, and prevention of suicide among the elderly population in South East Asia. We tried to observe and explain the challenging paradigms to excerpt attributes and the context of geriatric suicide. It is observed in this review that lack of social integration or interaction along with some psychiatric disorders leads to suicidal ideation and completed suicide in the elderly. South East Asia has unique characteristics in several aspects like religious and cultural diversity, poverty, unemployment, demographic structure of the region, migration, natural disasters and calamities, political environment, poor policy implementation, and easy access to suicide means (e.g. pesticides). Primary care physicians, specialized mental health support, gate-keeper training, means restriction, raising awareness, supportive family environment, and dedicated call centers could be potential areas for suicide prevention among the elderly people of the region. Further studies are warranted to formulate effective suicide prevention strategies.
... The control variables, which are commonly seen as important factors of suicide turned consistently significant in all regressions currying the expected sign. In particular, a higher divorce rate or a lower fertility can aggravate suicide risk due to reduced family ties and isolation (e.g., Chang, et al. 2009, Chen, et al. 2010Zervoyianni, 2016). Besides, limited access to mental health care system is more likely to create a contributing factor for increased suicide rates (Yoon and Bruckner, 2009;Bastiampillai, 2016;Allison et al., 2018), while life expectancy at birth as a measure of a nation's overall health is driven also by suicide rates (Rottmann, 2014;Breuer 2015). ...
... Moving now to the parameter of interest, we find evidence that NPLs are positively associated with suicide rates. Hence, the socioeconomic costs of indebtedness capturing the daily life of people may contribute to the development of mental health problems, social isolation and overall life dissatisfaction making suicidal behaviour more evident.(e.g., Chang et al. 2009;Antonakakis and Collins 2015;Mattei and Pistoresi, 2019 etc.). When the degree of uncertainty enters in the estimation (columns 2-4), it is revealed that there is an asymmetric response of NPLs to suicide. ...
Article
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This study aims to investigate for the first time whether the NPLs interacted with economic sentiment exert any impact on people’s decision to commit a suicide. Using a panel sample for Eurozone countries for the period 1999-2017 and employing a fixed effect model we find that NPLs is a factor that aggravates the rate of suicides. In addition, according to our results the magnitude of this effect differs during periods of high and low uncertainty when perceived peoples’ expectations are included in the estimation.
... This result can be interpreted from the perspective of unemployment or fewer opportunities for reemployment among the South Korean 'baby-boomer' generation. In South Korea, patients aged 50-64 are mostly baby-boomers who experienced two economic crises: one in 1997-1998 (Chang et al., 2009) and one in 2008 (Chan et al., 2014). Additionally, they have been reported to have lower quality of life because of the burden of taking care of their children and parents (Kim and Kang, 2012), preparing for old age (Kim and Kang, 2012), and poor job satisfaction (Kim and Yu, 2013). ...
... These factors are all directly or indirectly related to their economic status. Furthermore, the average retirement age of this generation is around fifty-five, at which their economic capability declines gradually (Kim and Lim, 2011), possibly leading to increased risk of suicide (Agerbo, 2007;Chan et al., 2014;Chang et al., 2009). Considering the existing research stating that highly deprived areas had more inequality among individuals (McCulloch, 2001) and fewer employment opportunities (Burrows et al., 2011), the result of 50-64-year-old patients from highly deprived areas showing greater risk of suicide is understandable. ...
Article
Continuity of care and area deprivation have been implicated as possible risk factors of suicide in psychiatric patients. This nested case-control study aimed to examine the association between continuity of care and area deprivation and suicide completion in patients with psychiatric disorders. Data were collected from the Korean National Health Insurance Service National Sample Cohort, 2003–2013. The subjects were 974 patients with psychiatric disorders who completed suicides. Each case was compared to three control cases with propensity score matching by gender, age, and follow-up period with incidence density sampling, comprising the final control group of 2,922 living patients. Hazard ratios (HR) for suicide risk considering continuity of care and area deprivation were analysed using a multiple conditional logistic regression. The average follow-up periods between the case and control groups were not statistically different (case: 277.6 weeks, control: 271.4 weeks, p = .245). Both poor continuity of care and higher area deprivation proved to be associated with increased risk of suicide (poor continuity of care; adjusted HR [AHR]: 3.38, 95% confidence intervals [CI]: 2.58–4.43, highest area deprivation; AHR: 1.93, 95% CI: 1.53–2.44). Poor continuity of care combined with highest area deprivation showed a negative synergistic effect on a highly increased risk of suicide (AHR: 2.88, 95% CI: 1.45–5.74). Age was effect modified between suicide risk and poor continuity of care as well as suicide risk and higher area deprivation. A strong patient-provider relationship with good continuity of care may lead to a lower possibility of suicide in psychiatric patients. Moreover, improving community capacity for suicide prevention as well as appropriate postvention should be addressed.
... The Asian economic crisis in 1997 caused the economic recession and rising suicide rates in Hong Kong in 1997/98. 42 After that, Hong Kong had a short rapid economic recovery during 1999/2000, corresponding to the relative stationery of adolescent SRH during 1999/2000 to 2002/03. Due to the burst of international technology and Nasdaq bubble and the subsequent global economic slowdown in 2001, the recovery process in Hong Kong had been restrained and a tremendous economic contraction happened in 2001 again, 43 followed by the increase of very poor/poor SRH in adolescents since 2002/03. ...
... 44 Consistently, adolescent SRH showed a slightly increasingly worsen trend after 2008/09. Increases in parental divorce and unemployment are unavoidable attendant problems due to economic crisis, 42 which may pose a long-term deleterious impact on young people's subjective health. 45 Future studies may compare more population-based psychosocial health indicators before, during and after the global recession, which can help policymakers to identify and justify priorities of health promotion in the face of economic crisis. ...
Article
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Objectives To examine the 15-year secular trends of self-rated health (SRH) and correlates in Chinese adolescents in Hong Kong. Design A territory-wide population-based panel data study. Setting Anonymised records of the annual health examination from the Student Health Service, Department of Health in Hong Kong. Participants 397 324 students in Secondary 2 (US grade 8), 335 902 in Secondary 4 and 113 892 in Secondary 6 during the academic year 1999/2000 and 2014/15. Outcome measures SRH and lifestyles were self-reported using standardised questionnaires. Sex-standardised and age-standardised prevalence of very poor/poor SRH and its secular annual changes across sex, grade, weight status, breakfast habits, and frequency/duration of aerobic exercises were examined. Their disparities over time were examined by interactions with the academic year in generalised estimating equations. Results The overall prevalence of very poor/poor SRH increased from 9.3% (95% CI: 8.9% to 9.7%) in 1999/2000 to 15.5% (15.1% to 15.8%) in 2014/15. Very poor/poor SRH was more prevalent in girls (adjusted OR: 1.02), in those having unemployed parents (1.29), being overweight (1.42) or obese (2.62), eating breakfast away from home (1.27) and skipping breakfast (1.49) or doing <1 time/week or ≤60 min/week aerobic exercises (1.78 and 1.88, respectively) than others. The corresponding disparities increased over time (ratios of OR: 1.006–1.042). Conclusions Increasing prevalence of very poor/poor SRH from 1999/2000 to 2014/15 was found among Hong Kong Chinese adolescents, which was greater in girls, adolescents being overweight/obese and those having unemployed parents or unhealthy lifestyles. Strategies to reduce health inequality should consider multiple factors, especially modifiable factors including lifestyles.
... In 2016 the Southeast Asian and South Asian countries comprised 8.8% and 23.75% of the world's population respectively and made a combined contribution of 5.81% to the world's GDP (Rahman et al., 2018). Economic conditions in Southeast Asian and South Asian countries are quite different, with GDP per capita in Southeast Asian el Barka: Journal of Islamic Economics and Business countries much higher than South Asian countries (Chang et al., 2009), and the convergence of income among member countries is more visible in the Southeast Asia region than in the South Asia region (Zia & Mahmood, 2019). Compared to OECD (Organization for Economic Cooperation and Development) countries, which generally have larger elderly populations, the South and Southeast Asia regions have younger populations. ...
Article
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Introduction/Main Objectives: This study reviews the presence of Fintech in South and Southeast Asian countries through several categories. Background Problems: Many people doubt the presence of Fintech in South Asia and Southeast Asia as part of a developing country with all its limitations, especially Sharia Fintech. Novelty: Developing Sharia Fintech in South Asian and Southeast Asian countries, which have not spread evenly before. Research Methods: Qualitatively using GFD (Global Findex Database) data collected in 2021, which was then elaborated with 115 research studies (50 from Scopus, 24 from Research Gate, 21 from Google Scholars and 20 from other sources). Finding/Results: The presence of Fintech is more likely to develop rapidly in the Southeast Asia region, not so in the South Asian region. The lneeds of each region are different. It is different if developed by Sharia Fintech (I-Fintech/Islamic Financial Technology). Its potential is almost acceptable in all regions, including in countries that are sensitive to religious issues. Conclusion: It is not only Fintech that is the future of cutting-edge banking, but also the presence of I-Fintech (Islamic Financial Technology) which empirically opens up great opportunities and repositions mainstream financial institutions into traditional banking, including Islamic banking. However, the presence of Fintech and I-Fintech still requires the support of local government policies and the wider community, Muslims and non-Muslims in any part of the world.
... Several empirical studies find evidence, both across countries and time, supporting this hypothesis. These studies show that recessions are correlated with short-term increases in suicide mortality rates (Chang et al., 2009;Tapia Granados 5 Browning and Heinesen (2012) mention that it is very difficult to assess the social costs of the estimated increase in mortality and incidence of serious diseases caused by plant closures. These costs are borne by a small share of the displaced workers. ...
Article
Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to healthcare, social distancing, and restrictions on economic activity. These factors indirectly influence health outcomes in the short- and long-term perspective. In a narrative review based on targeted literature searches, we develop a comprehensive perspective on the concepts available as well as the challenges of estimating the overall disease burden and the direct and indirect effects of COVID-19 interventions from both epidemiological and economic perspectives, particularly during the early part of a pandemic. We review the literature and discuss relevant components that need to be included when estimating the direct and indirect effects of the COVID-19 pandemic. The review presents data sources and different forms of death counts, and discusses empirical findings on direct and indirect effects of the pandemic and interventions on disease burden as well as the distribution of health risks.
