Citation

Riblet NB, Gottlieb DJ, Watts BV, Cornelius SL, Fan VS, Shi X, Shiner B. Psychiatry Res. 2019; 273: 247-251.

Affiliation

Veterans Affairs Medical Center, White River Junction VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon NH, USA.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.psychres.2019.01.040

PMID

30658209

Abstract

The relationship between three markers of chronic hypoxia (altitude, smoking and chronic obstructive pulmonary disease (COPD)) and suicide risk has not been well-studied. We conducted a population-based cohort study evaluating the association between chronic hypoxia and suicide risk. Patients entered the cohort in their first year with a documented healthcare encounter and remained in the cohort until their death or the end of the study period. Generalized estimating equation (GEE) methodology was used to assess the association between suicide and three risk markers of chronic hypoxia.

FINDINGS were summarized using odds ratio (OR) and 95% confidence intervals (CI). Among the 9,620,944 patients in the cohort, there were 22,403 suicide deaths. There was a statistically significant progression of suicide risk as altitude rose in increments of 1000 m (OR: 1.22). There was a strong association between the number of hypoxic conditions and the odds of suicide. Patients with three markers of chronic hypoxia was nearly four times more likely to die by suicide than patients with no markers (OR: 3.96). Chronic hypoxia is a risk factor for suicide and having multiple indicators of hypoxia confers a greater risk for suicide, indicating a dose-response relationship.

Published by Elsevier B.V.

Language: en

Keywords

Altitude; Nicotine; Pulmonary disease