National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Italian National Institute of Health (ISS), Rome, Italy.
Psychiatr Q. 2010 Mar;81(1):57-71. doi: 10.1007/s11126-009-9118-2.
Completed suicide is associated with marital status; being unmarried is associated with a higher suicide rate as compared with being married or living with a partner. Moreover, the region of origin may be particularly important when trying to explain major inequalities in suicide rates across a country. Data were obtained from the Italian Database on Mortality, collected by the Italian Census Bureau (ISTAT) and processed by the Italian National Institute of Health-Statistics Unit. The Italian population in the last Italian census (October 2001) was used to estimate age-standardized mortality rates from suicide by marital status (ICD-9 revision: E950-959) and "natural" causes (ICD-9 revision: 0-280; 320-799). Rate Ratios and 95% confidence intervals were calculated using married individuals as a reference. All analyses were conducted separately for men and women for 2000-2002, the most recent years with data available. Logistic regression analysis was used to compare differences by marital status for suicide versus death from natural causes. There are major inequalities in suicide rates in Italy. The North region has the highest suicide rates both for married and non-married individuals. Sardinia Island has the highest male suicide rate in Italy-23.07 per 100,000 per year-compared with the average national male suicide rate of 13.80, a difference which is significantly higher by 67% (RR: 1.67; 95%CI = 1.40-1.99). In contrast, Sardinia has one of the lowest female suicide rates among the Italian regions, close to that of the South and the Center regions. The North-East is the only region where the suicide rate among divorced men is significantly higher than that of married men. In the South, widowers have the highest suicide rate, with a rate 6-times that of married men (RR = 5.66; 95%CI = 4.46-7.18). Major inequalities in suicide rates by region may derive from different socio-cultural backgrounds, confirming the notion that suicide is a multifaceted phenomenon. The results of the present study indicate that suicide prevention must take into account the social and cultural characteristics of different communities. Moreover, these findings support the notion that marital status may play a central role in influencing suicide.
自杀与婚姻状况有关；与已婚或与伴侣生活相比，未婚与更高的自杀率有关。此外，在试图解释一个国家内自杀率的主要不平等时，原籍地区可能特别重要。数据来自意大利死亡率数据库，由意大利人口普查局（ISTAT）收集并由意大利国家卫生统计单位处理。最后一次意大利人口普查（2001 年 10 月）中的意大利人口用于估计按婚姻状况（ICD-9 修订版：E950-959）和“自然”原因（ICD-9 修订版：0-280；320-799）计算的标准化自杀死亡率。使用已婚者作为参考计算率比和 95%置信区间。所有分析均针对 2000-2002 年男性和女性分别进行，这是数据可用的最近几年。逻辑回归分析用于比较婚姻状况对自杀与自然原因死亡的差异。意大利的自杀率存在很大的不平等。北方地区已婚和未婚人士的自杀率都最高。撒丁岛的男性自杀率在意大利最高，为每年每 10 万人 23.07 人，而全国男性平均自杀率为 13.80 人，这一差异高出 67%（RR：1.67；95%CI = 1.40-1.99）。相比之下，撒丁岛是意大利地区女性自杀率最低的地区之一，接近南部和中部地区。东北地区是离婚男性自杀率明显高于已婚男性的唯一地区。在南部，鳏夫的自杀率最高，是已婚男性的 6 倍（RR = 5.66；95%CI = 4.46-7.18）。按地区划分的自杀率的主要不平等可能源于不同的社会文化背景，证实了自杀是一个多方面现象的概念。本研究的结果表明，预防自杀必须考虑到不同社区的社会和文化特征。此外，这些发现支持了婚姻状况可能在影响自杀方面发挥核心作用的观点。