... In times of economic recession, the deterioration of a family's economic condition and unemployment in a child's parents have been found to relate to negative mental health outcomes in children [34]. The 1997 Asian financial crisis increased the suicide rates of several East Asian countries including Korea, Japan, and Hong Kong, with unemployment appearing to contribute to some of these associations [35]. Given the tremendous economic impact of the COVID-19 pandemic, its influence on adolescents should also be examined in detail. ...
Article
Objectives: Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors. Methods: This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions. Results: The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively. Conclusions: ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.
... The authors concluded that the differential increase in suicide rates was most closely associated with the impact on unemployment. 36 Another study reported no significant increase in the suicide rate in Iceland following the 2008 Global Recession, noting that investing in social protection during the economic crisis and the strong welfare system may have mitigated suicide risk. 37 ...
Article
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Suicide is one of the leading causes of death in the world, and the rates of suicides have been steadily increasing. The COVID-19 pandemic brings a number of potential stressors that may lead to a further increase in the suicide rate. This review paper analyzes the suicide rates of previous similar historic events, including pandemic/epidemic, mass violence events, natural disasters, and economic recessions. The impact of current stressors caused by the pandemic are examined, including economic, quarantine and isolation, media exposure and misinformation, substance use, and mental health. Evidence-based suicide prevention strategies are reviewed.
... Na última década, diversos países vivenciaram períodos de recessão econômica e desenvolveram estudos para analisar seu impacto na saúde, considerando a morbimortalidade das populações (1)(2) . Alguns desses estudos associaram a mortalidade por suicídio a crises econômicas, principalmente entre as populações masculinas (3) e em países com níveis de desemprego relativamente baixos antes dos períodos de recessão (4)(5) . ...
Article
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Objectives to analyze trends in suicide rates in Brazil in the period before and after the start of the economic recession. Methods interrupted time series research using national suicide data recorded in the period between 2012 and 2017 with socioeconomic subgroups analyses. Quasi-Poisson regression model was employed to analyze trends in seasonally adjusted data. Results there was an abrupt increase in the risk of suicide after economic recession in the population with less education (12.5%; RR = 1.125; 95%CI: 1.027; 1.232) and in the South Region (17.7%; 1.044; 1.328). After an abrupt reduction, there was a progressive increase in risk for the black and brown population and for those with higher education. In most other population strata, there was a progressive increase in the risk of suicide. Conclusions the Brazilian economic recession caused different effects on suicide rates, considering social strata, which requires health strategies and policies that are sensitive to the most vulnerable populations. Descriptors: Suicide; Economic Recession; Interrupted Time Series Analysis; Public Health; Social Determinants of Health
... In the last decade, several countries experienced periods of economic recession and developed studies to analyze their impact on health, considering the morbidity and mortality of populations (1)(2) . Some of these studies have associated suicide mortality with economic crises, especially among male populations (3) and in countries with relatively low levels of unemployment prior to periods of recession (4)(5) . ...
Article
Full-text available
Objectives: to analyze trends in suicide rates in Brazil in the period before and after the start of the economic recession. Methods: interrupted time series research using national suicide data recorded in the period between 2012 and 2017 with socioeconomic subgroups analyses. Quasi-Poisson regression model was employed to analyze trends in seasonally adjusted data. Results: there was an abrupt increase in the risk of suicide after economic recession in the population with less education (12.5%; RR = 1.125; 95%CI: 1.027; 1.232) and in the South Region (17.7%; 1.044; 1.328). After an abrupt reduction, there was a progressive increase in risk for the black and brown population and for those with higher education. In most other population strata, there was a progressive increase in the risk of suicide. Conclusions: the Brazilian economic recession caused different effects on suicide rates, considering social strata, which requires health strategies and policies that are sensitive to the most vulnerable populations.
... An interesting question is how mortality is affected by an economic crisis characterized by a sharp increase in unemployment and a significant drop in disposable income. To answer this question, studies analysing the impact of major past crises on mortality should be considered, starting from the great crisis of 1929 in the United States (e.g., Fishback et al., 2007;Tapia Granados & Diez Roux, 2009;Stucckler et al., 2010), the oil crisis of 1973, the economic crisis in Latin America in the 80s, the fall of socialism, especially in Russia-in the early 1990s (e.g., Field, 1995;Leon et al., 1997, Shkolnikov et al., 1998Stuckler et al., 2009b;Cornia & Paniccia, 2000), and the Asian crisis in the late 1990s, especially in South Korea (Chang et al., 2009;Hopkins, 2006;Khang et al., 2005;Kim et al., 2004). In recent studies, a pro-cyclical evolution of mortality is supported, as the pace of economic slowdown is positively related to the strengthening of the declining mortality trend (see, for example, Balester et al., 2019). ...
Chapter
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This article examines mortality trends in Greece from 1980 to 2019, a period characterized by extremely rapid economic growth at first and a deep recession after that. During these years, increases in life expectancies are recorded. These indicators can still mask marked differences in the transition from general mortality to specific causes of death, especially those most sensitive to socio-economic changes. To detect changes in trends that may be linked to the austerity policies and their consequences, an analysis of changes in the leading mortality indicators is undertaken, comparing the period before 2011 with recent years, marked by significant upheavals. Our results show a slowdown in the growth of life expectancies after 2010, an increase in infant mortality and death probability from suicide and certain diseases of the circulatory and respiratory system, infectious and parasitic diseases. Conversely, there has been a relatively large drop in the intensity of deaths from road accidents. Our work suggests that the substantial deterioration in Greece’s socio-economic situation has so far not had a significant effect on mortality. Although they do not reveal a health tragedy, some indicators deserve special attention. In fact, more time is needed to assess the likely effects of the crisis, as the deterioration of a population’s health does not automatically affect its mortality.
... While there is some consensus regarding the effect of job loss on suicide, the impact of income level and the phase of the economic cycle in some cases show conflicting results. While Dos Santos et al. (2016) and Luo et al. (2011) found a significant and inverse relationship between these variables and suicide rates in Portugal and the US, respectively, the results of studies carried out in other countries have been mixed (Chang et al., 2009;Chen et al., 2010;Wang et al., 2020). ...
Article
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Economic uncertainty is a driver of the business cycle. Its leading properties make it a key advanced indicator to assess the impact of socioeconomic factors on suicide for prevention purposes. This paper evaluates the effect of economic uncertainty on suicide rates worldwide. Uncertainty is gauged by a global economic policy uncertainty index. Suicide rates from 183 countries between 2000 and 2019 are matched to annual economic uncertainty, controlling for unemployment and economic growth in a fixed-effects panel model. Overall, the analysis suggests that increases in lagged economic uncertainty, as well as in unemployment and economic growth, may lead to an increased risk of suicide. When replicating the experiment for different regions of the world, the greatest impact of an increase in economic uncertainty can be found in Africa and the Middle East. Given the anticipatory nature of economic uncertainty regarding the evolution of economies, and its relationship with suicide rates, the results highlight the usefulness of uncertainty indicators as tools for the early detection of periods of increased suicide risk and the design of suicide prevention strategies.
... 33 Second, the greater effect of non-climatic factors such as socio-economic conditions on suicides might dilute the seasonal effect in recent years. 34,35 Third, there may have been some changes in climatic conditions that could affect the seasonality of suicides since the 2000s. 36 We need further research to explore climatic and non-climatic factors contributing to changing seasonal patterns of suicides in Korea. ...
Article
Objective: This study aimed to investigate the changing seasonal pattern of suicides in Korea between 2000 and 2019. Methods: We calculated a seasonal pattern of suicides between 2000 and 2019 using a non-stationary cosinor model. In addition, we estimated the effect of each month on the suicide incidence compared to a reference month, using a generalized linear model with a categorical variable of the month. Then, we visualized the rate ratio curves of suicides by gender, age group, and subperiod. Results: We observed a seasonal pattern of suicides in Korea with a spring peak and a winter trough. The seasonal ups and downs were most pronounced in suicides among the elderly ≥65 years. However, the seasonal pattern has not been consistent over the past two decades, with lowering seasonal peaks since 2012. The amplitude of seasonality was also lower in 2010-2019 than in 2000-2009. Conclusion: The seasonal pattern of suicides seems to have diminished in Korea in recent years. Thus, we need further studies to investigate climatic and non-climatic factors influencing the seasonality of suicides and the consequence of the change.
... The causes of suicide are highly complex ranging from internal factors to external ones, including involvement of genetic, psychological, socio-cultural factors as well as personal experiences like trauma [19]. However, factors such as depression or economic crisis are wellknown to increase the risk of suicide [20,21]. In addition, there is growing evidence that patients diagnosed with diseases that lower the quality of life such as, prostate cancer and asthma also increase the probability of suicide [22,23]. ...
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Benign prostatic hyperplasia is a commonly diagnosed disease in elderly men, but elderly men with benign prostatic hyperplasia are more likely to have a lower quality of life and depressive symptoms. This study aims to examine the association benign prostatic hyperplasia patients with suicide death relative to a control group comprising individuals without benign prostatic hyperplasia. We used the Korean National Health Insurance Service-National Sample Cohort from 2006 to 2015 comprising of 193,785 Korean adults ≥40 years old, and followed-up for suicide death during the 8.7 years period. Cox-proportional hazard model was used to estimate hazard ratios for suicide among patients with benign prostatic hyperplasia. From 2006 to 2010, a total of 32,215 people were newly diagnosed with benign prostatic hyperplasia. The suicide rate of people without benign prostatic hyperplasia was 61.6 per 100,000 person-years, whereas that of patients with benign prostatic hyperplasia was 97.3 per 100,000 person-years, 1.58 times higher than the control group (p<0.01). After adjusting for covariates, the hazard ratio for suicide among patients with benign prostatic hyperplasia was 1.47 (95% C.I. = 1.21 to 1.78; p<0.01) compared to people without benign prostatic hyperplasia. For men without mental disorders, the hazard ratio for suicide among patients with benign prostatic hyperplasia was 1.36 (95% CI = 1.05 to 1.76) compared to control group after adjusting for multiple covariates. Our study suggests that men with benign prostatic hyperplasia had a higher probability of suicide compared to men without benign prostatic hyperplasia in South Korea. This study suggests that physicians may be aware that men newly diagnosed with benign prostatic hyperplasia had high probability of suicide.
