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就业不安全感、心理健康与自杀

Employment insecurity, mental health and suicide.

作者信息

Fountoulakis K N

机构信息

3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece.

出版信息

Psychiatriki. 2017 Jul-Sep;28(3):259-264. doi: 10.22365/jpsych.2017.283.259.

Abstract

With the economic crisis an increase in suicidality has been reported across Europe but especially in Greece. Τhese reports hit the mass media headlines and were also included in the debate among political parties. The literature suggests that during periods of deep economic crisis, there is an increase specifically in suicides but causality remains unclear. The prevailing picture both in the scientific literature and in the mass media is that the economic crisis acts as a more or less generic risk factor on the entire population putting at risk literally anybody. Two recent studies clearly dispute it by reporting that suicides had increased several months before unemployment increased. Additionally and specifically concerning Greece, where the economic crisis is deeper and more prolonged, the detailed inspection of age and gender specific rates are not in accord with a "male gender" by "unemployment" interaction. Taking into consideration the above and since the rise in suicides also affects prospering countries without high unemployment, including Germany and Norway, another possible explanation is that the changes in the socioeconomic environment and especially in the employment conditions have overstressed vulnerable populations (e.g. mental patients) leading to the increased suicide rates. The problem is that in the majority of the literature the economic crisis/austerity is considered to be a generic risk factor affecting the entire population and subsequently generic horizontal measures are proposed. Unfortunately patients at risk to commit suicide are not considered as such; instead they are rather considered as normal healthy people from the general population who respond with suicide to generic adverse events.

摘要

随着经济危机的爆发,整个欧洲,尤其是希腊,自杀率有所上升的情况已被报道。这些报道登上了大众媒体的头条,也被纳入了政党间的辩论中。文献表明,在深度经济危机时期,自杀人数尤其会增加,但因果关系仍不明确。科学文献和大众媒体中的普遍观点是,经济危机或多或少地成为了影响全体人口的一般风险因素,实际上使任何人都处于危险之中。最近的两项研究对此提出了明确质疑,它们报告称自杀人数在失业率上升前几个月就已经增加。此外,具体就希腊而言,其经济危机更深且持续时间更长,对特定年龄和性别的自杀率进行详细考察后发现,并不符合“男性”与“失业”的相互作用关系。考虑到上述情况,而且自杀率上升的情况也出现在失业率不高的繁荣国家,包括德国和挪威,另一种可能的解释是,社会经济环境的变化,尤其是就业条件的变化,给弱势群体(如精神病人)带来了过大压力,导致自杀率上升。问题在于,在大多数文献中,经济危机/紧缩政策被视为影响全体人口的一般风险因素,随后提出的也是一般性的横向措施。不幸的是,有自杀风险的患者并未被如此看待;相反,他们相当于是被当作普通健康人群,因一般性的不良事件而以自杀应对。

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