Di Thiene Domitilla, Alexanderson K, Tinghög P, La Torre G, Mittendorfer-Rutz E
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
J Epidemiol Community Health. 2015 May;69(5):467-73. doi: 10.1136/jech-2014-204648. Epub 2014 Dec 16.
Previous research suggests that first-generation immigrants have a lower suicide risk than those both born in Sweden and with both parents born in Sweden (natives), while the suicide risk in the second generation seems higher. The aim of this study was to investigate to what extent suicide risk in first-generation and second-generation (both parents born abroad) and intermediate-generation (only one parent born abroad) immigrants compared with natives is associated with sociodemographic factors, labour market marginalisation and morbidity.
A prospective population-based cohort study of 4 034 728 individuals aged 16-50 years was followed from 2005 to 2010. HRs for suicide were calculated for first-generation, intermediate-generation and second-generation immigrants compared with natives. Analyses were controlled for sociodemographic factors, morbidity and labour market marginalisation.
The HR of suicide was significantly lower in first-generation immigrants (HR 0.83 CI 0.76 to 0.91), and higher in second-generation (HR 1.32, CI 1.15 to 1.52) and intermediate-generation immigrants (HR 1.20, CI 1.08 to 1.33) in comparison to natives. The excess risk was explained by differences in sociodemographics, morbidity and labour market marginalisation. In the fully adjusted models, a higher HR remained only for the Nordic second generation (HR 1.29, CI 1.09 to 1.52). There were no sex differences in HRs.
The risk of suicide was shown to be lower in the first generation and higher in the second generation compared with natives. The higher HR in the Nordic second generation was not explained by differences in sociodemographics, labour market marginalisation and morbidity. Further research is warranted to investigate factors underlying this excess risk.
先前的研究表明，第一代移民的自杀风险低于在瑞典出生以及父母双方均在瑞典出生的人（本地人），而第二代移民的自杀风险似乎更高。本研究的目的是调查与本地人相比，第一代和第二代（父母双方均出生在国外）以及中间代（只有一方父母出生在国外）移民的自杀风险在多大程度上与社会人口学因素、劳动力市场边缘化和发病率相关。
对4034728名年龄在16至50岁之间的个体进行了一项基于人群的前瞻性队列研究，随访时间为2005年至2010年。计算了第一代、中间代和第二代移民与本地人相比的自杀风险比（HR）。分析对社会人口学因素、发病率和劳动力市场边缘化进行了控制。
与本地人相比，第一代移民的自杀风险比显著较低（HR 0.83，置信区间0.76至0.91），第二代（HR 1.32，置信区间1.15至1.52）和中间代移民（HR 1.20，置信区间1.08至1.33）的自杀风险比更高。社会人口学、发病率和劳动力市场边缘化的差异解释了这种额外风险。在完全调整模型中，仅北欧第二代仍有较高的风险比（HR 1.29，置信区间1.09至1.52）。风险比不存在性别差异。
与本地人相比，第一代移民的自杀风险较低，第二代移民的自杀风险较高。北欧第二代较高的风险比无法用社会人口学、劳动力市场边缘化和发病率的差异来解释。有必要进行进一步研究以调查这种额外风险背后的因素。
