Systematic Reviews
Copyright ©The Author(s) 2015.
World J Psychiatr. Jun 22, 2015; 5(2): 243-254
Published online Jun 22, 2015. doi: 10.5498/wjp.v5.i2.243
Table 1 Positive Association Studies
Ref.Countries studiedStudy designSuicide data sourceRecession periodEconomic indicator(s) used Findings
Yang[45]United StatesTime series study Multiple regression analysisHollinger P.C Violent Deaths in the United States New York: Guild 1987[63]Not SpecifiedGross National Product per capita Unemployment rateTotal suicide rates were significantly and positively associated with increases in gross national product per capita and unemployment rate (P < 0.05 for both) However, total suicide rates were significantly and negatively associated with increases in gross national product with a one year lag (P < 0.05)
Lester et al[47]United States and JapanTime series study Pearson correlation analyses and regression analysesAnnual volumes of Vital Statistics of the United StatesNot SpecifiedChange in Gross National Product Unemployment RateIncrease in unemployment was significantly and positively correlated with increase in suicide rates in both the United States and Japan (P < 0.05 for both). Regression analyses, however, only showed a positive and significant relationship between unemployment and suicide rates in Japan (P < 0.05)
Gavrilova[16]RussiaTime series study Descriptive statisticsGokomstat (Russian statistical committee)1992-1993Average real earning and consumer pricesMale suicide rate + 61% and Female Suicide Rate + 22% over 1991-1994 Male morality rate (per 100000) 1991: 47.7 1994: 76.9 Female Mortality Rate (per 100000) 1991: 11.6 1994: 13.2
Ruhm[19]United StatesPanel Study Regression analysisUS Census BureauNot SpecifiedUnemployment RateSuicide rate predicted to increase by 1.3% for every percentage point increase in unemployment rate (P = 0.05)
Brainerd[21]22 former Soviet Bloc CountriesPanel study using regression analysisWorld Health Organisation “Health For All” Database 20001990-1994Gross national product per capita and employment to population ratioA $100 increase in GNP per capita predicted a decrease in suicide rate by 0.14% (P > 0.05) to -0.20% (P < 0.01) in males A one percentage point increase in employment to population ratio predicted decreased suicide rates in males by 3% (P < 0.01)
Lester[42]United StatesPanel Study Regression analysisStatistical Abstract of the United StatesNot SpecifiedGross state product per capita Female labour force participationA one percent increase in gross state product per capita was associated with a 0.45% decrease in total state suicide rates and a 0.55% decrease for male suicide rates (P < 0.05 for both)
Kim et al[28]South KoreaTime Series Study Descriptive statistics and regression analysis1999 report on cause specific mortality by the South Korean Statistical office1997-1999Unemployment rates and GDPSuicide cases increased for three months after the recession onset, but decreased after this point Estimated excess suicide mortality caused by recession = 5.1 in 1998 and 0.5 in 1999 (P < 0.01 for both estimates)
Gerdtham et al[12]SwedenCohort Study using descriptive statistics and probit regressionStatistic Sweden’s Survey of living conditionsNot specifiedAdvanced notification of job loss, changes in GDP, deviation from GDP trends unemployment rates, industry capacity utilisation, and industry confidence indicatorsA one standard deviation increase in GDP decreased the risk of suicide by 22.7% (P < 0.05) A one standard deviation increase in the confidence indicator reduces suicide risk by 22.3% (P < 0.05). A one standard deviation decrease in the advanced notification of job loss rate, decreased suicide risk by 21.5% (P < 0.05)
Khang et al[15]South KoreaTime-series Study Descriptive statisticsDeath certificates from South Korean Statistical office1997-2002Unemployment rate and GDP per capitaSubstantial increase in suicide rates post 1997 in males and females, and then a decline in the rate in both sexes until 2000 Age specific male and female suicide rates (per 100000) in 1996 and 1998: 1-14: MF = 0.8 (1996) and 0.8 (1998) 15-34: MF = 13.5 (1996) and 16.5 (1998) 34-65: M = 26.4 (1996) and 44.3 (1998) F = 8.9 (1996) and 11.9 (1998) 65-79: M = 42.4 (1996) and 58.5 (1998) F = 15.8 (1996) and 22.3 (1998)
Tapia Granados[44]United StatesTime series study Regression analysisHistorical Statistics of the United StatesNot SpecifiedUnemployment ratesSuicide rates significantly associated with increases in the rate of change of unemployment rates from 1920-1944 (P < 0.01) and 1920-1996 (P < 0.01)
Granados[20]SpainPanel study Regression analysisInstituto Nacional de Estadística. (National Statistics Institute)Not specifiedNational and province level unemployment ratesSuicide rate predicted to increase by 1.28% for every percentage point increase in the unemployment rate (P = 0.05)
Chang et al[27]27 European Countries 18 American Countries 8 Asian Countries One South African CountryTime series studyWorld Health Organisation Mortality Database and The Center for Disease Control Online Database (for the United States)2008-2010Gross Domestic Product and UnemploymentOverall suicide rates in men rose 3.3% (95%CI: 2.7-3.9) with a rate ratio of 1.033 (95%CI: 1.027-1.039) and an estimated excess mortality of 5124 (95%CI: 4219-6029) that could be attributed to the recession
Garcy et al[13]SwedenTime series study Cox regressionSwedish work and mortality database1993-1996Unemployment ratesNo excess hazard of suicide mortality attributable to unemployment during the recession in men or women, although an excess hazard post-recession (1997-2002) in men (Hazard ratio = 1.43, 95%CI: 1.31-1.56) and women (Hazard ratio = 1.26, 95%CI: 1.04-1.54)
Chan et al[30]South KoreaTime Series Study Regression analysisNational Statistical office of KoreaJanuary 2009 to December 2010Unemployment RatesBetween 2009 and 2010, there was a statistically significant positive association (P < 0.001 for most associations) between suicide rates and national unemployment rates in both the employed and unemployed except in employed men and women aged 50-59 and unemployed men aged 30-39
Madianos et al[32]GreeceTime series study Descriptive statistics correlation and regression analysesVital Statistics Bureau of the Hellenic Statistical Authority2008-2011Unemployment Rates Debt as a percentage of Gross Domestic ProductUnemployment and debt as percentage of GDP were significantly and positively correlated with suicide rates ρ = + 0.64, P < 0.001 for unemployment, and ρ = +0.47, P < 0.05 for debt as a percentage of GDP In regression models, increases in unemployment and debt as percentage of GDP were significantly associated with increases in suicide rate (P < 0.05 for debt as a percentage of GDP and P < 0.01 for unemployment)
Phillips et al[25]United StatesPanel study Regression analysisNational Center for Health Statistics2007-2009/2010Unemployment RatesUnemployment significantly (P < 0.05) and positively associated with changes in suicide rates but not in the elderly (65+) or young (15-24)
Pompili et al[33]ItalyTime series analysis Joinpoint regressionItalian Mortality Database2007-2010Gross Domestic Product Unemployment rate2006-2010: Age specific suicide rates increased in working age men (25-64) by 12% (RR = 1.12; 95%CI: 1.04-1.19), but not in older (65-85+) or younger age groups (1-24)
Reeves et al[26]Europe and North AmericaTime series studyWorld Health Organisation Mortality Database and The Center for Disease Control Database2008-2010 (Europe) 2008-2009 (Canada)Unemployment ratesUsing 2007 as a baseline, the excess suicide mortality attributable to the recession across the United States, Canada and Europe was 10000