Frequent Change of Residence and Risk of Attempted and Completed Suicide Among Children and Adolescents

Centre for Register-Based Research, University of Aarhus, Taasingegade 1, DK-8000, Aarhus C, Denmark.
Archives of General Psychiatry (Impact Factor: 14.48). 07/2009; 66(6):628-32. DOI: 10.1001/archgenpsychiatry.2009.20
Source: PubMed


In contemporary society, people change their place of residence frequently. However, large-scale population studies documenting the influence of frequent moves on mental health among children and adolescents are limited.
To evaluate the influence of frequent change of residence on risk of attempted and completed suicide among children and adolescents. Design, Setting, and
We used data from Danish longitudinal population registries to identify all children born from 1978 to 1995 in Denmark; 4160 of these children attempted suicide, and 79 completed suicide at ages 11 to 17 years. We adopted a nested case-control design and recruited 30 controls per case, matched individually on sex, age, and calendar time. Main Outcome Measure We used conditional logistic regression to compute the incidence rate ratio for attempted and/or completed suicide associated with the number of previous changes of residence.
We observed a significantly increased risk of attempted suicide associated with changes of living address, and there was an apparent dose-response trend for this association-the more frequent incidence of moving, the higher the risk for attempted suicide. This trend remained the same after controlling for possible confounding factors at birth, ie, birth order, birthplace, link to a father, and parental age at birth. However, it was somewhat attenuated, but still significant, after controlling for the child's own psychiatric morbidity and loss of a mother or father, as well as parental psychiatric history. The observed association was neither modified by sex nor age at the time of moving. Further analyses of suicide completers demonstrated a similar association between change of residence and completed suicide.
Frequent change of residence may induce distress among children and, therefore, increase their risk of suicidal behavior. More research is needed to explore this association.

Download full-text


Available from: Ping Qin
    • "before age 12 years) and a variety of adverse outcomes by including more extensive measured covariates and comparing differentially exposed cousins and siblings using data collected in population-based, longitudinal, Swedish registers. Although previous studies have highlighted the vulnerability of relocations in adolescence (Qin et al. 2009; Paksarian et al. 2015), we focused specifically on childhood relocations due to the minimal literature examining this age range. We examined the extent to which relocations are independently associated with suicide attempt, severe mental illness, substance abuse, criminal convictions, and academic achievement . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Given the frequency with which families change residences, the effects of childhood relocations have gained increasing research attention. Many researchers have demonstrated that childhood relocations are associated with a variety of adverse outcomes. However, drawing strong causal claims remains problematic due to uncontrolled confounding factors. Method We utilized longitudinal, population-based Swedish registers to generate a nationally representative sample of offspring born 1983–1997 (n = 1 510 463). Using Cox regression and logistic regression, we examined the risk for numerous adverse outcomes after childhood relocation while controlling for measured covariates. To account for unmeasured genetic and environmental confounds, we also compared differentially exposed cousins and siblings. Results In the cohort baseline model, each annual relocation was associated with risk for the adverse outcomes, including suicide attempt [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.19–1.20]. However, when accounting for offspring and parental covariates (HR 1.08, 95% CI 1.07–1.09), as well as genetic and environmental confounds shared by cousins (HR 1.07, 95% CI 1.05–1.09) and siblings (HR 1.00, 95% CI 0.97–1.04), the risk for suicide attempt attenuated. We found a commensurate pattern of results for severe mental illness, substance abuse, criminal convictions, and low academic achievement. Conclusions Previous research may have overemphasized the independent association between relocations and later adverse outcomes. The results suggest that the association between childhood relocations and suicide attempt, psychiatric problems, and low academic achievement is partially explained by genetic and environmental confounds correlated with relocations. This study demonstrates the importance of using family-based, quasi-experimental designs to test plausible alternate hypotheses when examining causality.
    No preview · Article · Dec 2015 · Psychological Medicine
  • Source
    • "However, the findings seen here also appear in line with the idea that even in a population that does well with moves [10], there can be harmful effects of a move on a child's mental health. Previous studies have suggested that geographic moves in civilian families are linked with emotional and behavioral problems [12], an increased likelihood of dropping out of school [13], increased drug use [6], and suicide attempts [3]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose Geographic moves have been reported to have a negative impact on the mental health of children, but it is often difficult to separate the effect of the move from the circumstances that impelled it. Military populations may offer a way to examine this issue. Moves are common in military families, but parental employment and healthcare coverage remain constant. Methods Children of military parents with geographic moves in 2008 were compared with those without geographic moves with regard to the odds of mental health service use in 2009. Results This study included 548,336 children aged 6–17 years, and 179,486 (25%) children moved in 2008. Children aged 6–11 years with a geographic move had higher odds of mental health and outpatient visits (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.01–1.06). Children aged 12–17 years with a geographic move had higher odds of mental outpatient visits (OR 1.04; 95% CI 1.01–1.07), psychiatric hospitalizations (OR 1.19; 95% CI 1.07–1.32), and emergency psychiatric visits (OR 1.20; 95% CI 1.07–1.32). Conclusion Children with a geographic move in the previous year have increased odds of mental health encounters. Among adolescents, this increase extends to psychiatric hospitalizations and emergency visits.
    Full-text · Article · Aug 2014 · Journal of Adolescent Health
  • Source
    • "This "gender paradox" is known to be extremely distinctive in adolescents; during this period of life suicide attempts are 3-9 times more common in girls while completed suicides rates are 2-4 times higher in adolescent males [15]. Many epidemiological studies so far have reported higher rates of non-fatal suicidal behaviour in females which could indicate a gender-specific predisposition for the experience of suicidal thoughts and suicide attempts during this life-period [6,15,16]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: While suicide is the second leading cause of death among young people in most industrial countries, non-fatal suicidal behaviour is also a very important public health concern among adolescents. The aim of this study was to investigate gender differences in prevalence and emotional and behavioural correlates of suicidal behaviour in a representative school-based sample of adolescents. A cross-sectional design was used to assess suicidal behaviour and various areas of emotional and behavioural problems by using a self-report booklet including the Youth Self-Report. One hundred sixteen schools in a region of Southern Germany agreed to participate. A representative sample of 5,512 ninth-grade students was studied. Mean age was 14.8 years (SD 0.73); 49.8% were female. Serious suicidal thoughts were reported by 19.8% of the female students and 10.8% of the females had ever attempted suicide. In the male group, 9.3% had a history of suicidal thoughts and 4.9% had previously attempted suicide. Internalizing emotional and behavioural problems were shown to be higher in the female group (difference of the group means 4.41) while externalizing emotional and behavioural problems slightly predominated in male students (difference of the group means -0.65). However, the total rate of emotional and behavioural problems was significantly higher in the adolescent female group (difference of the group means 4.98). Using logistic regression models with suicidal thoughts or attempted suicide as dependent variables, the pseudo-R2 of gender alone was only 2.7% or 2.3%, while it was 30% or 23.2% for emotional and behavioural problems measured by the YSR syndrome scales. By adding gender to the emotional and behavioural problems only an additional 0.3% of information could be explained. The findings suggest that gender differences in non-fatal suicidal behaviour among adolescents can to a large extent be explained by the gender differences in emotional and behavioural problems during this age.
    Full-text · Article · Jul 2011 · BMC Public Health
Show more