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Citation
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Huang WC, Hsu CY, Chang CM, Yang AC, Liao SC, Chang SS, Wu CS. Psychiatry Clin. Neurosci. 2023; ePub(ePub): ePub. |
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Abstract
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AIM: No previous studies investigated the association between psychiatrist density and suicide, accounting for individual- and area-level characteristics.
METHODS: All suicide cases in 2007-2017 were identified from the national cause-of-death data files, with each suicide case matched to ten controls by age and sex and each suicide case/control assigned to one of the 355 townships across Taiwan. Our primary outcome was the odds ratios (OR) of suicide estimated via multi-level models, which included both individual-level and area-level characteristics. Townships with no psychiatrists were compared with the quartiles of townships with psychiatrists (density per 100,000 population): Q1 (0.01-3.02); Q2 (3.02-7.20); Q3 (7.20-13.82); and Q4 (>13.82).
RESULTS: A total of 40,930 suicide cases and 409,300 age-sex-matched controls were included. We found that increased psychiatrist density was associated with decreased suicide risk (Q1: adjusted OR [aOR] = 0.95 [95% CI 0.90-1.01]; Q2: aOR = 0.90 [95% CI 0.85-0.96]; Q3: aOR = 0.89 [95% CI 0.83-0.94]; Q4: aOR = 0.89 [95% CI 0.83-0.95]) after adjusting for individual characteristics (employment state, monthly income, physical comorbidities, and the diagnosis of psychiatric disorders) and area socioeconomic characteristics.
CONCLUSIONS: The psychiatrist density-suicide association suggests an effect of the availability of psychiatric services on preventing suicide. Suicide prevention strategies could usefully focus on enhancing local access to psychiatric services. This article is protected by copyright. All rights reserved.
Language: en |