... The negative outcomes of COVID-19 indicated that the pandemic has led to unprecedented hazards and impacts that are more than health or mental health crises alone 21 . Specifically, the economic recession was positively associated with a higher suicide rate compared with the period of prosperity 22,23 . Recent surveys showed that the COVID-19 related mental health impact might not be prominent during the outbreak; however, those who were jobless or under financial issues might be the target for follow-ups in long-term suicide prevention strategies 20,21 . ...
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COVID‐19 stressors and psychological stress response are important correlates of suicide risks under the COVID‐19 pandemic. This study aimed to investigate the prevalence of COVID‐19 stress, its impact on mental health and associated risk factors among the general population during the outbreak of COVID‐19 in July 2020 throughout Taiwan. A nationwide population‐based survey was conducted using a computer‐assisted telephone interview system with a stratified, proportional randomization method for the survey. The questionnaire comprised demographic variables, psychological distress assessed by the five‐item Brief Symptom Rating Scale and independent psychosocial variables including COVID‐19 stressors, loneliness, suicidality, and health‐related self‐efficacy. In total, 2094 respondents completed the survey (female 51%). The COVID‐19 stress was experienced among 45.4% of the participants, with the most prevalent stressors related to daily life and job/financial concerns. Higher levels of suicidality, loneliness, and a lower level of self‐efficacy had significantly higher odds of having COVID‐19 stress. The structural equation model revealed that COVID‐19 stress was moderately associated with psychological distress and mediated by other psychosocial risk factors. The findings call for more attention on strategies of stress management and mental health promotion for the public to prevent larger scales of psychological consequences in future waves of the COVID‐19 pandemic.
... καταθλιπτική και αγχώδη συμπτωματολογία, κοινωνική δυσλειτουργία) συγκριτικά με άτομα που εργάζονται (Manzano, Llorca, Salamero, Montejo, Matias, Beato, & Diez, 1995). Η αύξηση της ανεργίας σε περιόδους οικονομικής κρίσης έχει βρεθεί να συσχετίζεται και με μεγαλύτερο αριθμό αυτοκτονιών (Chang, Gunnell, Sterne, Lu, & Cheng, 2009), εύρημα που συναντάται και στην περίπτωση της Ελλάδας (Κατσαδώρος, 2011). Σύμφωνα με τα αποτελέσματα πρόσφατης έρευνας, η αύξηση των ποσοστών αυτοκτονίας στη χώρα συσχετίζεται με μείωση στο μέσο εισόδημα κατά την περίοδο της οικονομικής κρίσης (Γιωτάκος, Καράμπελας, & Κάφκας, 2011). ...
Article
Στο συγκεκριμένο άρθρο παρουσιάζονται περιγραφικά συγκριτικά στοιχεία που αφορούν σε δημογραφικές και σε οικονομικές μεταβλητές αναφορικά με τα άτομα που προσήλθαν για πρώτη φορά στο ΚΨΥ Κορυδαλλού την τετραετία 2008-2011. Σύμφωνα με τα αποτελέσματα, τόσο η προσέλευση όσο και η παραμονή για θεραπεία στο Κέντρο αυξάνονται συστηματικά, ενώ παρουσιάζονται επίσης αυξητικές τάσεις στους άνδρες και τους νέους σε ηλικία ασθενείς. Ιδιαίτερα αυξημένα εμφανίζονται και τα ποσοστά που αφορούν σε οικονομικές παραμέτρους (π.χ. ανεργία, οικονομική εξάρτηση, ιατροφαρμακευτική ασφάλιση). Τα προκαταρκτικά αυτά αποτελέσματα συζητούνται υπό το πρίσμα της ευρύτερης κοινωνικο-οικονομικής κρίσης στη χώρα, κατά την τελευταία τετραετία.
... These shared risk factors include financial stress and domestic violence (Morgan and Boxall, 2020;Pfitzner et al., 2020;Roesch et al., 2020), alcohol misuse (Newby et al., 2020) and loneliness (O'Connor et al., 2021). Previous studies have suggested contemporaneous impacts of social and economic disruption on suicide (Chang et al., 2009(Chang et al., , 2013Värnik et al., 1998) which, as yet, appear not to have emerged. The current findings relating to suicidal ideation may reflect an indication of emerging risk, and continuous monitoring over the longer term is needed given the likely social and economic challenges associated with the COVID-19 pandemic. ...
Article
Objectives This study investigated trends in hospital-treated self-harm and hospital presenting suicidal ideation in the period before and after COVID-19 public health responses by key socio-demographic groups among those presenting to hospitals in the Western Sydney (Australia) population catchment. Methods Emergency department presentations for the period January 2016 to June 2021 were used to specify a series of interrupted time-series models to compare the observed and expected event rates of (1) hospital-treated self-harm and (2) hospital presenting suicidal ideation in the period following the onset of COVID-19 public health measures in March 2020. Rate differences between observed and expected rates in the post-implementation period were also estimated in models stratified by sex, age group, country of birth and socio-economic status. Results There was no significant increase in hospital-treated self-harm in the period post-implementation of public health orders (March 2020) compared to the previous period, although there were lower than expected rates of emergency department presentations among non-Australian-born males, males aged 0–14 years and 25–44 years, and females aged 45–64 years. In contrast, there was a significant increase in hospital presenting suicidal ideation, particularly among women (rate difference per 100,000 = 3.91, 95% confidence interval = [1.35, 6.48]) and those aged 15–24 years (both males and females, rate differences ranging from 8.91 to 19.04), and among those residing in lower socio-economic status areas (both males and females, rate differences ranging from 0.90 to 2.33). Conclusion There was no increase in hospital-treated self-harm rates in the 15 months post-implementation of COVID-19 public health orders in Western Sydney; however, there was a significant increase in hospital presenting suicidal ideation. The limited change in suicidal behaviour may reflect the success of social and economic supports during this period, the benefits of which may have been different for young people, and those of lower socio-economic status.
... 8 Furthermore, after the 2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong, rising suicide deaths as well as higher prevalence of general anxiety, social isolation and psychological distress were found in people aged 65 and over. 9 Social isolation is a well-known risk factor for suicidality 10 and may explain to some degree why suicidality rates rise after global virus pandemics. ...
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Background There is a substantial burden on global mental health as a result of the Coronavirus disease 2019 (COVID-19) pandemic that has become putting pressure on healthcare systems. There is increasing concern about rising suicidality consequential to the COVID-19 pandemic and the measures taken. Existing research about the impact of earlier epidemics and economic crises as well as current studies about the effects of the pandemic on public mental health and populations at risk indicate rising suicidality, especially in the middle and longer term. Aims This study investigated the early impact of the COVID-19 pandemic on suicidality by comparing weekly in-patient admissions for individuals who were suicidal or who attempted suicide just before admission, for the first 6 months after the pandemic's onset in Switzerland with corresponding 2019 control data. Method Data was collected at the Psychiatric University Hospital of Zurich. An interrupted time-series design was used to analyse the number of patients who were suicidal. Results Instead of a suggested higher rate of suicidality, fewer admissions of patients with suicidal thoughts were found during the first 6-months after the COVID-19 outbreak. However, the proportion of involuntary admissions was found to be higher and more patients have been admitted after a first suicide attempt than in the corresponding control period from 2019. Conclusions Although admissions relating to suicidality decreased during the pandemic, the rising number of patients admitted with a first suicide attempt may be an early indicator for an upcoming extra burden on public mental health (and care). Being a multifactorial process, suicidality is influenced in several ways; low in-patient admissions of patients who are suicidal could also reflect fear of contagion and related uncertainty about seeking mental healthcare.
... A Recent study, using monthly data from all 50 states and Washington, DC from 1990 to 2015, found the effect of a US $1 increase in the minimum wage ranged from a 3.4% decrease to a 5.9% decrease in the suicide rate among adults aged 18-64 years (Kaufman et al., 2020). With the Asian economic crisis from 1997 to 1998, male suicide rates in 1998 rose by 39% in Japan, 44% in Hong Kong, and 45% in Korea (Chang et al., 2009). During the long term of economic crisis with adverse effects on various aspects of daily life in Greece, the Greek Ministry of Health reported that the annual suicide rate has increased by 40% (Madianos et al., 2011). ...
Article
Objectives : This study is aimed to summarize the declining trends of suicide rates by gender in China and in each of its provinces, and to explain the changes from a public health perspective. Study Design : This is a study with existing data. Methods : Data of suicide mortality were provided by China CDC (1990 to 2017). Data of suicide in each of the 33 provinces were aggregated every five years, except for the year of 2017. A statistical model was performed with the provincial region as the unit of analysis. Results : The overall suicide rate in China decreased from 20.9/100,000 in 1990 to 7.2 in 2017, marking a decrease of suicide rate in China by 65%. The gender ratio has increase from 0.88 in 1990 to 1.56 in 2017. Suicide rates have been going down in each of the 33 provinces. The national suicide rates are negatively correlated with GDP per capita, population density, and life expectancy, but positively related to rural population density. Conclusions : The reduction of suicide rates in China is explained by the reduction of psychological strains which is a consequence of the fast-growing economy in the country. Given its large population and rapid decrease of the suicide deaths, China contributed to the global reduction of suicide mortalities.
... At a time of heightened public health crisis as well as economic uncertainty, it is essential to safeguard the mental wellness of the population with effective, sensitive, and timely public policies for potentially silent sources of universal psychological distress, which will likely impair the occupational and social functioning of the population for an extended period. Our findings support and complement previous results that economic downturns are related to deteriorating mental health [13,25,26]. ...
Article
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Mental health disorders represent an enormous cost to society, are related to economic outcomes, and have increased markedly since the COVID-19 outbreak. Economic activity contracted dramatically on a global scale in 2020, representing the worst crisis since the Great Depression. This study used the COVID Impact Survey to provide insights on the interactions of mental illness and economic uncertainty during COVID-19. We used a probability-based panel survey, COVID Impact Survey, conducted in the U.S. over three waves in the period April-June 2020. The survey covered individual information on employment, economic and financial uncertainty, mental and physical health, as well as other demographic information. The prevalence of moderate mental distress was measured using a Psychological Distress Scale, a 5-item scale that is scored on a 4-point scale (total range: 0–15). The mental distress effect of employment, economic, and financial uncertainty, was assessed in a logit regression analysis conditioning for demographic and health information. It is found that employment, health coverage, social security, and food provision uncertainty are additional stressors for mental health. These economic factors work in addition to demographic effects, where groups who display increased risk for psychological distress include: women, Hispanics, and those in poor physical health. A decrease in employment and increases in economic uncertainty are associated with a doubling of common mental disorders. The population-representative survey evidence presented strongly suggests that economic policies which support employment (e.g., job keeping, job search support, stimulus spending) provide not only economic security but also constitute a major health intervention. Moving forward, the economic uncertainty effect ought to be reflected in community level intervention and prevention efforts, which should include strengthening economic support to reduce financial and economic strain.
