The descriptive epidemiology of suicide in Tuscany, 1988-2002

Martiello, Michele Arcangelo; Cipriani, Francesco; Voller, Fabio; Buiatti, Eva; Giacchi, Mariano Vincenzo

doi:10.1017/s1121189x00004450

Cited by 11 publications

(8 citation statements)

References 33 publications

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“…The former may be seen as largely responsible for the variation in social conditions that foster different national suicide rates, while the variation in the latter explain why a particular individual will succumb to suicide whereas others in broadly similar circumstances will not [21]. Suicide risk factors at the regional level include, for example, levels of economic deprivation and social fragmentation [22][23][24], societal integration [25,26], isolation (low population density and high proportions of households with only one member) [27], unemployment [27,28], state public welfare expenditures [29], urban/rural proportions [30][31][32], and access to health care [33,34]. All of these variables have been found to be associated with suicide and self-injurious behavior in high-income countries.…”

Section: Discussionmentioning

confidence: 99%

Completed Suicide and Marital Status According to the Italian Region of Origin

Masocco

Pompili

Vanacore³

et al. 2009

Psychiatr Q

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Completed suicide is associated with marital status; being unmarried is associated with a higher suicide rate as compared with being married or living with a partner. Moreover, the region of origin may be particularly important when trying to explain major inequalities in suicide rates across a country. Data were obtained from the Italian Database on Mortality, collected by the Italian Census Bureau (ISTAT) and processed by the Italian National Institute of Health-Statistics Unit. The Italian population in the last Italian census (October 2001) was used to estimate age-standardized mortality rates from suicide by marital status (ICD-9 revision: E950-959) and "natural" causes (ICD-9 revision: 0-280; 320-799). Rate Ratios and 95% confidence intervals were calculated using married individuals as a reference. All analyses were conducted separately for men and women for 2000-2002, the most recent years with data available. Logistic regression analysis was used to compare differences by marital status for suicide versus death from natural causes. There are major inequalities in suicide rates in Italy. The North region has the highest suicide rates both for married and non-married individuals. Sardinia Island has the highest male suicide rate in Italy-23.07 per 100,000 per year-compared with the average national male suicide rate of 13.80, a difference which is significantly higher by 67% (RR: 1.67; 95%CI = 1.40-1.99). In contrast, Sardinia has one of the lowest female suicide rates among the Italian regions, close to that of the South and the Center regions. The North-East is the only region where the suicide rate among divorced men is significantly higher than that of married men. In the South, widowers have the highest suicide rate, with a rate 6-times that of married men (RR = 5.66; 95%CI = 4.46-7.18). Major inequalities in suicide rates by region may derive from different socio-cultural backgrounds, confirming the notion that suicide is a multifaceted phenomenon. The results of the present study indicate that suicide prevention must take into account the social and cultural characteristics of different communities. Moreover, these findings support the notion that marital status may play a central role in influencing suicide.

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Section: Discussionmentioning

confidence: 99%

Completed Suicide and Marital Status According to the Italian Region of Origin

Masocco

Pompili

Vanacore³

et al. 2009

Psychiatr Q

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“…Deinstitutionalization, however, also seems to be associated with increased rates in deaths for causes considered ' behaviourally avoidable ' (i.e. preventable with adequate health promotion policies), such as cardiovascular and unnatural causes for both genders (Hansen et al 2001) and for suicide (Mortensen & Juel, 1993 ;Martiello et al 2006). Vreeland (2007) stated that the problem of increased morbidity and premature death in people with serious mental illness needed to be addressed with a transformation of the current mental health system and the integration of physical and mental health care, towards a system that uses a coordinated, multidisciplinary holistic approach.…”

Section: Introductionmentioning

confidence: 99%

Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

et al. 2009

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Background. Most mortality studies of psychiatric patients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatric patients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services.Method. All subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population.Results. The overall SMR of the psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95 % confidence interval (CI) 1.6-1.8], and higher still following the first admission (SMR 2.61, 95 % CI 2.4-2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95 % CI 142.5-328.6) and personality disorders (20.87, 95 % CI 5.2-83.4).Conclusions. This study found that psychiatric patients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.

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“…Smoothed mortality suicide rates were obtained using empirical Bayes in Tuscany. 35 A comparison of fully Bayesian and empirical Bayes methods was done in estimation of disease rates in spatial temporal variations. 36 Rezaeian et al 37 suggested the use of smooth rates in case of instability and used non iterative empirical Bayes method.…”

Section: Discussionmentioning

confidence: 99%

Spatial mapping of acute diarrheal disease using GIS and estimation of relative risk using empirical Bayes approach

Kumar

Shanmugasundaram

George³

et al. 2017

Clinical Epidemiology and Global Health

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a b s t r a c t Background/objectives: Diarrheal disease is one among the top five causes of death in low-and middle-income countries. It is the second leading cause of death in children under five years of age. Diarrheal disease contributes to the mortality of nearly 1.5 million children and globally there are about two billion cases of diarrheal diseases every year. In the present study, we studied the spatio-temporal pattern of acute diarrheal disease (ADD) ward-wise and to estimate and compare two widely used Bayesian models in the study of measuring relative risk of ADD in Chennai Corporation, Tamilnadu, India.Materials and methods: Data on ADD were obtained from Communicable disease hospital, Chennai, Tamilnadu, India from 2009-11. Geographical Information System (GIS) technique was used to map ADD data ward-wise and relative risk was estimated using empirical Bayes approach using Poisson gamma and Poisson log normal models.Results: Over a period of three years from 2009-11, nearly 7661 cases of ADD were reported in Chennai Corporation. The cumulative incidence rate of diarrhea was 142.6 cases per 100,000 population ranging from minimum of 0 to maximum of 1699.7 cases per year. Males had higher average incidence 147.4 cases than females with 137.7 cases per 100,000 population per year. Also, the cumulative incidence was higher in the age group of 0-4 years (306.8 cases) than that in any other category. Higher incidence was observed during the months of Apr-Jun (55.2 cases) than that in any other seasons. Choropleth map indicates that higher incidence of ADD was more prevailed in northern part of Chennai near coastal area which includes the wards from Tondiarpet, Basin bridge, and Pulianthope zones. The posterior relative risk estimate obtained using empirical Bayes approach identified 23, 30, and 19 wards having relative risk significantly greater than 1 for years 2009, 2010, and 2011, respectively. Fitting standardized morbidity ratio (SMR) and the other two models showed that, consistently Tondiarpet ward had the highest relative risk of ADD in all the three years (relative risk (95% credible interval) based on SMR, Poisson gamma and Poisson log normal

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The descriptive epidemiology of suicide in Tuscany, 1988-2002

Abstract: The cluster of excessive mortality from suicide in Southern Tuscany could be the consequence of social determinants, related to the urban and social crisis following agriculture decline and mine closure.

Cited by 11 publications

References 33 publications

Completed Suicide and Marital Status According to the Italian Region of Origin

Completed Suicide and Marital Status According to the Italian Region of Origin

Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

Spatial mapping of acute diarrheal disease using GIS and estimation of relative risk using empirical Bayes approach

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