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Previous suicide attempt and subsequent risk of re-attempt and suicide: Are there differences in immigrant subgroups compared to Swedish-born individuals?

Abstract：

BACKGROUND:Studies investigating how suicide attempting refugees and non-refugee migrants differ from Swedish-born individuals in terms of re-attempts and suicide are missing. It remains unknown how mental disorders and labour market marginalization (LMM) impact on these associations. METHODS:This longitudinal cohort study included Swedish residents aged 20-64 with suicide attempt in 2004-2012. In total, 42,684 individuals including 2017 refugees, and 2544 non-refugee migrants were included and followed until December 31, 2016. Risks of re-attempt and suicide were calculated as hazard ratios (HR) with 95% confidence intervals (CI), and adjusted for important confounders. Stratified analyses were to assess if mental disorders or LMM modified these associations. RESULTS:In the adjusted models, refugees had an adjusted HR (aHR) of suicide re-attempt of 0.74 (CI: 0.67-0.81), and an aHR of 0.67 (CI: 0.53-0.86) for suicide death. These estimates were very similar to those of non-refugee migrants. Refugees and non-refugee migrants with suicide attempt had a lower prevalence of specialised health care due to mental disorders compared to Swedish-born attempters (48%, 44% and 61%, respectively). Mental disorders and LMM in terms of long-term sickness absence and disability pension increased the risk of re-attempt and suicide in all three groups. LIMITATIONS:Only suicide attempts and mental disorders resulting in specialized in-and outpatient care were registered. CONCLUSION:Migrants show considerably lower risks of re-attempt and suicide than Swedish-born individuals, with no differences between migrant groups. Despite vast differences in the prevalence of specific mental disorders, the role of mental disorders in the pathways to re-attempt and suicide does not appear to differ considerably between these groups.

journal_name

J Affect Disord

journal_title

Journal of affective disorders

authors

Niederkrotenthaler T,Mittendorfer-Rutz E,Mehlum L,Qin P,Björkenstam E

doi

10.1016/j.jad.2020.01.013

subject

Has Abstract

pub_date

2020-03-15 00:00:00

pages

263-271

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(19)32654-0

journal_volume

265

pub_type

杂志文章

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Previous suicide attempt and subsequent risk of re-attempt and suicide: Are there differences in immigrant subgroups compared to Swedish-born individuals?