Iemmi Valentina, Bantjes Jason, Coast Ernestina, Channer Kerrie, Leone Tiziana, McDaid David, Palfreyman Alexis, Stephens Bevan, Lund Crick
London School of Economics and Political Science, London, UK.
Stellenbosch University, Stellenbosch, South Africa.
Lancet Psychiatry. 2016 Aug;3(8):774-783. doi: 10.1016/S2215-0366(16)30066-9.
Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events.
自杀是全球第15大死因，超过75%的自杀事件发生在低收入和中等收入国家。然而，关于低收入和中等收入国家自杀与贫困之间关联的证据却很稀少。我们进行了一项系统综述，以了解低收入和中等收入国家中自杀意念及行为与经济贫困之间的关联。我们纳入了2004年1月至2014年4月期间发表的、使用双变量或多变量分析检验低收入和中等收入国家自杀意念及行为与经济贫困之间关联的英文研究。我们确定了37项符合这些纳入标准的研究。在18项报告自杀死亡与贫困之间关联的研究中，探讨了31种关联。大多数研究报告呈正相关。在20项报告非致命自杀意念及行为与贫困之间关系的研究中，探讨了36种关联。同样，几乎所有研究都报告呈正相关。然而，当分别考虑每个贫困维度时，我们发现存在很大差异。这些研究结果在个体层面显示出一致的趋势，表明贫困，尤其是经济状况较差、财富减少和失业形式的贫困，与自杀意念及行为相关。在国家层面，没有足够的数据得出明确结论。现有数据表明，在自杀预防策略中解决经济贫困问题可能有益，尤其要关注长期贫困和急性经济事件。
