Unemployment as a Risk Factor for Completed Suicide: A Psychological Autopsy Study

Abstract

This study adopts a psychological autopsy method to compare (1) unemployed suicides, (2) other suicides who were either employed or not in the labor force, and (3) psychiatric outpatients without any prior suicidal behavior. A total of 245 consecutive suicides from Province of Parma (Italy) with recorded employment status were included in the analysis. The control group included 41 psychiatric outpatients aged 18 to 64 years, who had not engaged in any previous suicidal act, and who were unemployed. The unemployed suicides had a risk 17 times higher to have had financial problems in the last 12 months (95% confidence interval [CI]: 2.0/149.5; p < 0.01) than other suicides. Unemployed suicides (compared to living unemployed controls) were 10 times more likely to have had poor social support (95% CI: 1.7/56.1; p < 0.01), 16 times more likely to have had any stressful life events in the past 12 months (95% CI: 2.5/103.9; p < 0.01), and 22 times more likely to have a diagnosis of borderline personality disorder (95% CI: 2.4/203.2; p < 0.01). New suicide prevention strategies for those who are facing job loss need to focus on social support and personality disorders, as well as hopelessness and despair.

Keywords:

• Italy
• mental illness
• psychological autopsy
• suicide
• unemployment

Notes

Note. Hochberg and Benjamini correction for multiple testing (n = 22 for comparisons between groups of suicides, n = 20 for comparisons between unemployed suicides and controls): *significant for p < 0.05; **significant for p < 0.01.

Note. Fit indices: Likelihood Ratio ; p = 0.98.

Note. Fit indices of the loglinear model: Likelihood Ratio  = 18.00; p = 0.88. Controls are living unemployed without previous suicide behavior. The variables Any DSM-IV-TR diagnosis, and Hospitalizations were not inserted in the model due to the low numbers in some categories or their strong association with other predictors.