Lurie Ido, Goldberger Nehama, Gur Orr Adi, Haklai Ziona, Mendlovic Shlomo
Arch Suicide Res. 2022 Jul-Sep;26(3):1219-1231. doi: 10.1080/13811118.2020.1868366. Epub 2021 Jan 6.
Previous findings regarding European Holocaust survivors' suicide risk are conflicting. North African survivors' suicide risk was not previously studied. In this study, we aimed to determine suicide risk among European and North African Holocaust survivors. The study was based on the Israeli population census from 1972, followed until 2015 for suicide. European survivors were grouped into survivors of severe Nazi persecution (HS) and early HS. North African survivors were grouped into those from Algeria, Libya and Tunisia who were likely to have suffered more severe persecution (group 1) and those from Morocco who apparently suffered less persecution (group 2). Comparison groups were chosen according to similar ethnic origins who were not under Nazi control. Age standardized suicide rates, Standard Mortality Ratios (SMR) were calculated. Cox regression analysis was used to assess suicide risk. The age adjusted suicide rates (per 100,000) among Europeans were: HS 17.8 (95%CI 16.9-18.6), early HS 28.6 (95%CI 24.9-32.2), comparison group 20.3 (95%CI 18.5-22.1). Among North Africans: group 1, 6.9 (95%CI 5.6-8.2), group 2, 4.8 (95%CI 4.0-5.5), comparison group, 8.5 (95% CI 6.4-11.0). The SMRs with European comparisons were 0.88 (95%CI 0.84-0.92) for HS and 1.41 (95%CI 1.20-1.65) for early HS. SMRs with North African comparisons were 0.81 (95%CI 0.67-0.97) for group 1 and 0.57 (95%CI 0.48-0.66) for group 2. Cox regression models showed significantly higher suicide risk for European early HS vs comparisons (Hazard Ratio (HR) = 1.31, 95% CI 1.12-1.52), and lower risk for HS (0.89, 95%CI 0.80-0.98). North African group 2 had significantly lower HR (0.58, 95%CI 0.43-0.79). To conclude, higher resilience was found among European survivors of severe adversity, compared to those who suffered lesser persecution. No elevated risk was found among North African survivors.
先前有关欧洲大屠杀幸存者自杀风险的研究结果相互矛盾。此前尚未对北非幸存者的自杀风险进行研究。在本研究中，我们旨在确定欧洲和北非大屠杀幸存者的自杀风险。该研究基于1972年的以色列人口普查数据，并追踪至2015年以统计自杀情况。欧洲幸存者被分为遭受纳粹严重迫害的幸存者（HS）和早期遭受迫害的幸存者。北非幸存者被分为可能遭受更严重迫害的来自阿尔及利亚、利比亚和突尼斯的人群（第1组）以及显然遭受较少迫害的来自摩洛哥的人群（第2组）。根据未受纳粹控制的相似种族背景选择对照组。计算年龄标准化自杀率、标准死亡比（SMR）。使用Cox回归分析评估自杀风险。欧洲人的年龄调整自杀率（每10万人）分别为：HS组17.8（95%置信区间16.9 - 18.6），早期HS组28.6（95%置信区间24.9 - 32.2），对照组20.3（95%置信区间18.5 - 22.1）。在北非人当中：第1组为6.9（95%置信区间5.6 - 8.2），第2组为4.8（95%置信区间4.0 - 5.5），对照组为8.5（95%置信区间6.4 - 11.0）。与欧洲人比较的SMR，HS组为0.88（95%置信区间0.84 - 0.92），早期HS组为1.41（95%置信区间1.20 - 1.65）。与北非人比较的SMR，第1组为0.81（95%置信区间0.67 - 0.97），第2组为0.57（95%置信区间0.48 - 0.66）。Cox回归模型显示，与对照组相比，欧洲早期HS组的自杀风险显著更高（风险比（HR） = 1.31，95%置信区间1.12 - 1.52），而HS组风险较低（0.89，95%置信区间0.80 - 0.98）。北非第2组的HR显著较低（0.58，95%置信区间0.43 - 0.79）。总之，与遭受较少迫害的欧洲幸存者相比，遭受严重逆境的欧洲幸存者具有更高的恢复力。在北非幸存者中未发现风险升高。
