South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
BMC Psychiatry. 2019 Jan 15;19(1):25. doi: 10.1186/s12888-018-2000-8.
There are an estimated 258 million international migrants worldwide. In Asia low-skilled workers often emigrate on a temporary basis (2-3 years) without their families. There is significant concern over the mental health and wellbeing of left-behind families in this region. No previous study has examined whether the risk of suicidal behaviour is elevated in left-behind family members.
Cohort study using baseline data from a large randomised controlled trial in Sri Lanka (n = 178,730 participants; 8% households had a current temporary foreign migrant) and prospective hospital presentations of suicide attempts. Using multilevel Poisson regression models, we compared the risk of attempted suicide in households with left-behind and non-left-behind family members. We also investigated whether the sex of the migrant or the age/sex of the household member left behind altered any associations.
The risk of an attempted suicide was elevated in female migrant households (IRR 1.60 95% CI 1.38, 1.85), but not male migrant households (IRR 1.01 95% CI 0.76,1.36)) with strong evidence that risk differed for female vs. male migrant households (p-value = 0.005). We found no evidence that the age or sex of the left-behind household member altered the association observed.
This analysis suggests that members of households with a temporary female foreign migrant are at an increased risk of attempted suicide, but these findings must be interpreted with caution. The increased risk of suicidal behaviour in these households may be due to factors that were present before the migration and persist post-migration (e.g. household violence, poverty).
全球估计有 2.58 亿国际移民。在亚洲，低技能工人经常以临时（2-3 年）的方式移民，不带家属。该地区对留守家庭的心理健康和幸福状况存在重大担忧。以前没有研究检查过留守家庭成员自杀行为的风险是否升高。
使用斯里兰卡一项大型随机对照试验的基线数据（n=178730 名参与者；8%的家庭有当前的临时外国移民）和前瞻性医院自杀未遂就诊情况进行队列研究。使用多级泊松回归模型，我们比较了留守和非留守家庭成员的自杀未遂风险。我们还调查了移民的性别或留守家庭成员的年龄/性别是否改变了任何关联。
女性移民家庭自杀未遂的风险增加（IRR 1.60，95%CI 1.38，1.85），但男性移民家庭的自杀未遂风险没有增加（IRR 1.01，95%CI 0.76，1.36），有强有力的证据表明女性移民家庭与男性移民家庭的风险存在差异（p 值=0.005）。我们没有发现留守家庭成员的年龄或性别改变了观察到的关联的证据。
这项分析表明，有临时外国女性移民的家庭的成员自杀未遂的风险增加，但这些发现必须谨慎解释。这些家庭中自杀行为风险增加的原因可能是移民前存在并在移民后持续存在的因素（例如家庭暴力、贫困）。