... Studies published before the current pandemic suggest that suicide rates might be sensitive to disease outbreaks and macroeconomic indicators, particularly unemployment levels ( Chang et al., 2009 ;McIntyre and Lee, 2020 ;Reeves et al., 2014 ;Stuckler et al., 2009 ). For example, the severe acute respiratory syndrome (SARS) outbreak and the 2008 recession were associated with an increased risk of completed suicide, especially in older adults ( Chan et al., 2006 ;Chang et al., 2013 ). ...
Article
The COVID-19 pandemic is expected to increase suicidal behavior. However, data available to date are inconsistent. This study examines suicidal behavior and death trends in 2020 relative to 2019 as an approximation to the impact of the pandemic on suicidal behavior and death in the general population of Catalonia, Spain. Data on suicide-related thoughts and behaviors (STBs) and suicidal mortality were obtained from the Catalonia Suicide Risk Code (CSRC) register and the regional police, respectively. We compared the monthly crude incidence of STBs and suicide mortality rates of 2020 with those of 2019. Joinpoint regression analysis was used to assess changes in trends over time during the studied period. In 2020, 4,263 consultations for STBs and 555 suicide deaths were registered in Catalonia (approx. 7.5 million inhabitants). Compared to 2019, in 2020 STBs rates decreased an average of 6.3% (incidence rate ratio, IRR=0.94, 95% CI 0,90-0,98) and overall suicide death rates increased 1.2% (IRR=1.01, 95% CI 0.90-1.13). Joinpoint regression results showed a substantial decrease in STBs rates with a monthly percent change (MPC) of -22.1 (95% CI: -41.1, 2.9) from January-April 2020, followed by a similar increase from April-July 2020 (MPC=24.7, 95% CI: -5.9, 65.2). The most restrictive measures implemented in response to the COVID-19 pandemic reduced consultations for STBs, suggesting that the “stay at home” message may have discouraged people from contacting mental health services. STBs and mortality should continue to be monitored in 2021 and beyond to understand better the mid-to-long term impact of COVID-19 on suicide trends.
... The annual suicide mortality of males decreased compared to that in 2019, but that of females increased [15][16][17][18][19] (Figure 1). In various Asian countries including Japan, where an adverse effect of the economic crisis on suicide mortality was detected around the 2008 Asian economic crisis, the impact of the economic crisis on the suicide mortality of males and elderly populations was greater compared to that of females and younger populations ( Figure 1A) [8,20]. According to this evidence, comprehensive suicide prevention programmes in Japan reduced suicide mortality due to targeting males and elderly populations [21][22][23][24][25]; however, the economic recession and increasing suicide mortality in Japan were not temporally related between 2009 and 2019 ( Figure 1A). ...
Article
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The pandemic of 2019 novel coronavirus disease (COVID-19) caused both COVID-19-related health hazards and the deterioration of socioeconomic and sociopsychological status due to governmental restrictions. There were concerns that suicide mortality would increase during the COVID-19 pandemic; however, a recent study reported that suicide mortality did not increase in 21 countries during the early pandemic period. In Japan, suicide mortality was reduced from 2009 to 2019, but both the annual number of suicide victims and the national suicide mortality rates in 2020 increased compared to that in 2019. To clarify the discrepancy of suicide mortality between the first and second half of 2020 in Japan, the present study determines annual and monthly suicide mortality disaggregated by prefectures, gender, age, means, motive, and household factors during the COVID-19 pandemic and pre-pandemic periods using a linear mixed-effects model. Furthermore, the relationship between suicide mortality and COVID-19 data (the infection rate, mortality, and duration of the pandemic) was analysed using hierarchal linear regression with a robust standard error. The average of monthly suicide mortality of both males and females in all 47 prefectures decreased during the first stay-home order (April–May) (females: from 10.1–10.2 to 7.8–7.9; males: from 24.0–24.9 to 21.6 per 100,000 people), but increased after the end of the first stay-home order (July–December) (females: from 7.5–9.5 to 10.3–14.5; males: from 19.9–23.0 to 21.1–26.7 per 100,000 people). Increasing COVID-19-infected patients and victims indicated a tendency of suppression, but the prolongation of the pandemic indicated a tendency of increasing female suicide mortality without affecting that of males. Contrary to the national pattern, in metropolitan regions, decreasing suicide mortality during the first stay-home order was not observed. Decreasing suicide mortality during the first stay-home order was not observed in populations younger than 30 years old, whereas increasing suicide mortality of populations younger than 30 years old after the end of the first stay-home order was predominant. A decrease in suicide mortality of one-person household residents during the first stay-home order was not observed. The hanging suicide mortality of males and females was decreased and increased during and after the end of the first stay-home orders, respectively; however, there was no decrease in metropolitan regions. These results suggest that the suicide mortality in 2020 of females, younger populations, urban residents, and one-person household residents increased compared to those of males, the elderly, rural residents, and multiple-person household residents. Therefore, the unexpected drastic fluctuations of suicide mortality during the COVID-19 pandemic in Japan were probably composed of complicated reasons among various identified factors in this study, and other unknown factors.
... In 1998, the Asian financial crisis triggered a sudden rise in South Korea's suicide, which gradually stabilized in 2005 and then began to decline in 2010. The sharp increase in suicide mortality before 2005 might be mainly due to social issues caused by the economic recession, while much of the subsequent improvement could be attributed to the establishment of the National Strategy for Suicide Prevention in 2004 and followup policies, the increase in welfare facilities for the elderly after 2005, and the paraquat prohibition in 2011 by the government (44)(45)(46)(47). Poverty in the elderly may also play a role in the high suicide mortality rate, with their relative poverty rates in South Korea exceeding 40% and the highest among the Organization for Economic Co-operation and Development member countries (48). ...
Article
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Background: High suicide rate in the elderly is an important global public health problem but has not received the attention it deserves. This study aimed to examine time trends of suicide mortality for people aged 70 years and over by sex, age, and location from 1990 to 2017, and to provide predictions up to 2030. Methods: Using data from the Global Burden of Disease study 2017, we presented elderly suicide mortality changes and compared the patterns for the elderly with that for all ages. We estimated associations between socio-demographic index (SDI) and suicide mortality rates using a restricted cubic spline smoother, and predicted suicide mortality rates up to 2030. Results: In 2017, 118,813 people aged 70 years and over died from suicide, indicating a mortality rate of 27.5 per 100,000, with the highest rates in Eastern Sub-Saharan Africa, Western Sub-Saharan Africa, and Central Sub-Saharan Africa, and for countries and territories, the highest were in South Korea, Zimbabwe, Lesotho, Mozambique, and Senegal. Between 1990 and 2017, suicide mortality rate for the elderly aged 70 years and over decreased globally (percentage change −29.1%), and the largest decreases occurred in East Asia, Southern Latin America, and Western Europe. Nationally, the largest decrease was found in Chile, followed by Czech Republic, Hungary, Turkey, and Philippines. For most countries, the elderly mortality rate was higher than the age-standardized rate, with the largest percentage differences in China and countries in Sub-Saharan Africa. The elderly suicide mortality rate decreased as SDI increased, except for a slight rebound at mid to high SDI. According to projections, 10 out of 195 countries were expected to meet the SDGs indicator of a third reduction by 2030. Conclusions: Variability in suicide mortality rates for the elderly aged 70 years and over by sex, age, region, country, and SDI can guide preventive policies, but causes of the variability need further study. Comprehensive strategies should be adopted to reduce suicide rates and close the gap to the 2030 SDGs.
... [3][4][5][6] Unexpected, abrupt and large changes in economic/employment security have been reported to be associated with higher rates of completed suicide during previous economic crises. [7][8][9] The association between indices of macroeconomic distress and increase in suicide is, however, complicated by the multifactorial causes of suicide as well as potential mitigating factors including government interventions that allocate resources to mental health services, vocational retraining and economic security (e.g. wage subsidy, debt forbearance). ...
Article
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Objective The objective of this research was to evaluate the impact of federal, public health and social support programs on national suicide rates in Canada. Design Cross-sectional study. Setting Canadian National Database (i.e., Statistics Canada) and Statista. Participants Population-level data, and economic and consumer market data. Main Outcome Measures Suicide mortality data, population data and unemployment data were obtained from available statistical databases (e.g. Statistics Canada). We quantified suicide rate by dividing the total number of suicide deaths by the national population expressed as a rate per 100,000 population. Results Overall suicide mortality rate decreased in Canada from 10.82 deaths per 100,000 in the March 2019 - February 2020 period to 7.34 per 100,000 (i.e. absolute difference of 1300 deaths) in the March 2020 - February 2021 period. The overall Canadian unemployment rate changed from an average monthly rate of 5.7% in 2019 to 9.5% in 2020. Conclusion Our results indicate that for the first post-pandemic interval evaluated (i.e., March 2020 - February 2021), suicide rates in Canada decreased against a background of extraordinary public health measures intended to mitigate community spread of COVID-19. An externality of public health measures was a significant rise in national unemployment rates in population measures of distress. Our results suggest that government interventions that broadly aim to reduce measures of insecurity (i.e., economic, housing, health), and timely psychiatric services, should be prioritised as part of a national suicide reduction strategy, not only during but after termination of the COVID-19 pandemic.
... In their research conducted in China, Zhang et al. [17] have determined that people who stop working during the COVID-19 pandemic have worse health problems, more psychological distress, and less life satisfaction than people who continue work. Similar results were found in other research, which have asserted that worldwide crises cause unemployment problems and negative effects on an employee's mental and psychological health [113][114][115]. ...
