Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences.
BACKGROUND
To explore the risk of suicide associated with occupation while evaluating the impact of socio-economic, demographic and psychiatric differences.


METHODS
A nested case-control study with 3195 suicides and 63 900 matched controls. Information on causes of death, occupation, psychiatric admission, marital status and socio-economic factors was obtained from routine registers.


RESULTS
Across the 55 occupations investigated, the risk of suicide ranged from 2.73 [95% confidence interval (CI) 1.77-4.22] among doctors to 0.44 (95% CI 0.27-0.72) among architects and engineers compared with primary school teachers. With the exception of doctors and nurses, most of the excess risk of suicide associated with particular occupations is explained by the social and economic characteristics of people in those occupations. Much, but not all, of the excess risk in doctors and nurses is due to their increased use of self-poisoning, a method for which they have the knowledge to use effectively. Occupation has little association with suicide among people who suffer from a psychiatric illness, except for doctors, where the excess risk is 3.62 (p=0.007).


CONCLUSIONS
Most of the considerable variation in suicide risk across occupations is explained by socio-economic factors, except for doctors and nurses. Apart from in doctors, the risk of suicide has little association with occupation among people who suffer from a psychiatric illness. Restriction of access to lethal means is an important strategy in suicide prevention.
Agerbo
Esben
E
National Centre for Register-based Research, University of Aarhus, Aarhus C, Denmark. ea@ncrr.dk
Gunnell
David
D
Bonde
Jens Peter
JP
Mortensen
Preben Bo
PB
Nordentoft
Merete
M
D000328:Adult; D001108:Architecture / Q000706:statistics & numerical data; D002423:Cause of Death; D003430:Cross-Sectional Studies; D003718:Denmark; D004738:Engineering / Q000706:statistics & numerical data; D005178:Faculty / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009726:Nurses / Q000523:psychology / Q000706:statistics & numerical data; D009790:Occupations / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D012042:Registries; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*