Henderson Rob, Stark Cameron, Humphry Roger W, Selvaraj Sivasubramaniam
NHS Highland, Department of Public Health, Assynt House, Beechwood Park, Inverness, IV2 3HG, Scotland, UK.
BMC Public Health. 2006 Jun 23;6:167. doi: 10.1186/1471-2458-6-167.
It is believed that total reported suicide rates tend to decrease during wartime. However, analysis of suicide rates during recent conflicts suggests a more complex picture, with increases in some age groups and changes in method choice. As few age and gender specific analyses of more distant conflicts have been conducted, it is not clear if these findings reflect a change in the epidemiology of suicide in wartime. Therefore, we examined suicide rates in Scotland before, during and after the Second World War to see if similar features were present.
Data on deaths in Scotland recorded as suicide during the period 1931-1952, and population estimates for each of these years, were obtained from the General Register Office for Scotland. Using computer spreadsheets, suicide rates by gender, age and method were calculated. Forward stepwise logistic regression was used to assess the effect of gender, war and year on suicide rates using SAS V8.2.
The all-age suicide rate among both men and women declined during the period studied. However, when this long-term decline is taken into account, the likelihood of suicide during the Second World War was higher than during both the pre-War and post-War periods. Suicide rates among men aged 15-24 years rose during the Second World War, peaking at 148 per million (41 deaths) during 1942 before declining to 39 per million (10 deaths) by 1945, while the rate among men aged 25-34 years reached 199 per million (43 deaths) during 1943 before falling to 66 per million (23 deaths) by 1946. This was accompanied by an increase in male suicides attributable to firearms and explosives during the War years which decreased following its conclusion.
All age male and female suicide rates decreased in Scotland during World War II. However, once the general background decrease in suicide rates over the whole period is accounted for, the likelihood of suicide among the entire Scottish population during the Second World War was elevated. The overall decrease in suicide rates concealed large increases in younger male age groups during the War years, and an increase in male suicides recorded as due to the use of firearms. We conclude that the effects of war on younger people, reported in recent conflicts in Central Europe, were also seen in Scotland during the Second World War. The results support the findings of studies of recent conflicts which have found a heterogeneous picture with respect to age specific suicide rates during wartime.
人们认为战时报告的自杀总率往往会下降。然而,对近期冲突期间自杀率的分析显示情况更为复杂,一些年龄组的自杀率上升且自杀方式选择发生了变化。由于很少对更久远冲突进行年龄和性别特异性分析,尚不清楚这些发现是否反映了战时自杀流行病学的变化。因此,我们研究了第二次世界大战期间及前后苏格兰的自杀率,以查看是否存在类似特征。
从苏格兰总登记处获取1931 - 1952年期间苏格兰记录为自杀的死亡数据以及这些年份的人口估计数。使用电子表格计算按性别、年龄和方式划分的自杀率。使用SAS V8.2通过向前逐步逻辑回归评估性别、战争和年份对自杀率的影响。
在所研究期间,男性和女性的全年龄段自杀率均有所下降。然而,考虑到这种长期下降趋势,第二次世界大战期间自杀的可能性高于战前和战后时期。15 - 24岁男性的自杀率在第二次世界大战期间上升,1942年达到每百万148人(41例死亡)的峰值,到1945年降至每百万39人(10例死亡),而25 - 34岁男性的自杀率在1943年达到每百万199人(43例死亡),到1946年降至每百万66人(23例死亡)。这伴随着战争期间因枪支和爆炸物导致的男性自杀增加,战后有所下降。
第二次世界大战期间,苏格兰男性和女性的全年龄段自杀率均下降。然而,一旦考虑到整个时期自杀率的总体背景下降情况,第二次世界大战期间苏格兰全体人口自杀的可能性就有所升高。自杀率的总体下降掩盖了战争期间年轻男性年龄组自杀率的大幅上升以及记录为因使用枪支导致的男性自杀增加的情况。我们得出结论,在第二次世界大战期间,苏格兰也出现了在中欧近期冲突中所报告的战争对年轻人的影响。这些结果支持了近期冲突研究的发现,即在战时特定年龄自杀率方面存在异质性情况。