Article
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During the coronavirus disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hotel-sector employees attempted to cope with the fear of becoming infected; however, they were also faced with job insecurity. Both the anxiety over COVID-19 and the risk of job insecurity have affected the employees’ economic and social conditions as well as their mental state. The present study examined the effect of COVID-19 anxiety and job insecurity perceptions on the burnout levels of hotel-sector employees and the moderator role of the employees’ financial well-being on this relationship. The study was conducted by collecting data from 396 participants who worked in 17 different five-star hotels in Antalya, Turkey. Because of social isolation and social distancing rules, our research data were obtained using an online questionnaire to avoid close contact with other people. The findings showed that COVID-19 anxiety and perceptions of job insecurity had negative effects on hotel employees in the form of mental burnout. In addition, we determined that as an individual characteristic, financial well-being was a moderator variable that affected the severity of burnout based on COVID-19 anxiety and job insecurity. The research findings exhibited theoretical and practical contributions for decision makers and researchers.
... At a population level, suicide rates are highly sensitive to macroeconomic indicators, principally unemployment. (Chang et al., 2009, Reeves et al., 2012, Stuckler et al., 2009. The 2007-2008 Global Financial Crisis, saw increased unemployment with a resultant 10,000 additional economic suicides across North America and Europe (Reeves et al., 2012). ...
... During 1997-1998, the Asian economic crisis arose and during this time suicide rates surged in Thailand along with many other Asian countries. [18] In 2020, the corona disease 2019 pandemic has become a global health threat, which not only kills patients by infection but has also destroyed people by causing extremely negative socio-economic and psychological consequences. [19] This situation has now created an urgent need for suicidal prevention strategies worldwide, principally by the Thai media in this case. ...
... An open question is whether embitterment and other mental health load will decrease after the pandemic ends. Earlier experiences, for example, from the context of the global economic crisis, that found mental health load is rather an acute sign of burden which decreases when the stressor is disappearing [28,29]. Such acute reactions to global burdens must not be confused with mental disorders, which are regularly chronic and independent of life events. ...
Article
Introduction: Embitterment can occur as a reaction to perceived injustice. During the pandemic and restrictions in daily living due to infection risk management, a range of many smaller or severe injustices have occurred. Objective: The aim of this study is to investigate what characterizes persons with high embitterment, mental illness, embitterment and mental illness, and those without embitterment or mental health problems. Methods: We conducted an online survey including persons from the general population in November 2020 and December 2020, the phase during which a second lockdown took place, with closed shops, restaurants, cultural and activity sites. 3,208 participants (mean age 47 years) gave self-ratings on their present well-being, burdens experienced during the pandemic, embitterment, wisdom, and resilience. Results: Embitterment occurred among 16% of the sample, which is a high rate in comparison with 4% during pre-pandemic times. Embitterment was weakly correlated with unspecific mental well-being. There were more persons with embitterment than those with embitterment and a mental health problem. Persons with embitterment reported less coronavirus-related anxiety than persons without embitterment. However, embittered persons reported more social and economic burdens and more frequent experiences of losses (job loss and canceling of medical treatments). Embittered persons perceive their own wisdom competencies on a similar level as persons with mental health problems or persons without mental health problems. Conclusion: Embitterment is a specific potentially alone-standing affective state, which is distinguishable from general mental health and coping capacities (here: wisdom). The economic and social consequences of pandemic management should be carefully recognized and prevented by policy.
Article
Using an unbalanced data set covering the years from 1990 to 2017, this study examines the long-run relationship between three selected macroeconomic variables (unemployment, per capita gross domestic product (GDP) and inflation) and suicide rates for Turkic-speaking countries in Central Asia and the South Caucasus (Azerbaijan, Kazakhstan, Kyrgyzstan, Turkmenistan and Uzbekistan). The mean group estimation results suggest that among the three macroeconomic variables under study, only the unemployment rate has a statistically significant relationship with the suicide rate for the Central Asian Turkic-speaking countries. Regarding country-specific estimations, results suggest that all macroeconomic variables under study correlate with the suicide rate for some countries in the sample. Overall, the empirical findings of the study suggest that unemployment and per capita GDP are important contributors of suicide and intentional self-harm in Central Asia. Estimation results also call attention to the inflation rate.
Article
Background: In 2016, two consecutive moderate magnitude earthquakes occurred in Ulsan, South Korea. Therefore, we aimed to investigate the impact of earthquakes on the mental health of residents in Ulsan. Method: We used data from the 2015-2017 Korean Health Insurance Review & Assessment Service National Patient Sample. We conducted an interrupted time series analysis using location-based controls. Changes in the number of antidepressants, benzodiazepines, and zolpidem prescriptions in Ulsan were compared to controls. Overall changes in weekly prescriptions one year after the first earthquake, compared to a non-earthquake scenario, were estimated. Results: In antidepressant prescriptions, the increase in trend after an earthquake was significantly higher than controls. However, the changes in benzodiazepines and zolpidem were not significant. Overall, the impact of the earthquake on weekly antidepressant prescriptions at one year was estimated as a 1.32 (95% CI: 1.18 - 1.56) rate ratio compared to the non-earthquake scenario. This corresponded to a 1,989.7 (95% CI: 1,202.1 to 3,063.0) increase in the number of prescriptions. Among subgroups, the increase was highest among males aged 20-39 years. Conclusion: The moderate earthquake in Ulsan was associated with an increase in antidepressant prescriptions. The increase in the male group aged 20-39 was the highest. The impact may vary according to the context of the population.
Article
Bu çalışma, Türkiye'de Covid-19 salgını süresince özel sektör ve kamu sektörü çalışanları arasındaki ekonomik, sağlık, rutin değişikliği ve izolasyon kaygı (anksiyete) düzeylerini karşılaştırmayı amaçlamaktadır. Ekonomik kaygının özel sektör çalışanları üzerinde kamu çalışanlarına göre daha fazla etkisi olurken, sağlık kaygısının kamu sektörü çalışanları üzerinde daha baskın etkileri olacağı varsayımında bulunduk. Spielberger Durumluk Sürekli Kaygı Envanteri'nden (STAI) uyarlanan ve katılımcılara çevrimiçi olarak gönderilen anket sonuçlarına göre, özel sektör çalışanlarının ortalamada kamu sektörü çalışanlarına göre daha yüksek düzeyde ekonomik kaygı yaşadıkları ve iki grup arasında anlamlı bir fark bulunduğu görülmüştür (p=.000). Sağlık anksiyetesi açısından sektörler arasında anlamlı bir fark bulunamazken, her iki sektörde de diğer tüm kaygı düzeyleri arasında rutin değişikliği anksiyetesinin ortalamada daha yüksek olduğu görülmüştür. Tek yönlü ANOVA testi sonuçlarına göre, asgari geçim koşullarında yaşayan, yani düşük gelir grubundaki çalışanların, yüksek gelir grubuna göre çok daha yoğun ekonomik kaygı düzeylerine sahip olduğu, yüksek gelir grubu çalışanlarının ise içinde bulundukları rutin değişiklikleri sebebiyle psikolojik baskı altında bulundukları görülmüştür. Son olarak sonuçlar, özel sektör çalışanlarının, kamu sektörü çalışanlarına kıyasla kısa çalışma ödeneği almaktan duydukları endişenin daha yüksek olduğunu göstermiştir (p=.000).
Chapter
Mental disorders are a critical issue in modern society, yet it remains to be consistently neglected. The COVID19 pandemic has made it much more difficult to seek assistance when one needs it. People are feeling increasingly anxious and uncertain about their futures while being socially separated from their friends and relatives. As people continue to quarantine among the limitations imposed by governments, interaction between clinical therapists or social workers and those suffering from mental illness has gotten increasingly limited. Machine learning is a vital approach for allowing virtual analysis of many forms of textual, audio, and visual data for sentiment analysis and understanding the mental health of people utilizing numerous critical parameters in this situation. This chapter aims to provide a systematic review of the current literature investigating COVID-19's impact on mental well-being, as well as studies that explore machine learning and artificial intelligence techniques to detect and treat mental illnesses when traditional therapies are unavailable due to lockdown and social distancing norms imposed. The different machine learning algorithms and deep learning approaches utilized in earlier studies are thoroughly discussed in this chapter. Detailed explanation of the data sources utilized and a review of the types of features investigated in mental disorder identification are included as well. The study's major findings are thoroughly discussed. The obstacles of employing machine learning techniques in biomedical applications are explored, as well as possibilities to enhance and progress the discipline.
Article
Increases in minimum wages have been associated with reductions in suicide rates in the United States, but little evidence is available for Asia where social and contextual factors, as well as drivers of suicide, may be different. We investigated the impact of the introduction of the minimum wage in Hong Kong in May 2011 on suicide rates using an interrupted time series design for the period January 2006 to December 2016. We investigated both immediate and gradual changes in monthly suicide rates after the introduction of the minimum wage taking into account secular trends. We conducted stratified analyses by age and gender. In total 9396 suicides were recorded in Hong Kong during the 11-year study period. Introduction of the minimum wage was associated with an immediate decrease of 13.0% in the monthly suicide rate (95% confidence interval (CI) 5.4%–19.9%, P = 0.001). There was an immediate decrease of 15.8% in older working aged (25–64 years) men (95% CI: 4.2%–25.9%, P = 0.009). Point estimates of immediate effect for other subgroups were also in a negative direction, but were not statistically significant. There was no evidence of a gradual effect on suicide rates at the population level or by subgroup other than a small increase in younger working aged men. We estimate that 633 suicides were prevented by the minimum wage legislation for the period from May 2011 to December 2016, the majority in older working aged men. Our results provide new evidence that, similar to findings in Western settings, minimum wages may help to reduce suicide in Asia, particularly for working age men. Our study highlights the importance of examining the health impacts of government economic policy and suggests minimum wages may provide policy makers with an upstream population-based strategy to reduce suicide rates.
Article
This study aims to compare economic, health, routine-change and isolation anxiety levels between private and public sector employees during the Covid-19 pandemic in Turkey. For this purpose, an online questionnaire is adapted from the Spielberger State-Trait Anxiety Inventory (STAI), and sent to the 1111 participants from both sectors. It is hypothesized that economic anxiety would have a greater effect on private sector employees than public sector employees while the health anxiety has more dominant effects on public sector employees. To test the significance level of the mean differences between these groups, an independent sample t test was used and for testing the significance level of the mean differences among three or more groups one-way analysis of variance (ANOVA) was used. The t test results revealed that private sector employees had higher levels of economic anxiety on average than public sector employees. While there is no significant difference between the sectors in terms of health anxiety, routine change anxiety is higher on average over all other anxiety levels for both sectors. According to the results of one-way ANOVA test, employees living in minimum subsistence conditions, i.e., low-income group, had much more intense levels of economic anxiety than high-income group, and it was concluded that high-income group was under psychological pressure due to the routine changes they experienced. Finally, the results showed that private sector employees were more feared about getting short-time working allowances compared to public sector employees.
