Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain.
Centre of Studies on Geography and Spatial Planning (CEGOT), Coimbra, Portugal; Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530, Coimbra, Portugal.
Soc Sci Med. 2020 Nov;265:113411. doi: 10.1016/j.socscimed.2020.113411. Epub 2020 Oct 4.
Different authors have identified geographic variations in the rates of suicide. This study aims to discuss the limitations of the officially recorded suicide data and to evaluate the statistical relationship between a biometeorological index, Apparent Temperature (AT), and suicide in Madrid and Lisbon. We performed a time-series study. The association was analyzed using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of AT on suicides, a lag non-linear model was fitted in a generalized additive model. There was an average rate of 3.30 suicides/100,000 inhabitants in Madrid and of 7.92 suicides/100,000 inhabitants in Lisbon, and a downward trend was found throughout the period. In Madrid, there is no statistically significant association between AT and suicide. However, in Lisbon, under higher AT, there was a higher risk of suicide. The highest accumulated statistically significant Relative Risk (RR) of suicide was detected at 7 days after the exposure, when at 38 °C, the risk of suicide is 2.7 times that existing at the median AT, 20.62°. The average mortality rate recorded in Lisbon was 41.6% higher than that registered in Madrid. However, the limitations of suicide record databases in Spain and Portugal have to be taken into account when analyzing incidence and especially when comparing data from different countries. It is necessary to improve the filing systems of violent deaths in order to perform reliable epidemiological studies.
不同的作者已经确定了自杀率的地域差异。本研究旨在讨论官方记录的自杀数据的局限性，并评估马德里和里斯本的生物气象指数（表观温度 AT）与自杀之间的统计关系。我们进行了一项时间序列研究。使用拟泊松回归模型分析了关联。为了评估 AT 对自杀的潜在延迟和非线性影响，在广义相加模型中拟合了滞后非线性模型。马德里的平均自杀率为每 10 万人中有 3.30 人，里斯本的自杀率为每 10 万人中有 7.92 人，且整个时期呈下降趋势。马德里的 AT 与自杀之间没有统计学上的显著关联。然而，在里斯本，当 AT 较高时，自杀的风险更高。在暴露后 7 天时，自杀的累积统计显著相对风险（RR）最高，当 AT 达到 38°C 时，自杀的风险是 AT 中位数时的 2.7 倍，即 20.62°C。里斯本的平均死亡率比马德里高 41.6%。然而，在分析发病率时，特别是在比较来自不同国家的数据时，必须考虑西班牙和葡萄牙自杀记录数据库的局限性。为了进行可靠的流行病学研究，有必要改进暴力死亡的归档系统。
