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Affiliation
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Professor of Insurance Medicine, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden. |
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Abstract
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BACKGROUND: Mental disorders are associated with an elevated risk for suicide attempt and suicide. Whether the strength of the associations also holds for refugees is unclear. AIMS: To examine the relationship between specific mental disorders and suicide attempt and suicide in refugees and Swedish-born individuals.
METHOD: This longitudinal cohort study included 5 083 447 individuals aged 16-64 years, residing in Sweden in 2004, where 196 757 were refugees. Mental disorders were defined as having a diagnosis in psychiatric care during 2000-2004. Estimates of risk of suicide attempt and suicide were calculated as hazard ratios with 95% confidence intervals. Adjustments were made for important confounding factors, including history of attempt. The reference group comprised Swedish-born individuals without mental disorders.
RESULTS: Rates for suicide attempt in individuals with a mental disorder were lower in refugees compared with Swedish-born individuals (480 v. 850 per 100 000 person-years, respectively). This pattern was true for most specific disorders: compared with the reference group, among refugees, multivariable-adjusted hazard ratios for suicide attempt ranged from 3.0 (anxiety) to 7.4 (substance misuse), and among Swedish-born individuals, from 4.9 (stress-related disorder) to 9.3 (substance misuse). For schizophrenia, bipolar disorder and personality disorder, estimates for suicide attempt were comparable between refugees and Swedish-born individuals. Similar patterns were seen for suicide.
CONCLUSIONS: For most mental disorders, refugees were less likely to be admitted to hospital for suicide attempt or die by suicide compared with Swedish-born individuals. Further research on risk and protective factors for suicide attempt and suicide among refugees with mental disorders is warranted. DECLARATION OF INTEREST: None.
Language: en |