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Suicide is listed in the top ten causes of death in Taiwan. Previous studies have pointed out that psychiatric patients having suicide attempts in their history are more likely to attempt suicide again than non-psychiatric patients. Therefore, how to predict the future multiple suicide attempts of psychiatric patients is an important issue of public health. Different from previous studies, we collect the psychiatric patients who have a suicide diagnosis in the National Health Insurance Research Database (NHIRD) as the study cohort. Study variables include psychiatric patients’ characteristics, medical behavior characteristics, physician characteristics, and hospital characteristics. Three machine learning techniques, including decision tree (DT), support vector machine (SVM), and artificial neural network (ANN), are used to develop models for predicting the risk of future multiple suicide attempts. The Adaboost technique is further used to improve prediction performance in model development. The experimental results show that Adaboost+DT performs the best in predicting the behavior of multiple suicide attempts among psychiatric patients. The findings of this study can help clinical staffs to early identify high-risk patients and improve the effectiveness of suicide prevention.
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There is no doubt that the coronavirus disease 2019 pandemic has changed the world in unprecedented ways. Among its turbulent effects, it has impacted many aspects of the lives of individuals, ranging from their mental health to finances. As such, it is essential to determine the psychosocial factors at play and examine how they have impacted the lives of people around the world. This chapter examines psychosocial factors, such as depression, anxiety, and stress, which have been on the rise. Furthermore, the interplay of mental health factors and other stressors brought on by the pandemic has led to the concern that cases of suicidal ideation are also increasing. In response to the stay-at-home orders, family members spent unprecedented amounts of time in close contact with one another, which has had mental health repercussions. In addition, changes in the format of lesson delivery have been stress-inducing and have robbed many students of proper education. Another factor is unemployment, which has been on the rise since the start of the pandemic. Finally, rates of sexual and domestic violence have also increased, significantly impacting women. Exercise, limiting media exposure, counseling, and maintaining social networks are the strategies that have been identified to mitigate the effects of the psychosocial factors discussed in this chapter.
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Pandemics are not new phenomena in human history but in a globalised and interconnected planet the differential impact upon each generation may be distinctive. The concept of trauma has been widely discussed over the last 18 months with emphasis on a collective stress and distress but also in respect of those who are vulnerable to psychological adversity because of established prior mental health diagnoses. Much debate has centred on the impact of the pandemic on mental illness, both new and established, and this chapter will examine the utility of interpreting the psychological outcome at individual and societal level through the lens of collective trauma. At risk populations, such as healthcare workers and those recovering from infection will be a special focus of this chapter.
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Background : Little is known about cohort variations in the relationships between living arrangements and psychological health among older adults. The current study evaluated whether cohort differences in the intergenerational support affect the differences in the mental health benefits of multigenerational living arrangements, and how they do so. Methods : Using panel regression models with lagged variables based on South Korean data, we compared the shape of the relationships between living arrangements and psychological conditions of two cohorts of older adults. Results : The study found birth cohort differences in older adults’ psychological well-being. Among older adults in recent cohorts, living in a multigenerational household was positively associated with depression and negatively linked with life satisfaction. The cohort variations were partly explained by children's marital status and home ownership. Conclusion : The birth cohort variations in psychological health implications of living arrangements may reflect the changing patterns of intergenerational support and family values.
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We aimed to do a systematic review and meta-analysis of studies describing suicidal ideation, suicide attempts and suicide and associated risk factors during COVID-19 pandemic. We searched following electronic databases using relevant search terms: Medline, Embase, PsycInfo and CINAHL and systematically reviewed the evidence following PRISMA guidelines. The meta-analysis of prevalence of suicidal ideation was done using random effect model. The search returned 972 records, we examined 106 in full text and included 38 studies describing 120,076 participants. Nineteen studies described suicide or attempted self-harm, mostly in case reports. Out of 19 studies describing suicidal ideations, 12 provided appropriate data for meta-analysis. The pooled prevalence of suicidal ideation in these studies was 12.1 % (CI 9.3-15.2). Main risk factors for suicidal ideations were: low social support, high physical and mental exhaustion and poorer self-reported physical health in frontline medical workers, sleep disturbances, quarantine and exhaustion, loneliness, and mental health difficulties. We provide first meta-analytic estimate of suicidal ideation based on large sample from different countries and populations. The rate of suicidal ideations during COVID pandemic is higher than that reported in studies on general population prior to pandemic and may result in higher suicide rates in future.
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Background The global age-standardized suicide rate fell by 32.7% between 1990 and 2016. The decrease was largely due to suicide rate reductions in China and India. High-income Asian regions did not see such reductions. The aim of the current study was to explore recent suicide rate trends in Hong Kong and Taiwan to decompose which factors – age, period or cohort – explain suicide rate changes in these two regions. Methods Official mortality data for 1979-2018 in Hong Kong and Taiwan were collected. We utilized Web Tool from the NIH (National Institute of Health, USA) to analyze the Age-Period-Cohort (APC) effects. Results We found marked age-effect that suicide rates increased with age in both genders in both places. Period effect related to the dissemination of charcoal burning suicide was found during 1999-2003 in Hong Kong and 2004-2008 in Taiwan. Increasing suicide rates in the middle- and young-age male cohorts were found in both regions. No increase in suicide risks in young female cohorts was observed. Older cohorts in Hong Kong and older female cohorts in Taiwan also had high suicide rates, but older male cohorts in Taiwan had low rate. Limitations The interpretations and observations at the population level might not hold at the individual level. Conclusions The high suicide risk in middle- and young male cohorts in both regions contribute to the persistent high suicide rates in these two regions. Special attention should be turn to the factors underlying such increasing trends.
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From 1992 to 1994 life expectancy for Russian males dropped from 62.0 to 57.6 years. Female life expectancy dropped from 73.8 years to 71.2 years. This drop in life expectancy coincided in time with the introduction of painful economic reforms in Russia, leading to a rapid decrease in real wages and pensions, nearly complete loss of personal savings, and a tremendous increase in the poverty rate. This article examines the temporary changes in mortality for violent causes of death during the crisis period with a special emphasis on age-specific and gender-specific differences in the response to economic crisis.
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This paper examines the suicide rates of 23 cities and counties in Taiwan from 1983 to 2001. We found that a combination of economic and social variables can significantly account for the tremendous variations in suicide rates across Taiwan’s cities and counties over the last two decades. The level of income per capita in a region appears as the most important predictor of suicide rates. However, some sociological correlates (such as divorce rate) which were less powerful in explaining suicide rate variations in the earlier study appear to exert more significant influence over suicide rates when eight more recent years of information are added, as in the current study. This study also uncovered several gender differences in the determination of regional suicide rates, such as the proportion of elderly population in the region, and the impacts of earthquake and unemployment. Furthermore, this study confirmed the linkages between natural disaster (earthquake) and suicide, between economic and social miseries (unemployment and divorce, respectively) and suicide, as well as those between demographics (aboriginal and elderly sub-population groups) and suicide. This may help to identify high-risk groups or areas where suicide prevention and intervention efforts should be concentrated on or directed to. Lastly, the local suicide crisis-intervention agencies are found to be significantly effective in reducing suicide rates of the community they serve.
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During 1984-1990, a decline in suicide rates of 32% for males and 19% for females took place in the former Soviet Union. The observed annual decrease in mortality from suicide was most marked for men in 1984-1986 and for women in 1984-1988. This article illuminates the hypothesis that the restrictive anti-alcohol campaign initiated by Gorbachev on 1 June 1985, in which prices of alcoholic beverages were raised substantially, had an impact on female mortality from suicide in the former Soviet Union. Data regarding alcohol consumption, female violent death (n = 451,537), suicide (n = 94,149), death due to accidental alcohol poisoning (n = 28,078), and undetermined death, whether accidental or self-inflicted (n = 23,982) were analysed for three Slavic (Russia, Belarus and the Ukraine), three Baltic (Lithuania, Latvia and Estonia) and two Central Asian republics (Kazakhstan and Kirgizia). Regression analyses with alcohol consumption as the independent variable and female suicide rates and female violent-death rates as dependent variables showed that suicide and alcohol consumption, as well as violent death and alcohol consumption, were positively correlated. However, alcohol seems to have a lower explanatory value for female suicides and female violent deaths compared with male suicides and male violent deaths. The attributable fraction of alcohol for female suicides in the whole USSR (27%) is estimated at approximately half of that for male suicides (50%).
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The influence of the macro-economic climate on suicide is unclear. During the recent recession, rates have increased in young males but declined in females. To investigate associations between unemployment and suicide in 15- to 44-year-old men and women over a period spanning two major economic recessions (1921-1995). To minimise confounding by changes in method availability, analyses are restricted to suicides using methods other than poisons and gases. Time-series analysis using routine mortality and unemployment data. There were significant associations between unemployment and suicide in both males and females. Associations were generally stronger at younger ages. Secular trends in youth suicide may be influenced by unemployment or other factors associated with changes in the macro-economic climate. These factors appear to affect women to the same extent as men. Although it is not possible to draw firm aetiological conclusions from time-trend data, our findings are in keeping with those of person-based studies.
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To describe changes of the epidemiological profile of suicides in Hong Kong, and the burden of suicides in terms of years of life lost between 1981 and 2001. Retrospective study. Hong Kong. Data on registered deaths of the Hong Kong population from 1981 to 2001 were retrieved from records of the Census and Statistics Department of the Government of the Hong Kong Special Administrative Region. Crude, standardised, age- and sex-standardised suicide rates; years of life lost; suicide method used; and rank among leading causes of death. Suicide ranked sixth in the leading cause of deaths and represented about 3% of all deaths each year. The suicide rate has increased from 9.6 per 100000 to 15 per 100000 between 1981 and 2001. The total years of life lost due to suicide increased by 96.0%, from about 9900 years in 1981 to 19 400 years in 2001, whereas the figure for all causes of death decreased by 14.0%, from 274600 years to 236700 years. The total share of years of life lost attributable to suicide deaths has increased from 3.6% to 8.1% and is still increasing, especially among the middle age-groups (30-59 years). The use of charcoal burning as a suicide method has increased from 6.0% before 1998 to more than 28.0% in 2001. The burden on the years of life lost due to suicide is underestimated and overlooked. The increase of suicides in recent years has had a significant impact on the years of life lost and can be used as a useful indicator of performance in Hong Kong.
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The incidence of suicidal thoughts in the British population is unknown. To determine the factors associated with the development of, and recovery from, suicidal thoughts. An 18-month follow-up survey investigated 2404 of the adults who took part in the second National Psychiatric Morbidity Survey. The annual incidence of suicidal thoughts was 2.3%. Incidence was highest in women and among 16- to 24-year-olds. Increased incidence was associated with not being in a stable relationship, low levels of social support and being unemployed. Fifty-seven per cent of those with suicidal thoughts at baseline had recovered by the 18-month follow-up interview. Risk factors for suicidal thoughts are similar to those for completed suicide, although the age and gender patterning is different. Fewer than 1 in 200 people who experience suicidal thoughts go on to complete suicide. Further study into explanations for the differences in the epidemiology of suicidal thoughts and suicide is crucial to understanding the pathways (protective and precipitating) linking suicidal thoughts to completed suicide and should help inform effective prevention of suicide.
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Economic changes can be powerful determinants of health. In the late 1990s, South Korea experienced a steep economic decline. This study examines whether the massive economic changes affected trends in all-cause and cause-specific mortality in South Korea. Mid-year population estimates of 5 year age groups (denominators) and death certificate data (numerators) from the National Statistical Office of Korea were used to compute cause-specific age-standardized mortality rates before and after the economic crisis. All-cause mortality continued to decrease in both sexes and all age groups during the crisis. Cerebrovascular accidents, stomach cancer, and liver disease contributed most to this decline. A remarkable decrease in transport accident mortality rates was also observed. The most salient increase in mortality was suicidal death. Mortality from homicide, pneumonia, and alcohol dependence increased during the economic crisis, but these accounted for a small proportion of total mortality. Short-term mortality effects of the South Korean economic crisis were relatively small. It appears that any short-term effects of the economic decline were overwhelmed by the momentum of large declines in causes of death such as stroke, stomach cancer, and liver disease, which are probably related to exposures with much longer aetiological periods. However, this study focused on rather immediate mortality effects and follow-up studies are needed to elucidate any longer-term health effects of the South Korean economic crisis.
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The increasing suicide rate in South Korea in recent decades was found to be associated with measures of social integration/regulation (birth and divorce rates).
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The relative contribution of psychosocial and clinical risk factors to suicide among Chinese populations is an important issue. In Hong Kong, this issue requires vigorous examination in light of a 50% increase in suicide rate between 1997 and 2003. Using a case-control psychological autopsy method, 150 suicide deceased were compared with 150 living controls matched by age and gender. Semi-structured interviews were conducted with the next-of-kin of the subjects. Data were collected on a wide range of potential risk and protective factors, including demographic, life event, clinical and psychological variables. The relative contribution of these factors towards suicide was examined in a multiple logistic regression model. Six factors were found to significantly and independently contribute to suicide: unemployment, indebtedness, being single, social support, psychiatric illness, and history of past attempts. Both psychosocial and clinical factors are important in suicides in Hong Kong. They seem to have mediated suicide risk independently. In addition, socio-economic adversities seem to have played a relatively important role in the increasing suicide rate in Hong Kong.
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Following the first case in Hong Kong in 1998, the method of committing suicide by charcoal burning has spread to other communities. This aim of this study was to examine the impact of charcoal burning suicides on both overall suicide rates and older-method suicide rates in Hong Kong and urban Taiwan. Trend analysis of the overall and method-specific suicide rates between 1997 and 2002. Comparison of age and gender profiles of those who committed suicide by charcoal burning and other methods of suicide. Hong Kong and Urban Taiwan. Suicides by charcoal burning increased rapidly within five years in both Hong Kong and urban Taiwan. This increase was not paralleled by decreases in suicides by older methods and led to an increase of more than 20% in the overall suicide rates. Those in the 24-39 age range were more likely to choose charcoal burning than other methods. The lack of parallel decreases in the suicides rates of older methods with the rise of charcoal burning suicides suggests limited substitution between the methods. The preponderance of the rise in suicide deaths associated with charcoal burning suggests that its invention, followed by wide media dissemination, may have specifically contributed to the increase in suicides in both regions. As a similar increase was found in urban Taiwan as in Hong Kong, charcoal burning suicide should not be viewed as merely a local health problem and has the potential to become a major public health threat in other countries.
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Method-specific suicide trends varied across countries, and studies of the trends in different countries can contribute to the understanding of the epidemiology of suicide. The purpose of this study was to examine the changes in suicide trends by sex, age and method in the years 1971 to 2005 in Taiwan. Mortality data files of suicide and undetermined deaths for the years 1971-2005 were obtained for analyses. Age-, sex- and method-specific suicide rates were calculated by four age groups (15-24, 25-44, 45-64 and 65 and above) and five suicide methods (solids/liquids poisoning, other gases poisoning, hanging, jumping, and others). Both sexes experienced downward trends from 1971 to 1993, and then an upward trend since 1993. People aged 65 years and above had the highest suicide rates throughout the study periods. However, males aged 25-64 years experienced the steepest increasing trends. As to suicide methods, an annual increase, since 1991, of people jumping from heights to commit suicide, and a marked increase, since 1998, of people completing suicide by poisoning with other gases (mainly charcoal-burning) were observed. Suicide by means of charcoal-burning and jumping from heights has become a serious public health problem in Taiwan. Preventive measures to curb these increasing trends are urgently needed.
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The paper explores the view that the Asian currency and financial crises in 1997 and 1998 reflected structural and policy distortions in the countries of the region, even if market overreaction and herding caused the plunge of exchange rates, asset prices, and economic activity to be more severe than warranted by the initial weak economic conditions. The second part of the paper presents a reconstruction of the Asian meltdown -- from the antecedents in 1995-96 to the recent developments in the summer of 1998 -- in parallel with a survey of the debate on the strategies to recover from the crisis, the role of international intervention, and the costs and benefits of capital controls.
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This paper examines the emergence of a new method of suicide in Hong Kong by carbon monoxide poisoning generated by the burning of charcoal. In just 6 years, it has become the second most common means of suicide after jumping from heights. The profile of these charcoal-burning suicide victims is different from that of other suicide deaths. It seems that a significant proportion of the increase in the number of suicides for the period is attributable to the charcoal burning. The effect of mass media reporting and strategies on how to contain the contagious effect of charcoal-burning deaths are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Background Methodological IssuesLabour Market Conditions and Suicidal Behaviour: Empirical Evidence from the LiteratureSummary of Main FindingsImplications for PreventionConclusions References
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Using Maddison’s data, we compare levels and growth rates of real GDP per capita between Korea and Taiwan, along with Japan, and 53 other countries in the world, covering the prewar and postwar periods (1901–92). Both countries, along with Japan, experienced very rapid growth in both periods, especially Korea, whose growth rates ranked third or fourth in the prewar period. After WWII, however, Korea fell steadily below Taiwan, and both fell continuously behind Japan until 1970 when they simultaneously began to catch up. Finally, using Perron’s test, we analyze structural changes or continuity between the two periods. Both domestic and international economic conditions are examined to explain the findings.
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Ever since Durkheim postulated a relationship between economic change and suicide there has been evidence of a general association between aggregate data on unemployment and the frequency of suicide. Quantitatively, however, the association has been variable and it is clear that due to differing cultural, social and individual determinants of suicide, the relationship is complex. Methodological difficulties abound with interpretation of aggregate data. Australian records for most of the present century are suitable for examining secular trends in suicide and unemployment by age group and gender to gain an indication of the extent to which both parameters may be causally related. An aggregate/ecological study was designed to incorporate quantitative and qualitative strategies. Annual age-adjusted male and female suicide rates and annual unemployment rates were derived for the period 1907-1990. Female suicide rates were generally stable throughout the period, whereas those for males demonstrated sharp fluctuations with the peaks coinciding with times of high unemployment. The association between suicide and unemployment for 15-24 year old males was comparatively high for the recent period, 1966-1990. The increasingly youthful contribution to male suicide was demonstrated by a rise in the loss of life years during 1973-1984. Despite the inability of any investigation based on aggregate data to establish an unequivocable causal relationship, no evidence was detected to suggest that relatively high population levels of unemployment were not related to the occurrence of suicide.
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The research phase of the National Suicide Prevention Project in Finland (from 1 April 1987 to 31 March 1988) included medico-legal investigation and psychological autopsy of all deaths suspected of being suicides, including 1397 official suicides and 61 undetermined deaths. In later analyses on suicide, undetermined cases were excluded. This paper presents an analysis of all officially classified undetermined deaths (n = 139) over the study period, consisting of all the initially suspected suicides (n = 61) and the remaining undetermined deaths (n = 78) where suicide could not be excluded. Poisoning by solids or liquids and drowning were the most common causes of all undetermined deaths. Suicidal intent was observed in 87% of undetermined deaths initially suspected of being suicides. In addition, 31% of these subjects had previously attempted suicide, and 34% had made suicidal threats. Depression was diagnosed in 23% of cases and alcohol dependence or abuse in 31% of cases. Undetermined deaths resembled suicides and appeared to reduce the suicide rate by 10%.
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This is a study on associations between suicide mortality, unemployment, divorce rate and mean alcohol consumption during an economic cycle in Finland, from 1985 to 1995. Data on annual suicide mortality, gross domestic product, unemployment, divorce rate and mean alcohol consumption were collected from official Finnish statistics. Regression analyses using a correction for serial autocorrelation were performed. Suicide mortality in both males and females increased during an economic upswing from 1985 to 1990 and decreased during an economic recession from 1990 to 1995. Suicide mortality was not associated with unemployment or divorce rate. These results are opposed to those of many previous studies. However, a significant association was found between male suicide mortality and mean alcohol consumption, in accord with other studies. In conclusion, the results suggest diversity in associations between suicide mortality, socioeconomic factors and alcohol consumption.
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Health among the Japanese people has been faltering since the ‘ bubble’ economy burst in the early 1990s. The consequences of the recession are now visible. A middle-aged man committed hara-kiri, a ritual form of suicide often committed in the name of honour. In the past, samurai were willing to
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The aim of this study is to analyse the dynamics of suicide rates in Latvia 1980-98, when dramatic social and economical changes took place. Special attention is given to demographic risk groups and major socioeconomic correlates influencing the dynamics of suicide rates. Descriptive statistics of suicide rates and major social and economical correlates. During 1980-98 there were rapid swings of suicide rates. The increase was generated mainly by males reaching a maximum of 72 per 100 000 population in 1993. The sudden drop in gross domestic product, the rapid increase in first-time alcohol psychosis and the percentage of people unemployed did not correspond strictly with the dynamics of suicide rates. Demographic and socioeconomic factors could not explain sufficiently the rapid changes in suicide rates in Latvia during the years 1980-98; psychological factors also have to be considered.
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Open verdicts are often included in with suicides for research purposes and for setting health targets. To examine similarities and differences in cases defined by the coroner as suicide and open verdicts and the implications of open verdicts for suicide research. All cases of open and suicide verdicts recorded in the Newcastle Coroner's Court in the period 1985-1994 were compared on demographic and medical parameters. Open and suicide verdicts had many similarities, differing only in some respects, of which logistic regression identified the most significant to be a suicide note, method used and age. Open verdicts should be included in all suicide research after excluding cases in which suicide was unlikely. Objective criteria are needed to facilitate comparison between different studies.
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Work and employment has long been regarded as crucial for the mental health of human beings. Unemployment may lead to deterioration of physical and mental health. Nevertheless, for adults with psychiatric disabilities, discontinuity of employment is common. They may have various reasons to discontinue their employment. In Hong Kong, only 2.5% of people with psychiatric disabilities discharged from sheltered workshops are able to seek open employment. By means of illustration, the authors will show that traditional Chinese work culture tends to reinforce the discontinuity of employment of adult males with psychiatric disabilities. In Chinese culture, work is a means to occupy time, control misbehavior, show consistency of words and deeds, and to glorify parents and ancestors. All these factors contribute to the fulfillment of an adult male role and identity in traditional Chinese culture. In this case history, instead of finding realistic employment, a male adult with psychiatric disability tried to indulge himself in what he felt was his ideal job to fulfill all requirement as an adult male in Chinese culture. The imaginative ideal job gave him excuses to discontinue open employment. Its implications to vocational rehabilitation with male adults with psychiatric disability are also discussed.
Article
Suicide rates doubled in males aged <45 in England and Wales between 1950 and 1998, in contrast rates declined in older males and females of all ages. Explanations for these divergent trends are largely speculative, but social changes are likely to have played an important role. We undertook a time-series analysis using routinely available age- and sex-specific suicide, social, economic and health data, focussing on the two age groups in which trends have diverged most-25-34 and 60+ year olds. Between 1950 and 1998 there were unfavourable trends in many of the risk factors for suicide: rises in divorce, unemployment and substance misuse and declines in births and marriage. Whilst economic prosperity has increased, so too has income inequality. Trends in suicide risk factors were generally similar in both age-sex groups, although the rises in divorce and markers of substance misuse were most marked in 25-34 year olds and young males experienced the lowest rise in antidepressant prescribing. Statistical modelling indicates that no single factor can be identified as underlying recent trends. The factors most consistently associated with the rises in young male suicide are increases in divorce, declines in marriage and increases in income inequality. These changes have had little effect on suicide in young females. This may be because the drugs commonly used in overdose-their favoured method of suicide-have become less toxic or because they are less affected by the factors underlying the rise in male suicide. In older people declines in suicide were associated with increases in gross domestic product, the size of the female workforce, marriage and the prescribing of antidepressants. Recent population trends in suicide appear to be associated with by a range of social and health related factors. It is possible that some of the patterns observed are due to declining levels of social integration, but such effects do not appear to have adversely influenced patterns in older generations.
Article
To investigate trends in Russian mortality for 1991-2001 with particular reference to trends since the Russian economic crisis in 1998 and to geographical differences within Russia. Analysis of data obtained from the Russian State statistics committee for 1991-2001. All cause mortality was compared between seven federal regions. Comparison of cause specific rates was conducted for young (15-34 years) and middle aged adults (35-69 years). The number of Russian adults who died before age 70 in the period 1992-2001 and whose deaths were attributable to increased mortality was calculated. Age, sex, and cause specific mortality standardised to the world population. Mortality increased substantially after the economic crisis in 1998, with life expectancy falling to 58.9 years among men and 71.8 years among women by 2001. Most of these fluctuations were due to changes in mortality from vascular disease and violent deaths (mainly suicides, homicides, unintentional poisoning, and traffic incidents) among young and middle aged adults. Trends were similar in all parts of Russia. An extra 2.5-3 million Russian adults died in middle age in the period 1992-2001 than would have been expected based on 1991 mortality. Russian mortality was already high in 1991 and has increased further in the subsequent decade. Fluctuations in mortality seem to correlate strongly with underlying economic and societal factors. On an individual level, alcohol consumption is strongly implicated in being at least partially responsible for many of these trends.
Article
To examine the changes in all cause mortality and cause-specific mortality after the economic crisis in South Korea. Monthly mortality data for an entire country was used and intervention analysis applied to compare mortality after the crisis with mortality which would have occurred if the trends before the crisis had continued. All cause mortality began to increase about 1 year after the crisis, while cardiovascular increased immediately. Transport accidents decreased significantly during the year following the crisis and then regressed towards the pre-economic crisis level. Suicides increased rapidly and maintained an upward trend but subsequently reduced towards the pre-economic crisis level. This study has shown an evidence of a relationship between economic crisis and mortality.
Article
We examined the prevalence of high levels of depressive symptoms and their association with sociodemographic and health characteristics in an urban Korean population following the financial crisis in late 1997. Using data from a cross-sectional survey conducted in Ansan-city, Korea, from June 1999 to June 2000, we examined the prevalence and correlates of depressive symptoms in a randomly selected sample of 4897 (2531 male and 2366 female) subjects aged 18 to 92 years. The prevalence and odds ratios of "probable" and "definite" depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of > or = 16 and > or = 24, respectively, were calculated. The mean CES-D score and prevalence of "probable" and "definite" depression were significantly higher in women (15.63, 41.67%, and 12.05%, respectively) than in men (14.43, 35.05%, and 8.10%, respectively) (p < 0.0001). In multiple logistic regression analysis, being female, unemployed, unmarried, self-assessed as unhealthy, and having a low income were found to be significant predictors of "probable" and "definite" depressive symptoms in Korean adults. Although current data cannot be directly compared with those reported in the most recently published Korean data from 1994, considerably high mean CES-D score and prevalence of depression speculate that the Korean financial crisis of 1997 had an effect on the development of depressive symptoms in Korean adults.
Article
This article introduces the reader to present conditions and suicide prevention measures in Japan. The suicide rate has increased gradually since the early 1990s, reaching a postwar peak in 1998. The number of suicides has remained at about 30,000 every year since 1998. Middle-aged (55-59 years) and elderly men have especially high suicide rates. In 2002, The Council of Learned People on Measures Against Suicides (organized by the Japanese Ministry of Health, Labor, and Welfare) released its report on national suicide prevention strategies. Although national suicide prevention strategies have just begun to be established, some prefectures or regions have undertaken unique suicide prevention measures.
Article
The epidemiology of suicide in Thailand from 1977-2002 was presented. In the years 1977 and 2002, the suicide rates were 5.9 and 7.8 per 100,000 population. This is low compared to nearby Asian countries. The highest suicide rate was 8.6 per 100,000 in the year 1999, a time of economic crisis. The ratio of male to female suicide rate was 1.14:1 in the year 1977 and increased to 3.16:1 in the year 2002. The highest suicide rate was in young males, ages 25-29 and the trend shows an increase. Despite the increasing incidence, there has been little study to date; however, HIV/AIDS has been identified as a major risk factor.
Article
This study provides an analysis of 640 completed suicide cases in Singapore for the years 2001 and 2002, compared to previous years and in relation to demographic and socioeconomic factors, as well as to the characteristics of a subgroup of suicide victims with prior psychiatric illness. There was little change in the suicide pattern over the 2 years studied compared to previous years. The sex ratio was constant at 1.5. Population-adjusted ratios were 1 for Chinese, 0.5 for Malays, and >1 for both Indians and other ethnic groups. Falling from heights ranked first in terms of method adopted for both years. A disproportionately higher number of suicides were recorded for the 25-34 and the > or =75-year-old age groups. A total of 47 (17.2%) in 2001 and 74 (20.2%) in 2002 of the cases had a history of prior psychiatric illness, with psychotic disorders being the most common diagnostic category. There was also a statistically significant correlation between unemployment and incidence rates. Although the overall rate of elderly suicides had gone down since the 1990s, prevention strategy should focus on the elderly as this rate is still about 3-4 times the national average.
Article
Internet suicide, also known as 'net suicide', is a phrase which has become one of the most notorious terms to the Japanese in recent times. 'Net suicide' refers to suicide pacts that are prearranged between strangers who meet over the internet. Japan has one of the highest suicide rates in the world with 32,325 people killing themselves in 2004. A worrying new trend of net suicide has emerged; as many as 60 people a year have died of this method and the numbers continue to rise. This phenomenon, however, does not limit itself to Japan; for instance in February 2005, the death of two strangers in London, believed to be Britain's first internet suicide, has given cause for concern that this could set a precedent for future such events in Europe and elsewhere. Although there is much research regarding suicide pacts, far less is known about such 'net suicide' pacts. Suicide is a multifaceted problem encompassing cultural, social, religious and economic dimensions, and suicide prevention is therefore best managed within a multidisciplinary framework. By examining this Japanese phenomenon, I conclude that individuals as well as society will have to play a complex, dynamic and interactive role in preventing future tragedies.
Article
The number of suicide in Japan in 2007 is expected to exceed 30 000 for the 10th year in a row The figurer is proof that national efforts to tackie the problem are not working, say critics, who are urging the government to adopt better anti-suicide measures, Justin McCurry reports.