Suicide and marital status in Italy.
BACKGROUND
Completed suicide has been reported as being linked to marital status, with being unmarried associated with a higher suicide rate as compared with being married or living with a partner.


METHODS
Data were obtained from the Italian Data Base on Mortality, collected by the Italian Census Bureau (ISTAT) and processed by the Italian National Institute of Health-Statistics Unit. The Italian population in the last Italian census (October 2001) was used to estimate age-standardized mortality rates from suicide by marital status (ICD-9 revision: E950-E959) and "natural" causes (ICD-9 revision: 0-280; 320-799). Rate ratios and 95% confidence intervals were calculated using married individuals as a reference. All analyses were conducted separately for men and women and for three different age groups (25-44 years, 45-64 years and 65 years and over) for 2000-2002, the most recent years with data available. Logistic regression analysis was used to compare differences by marital status for suicide versus death from natural causes.


RESULTS
Being married appears to be a protective factor for suicide, but the impact of being never-married, divorced/separated or widowed varies with age and gender. It is noteworthy that the differences between married and non-married women were less consistent than those among men, especially for elderly women. The results confirm that the protective impact of marriage is higher for suicide than for natural causes of death, and the comparison between the risks of suicide and natural causes of death reveals that the groups relatively more at risk for suicide are divorced/separated women, divorced/separated men (under the age of 64) and widowed men.


CONCLUSIONS
Both among men and women, being unmarried, widowed or divorced/separated is associated with a higher suicide rate. This study, however, adds information on suicide mortality in specific age-groups compared to mortality from natural causes of death. Overall, these findings support the notion that marital status may dramatically influence the risk of suicide.
Masocco
Maria
M
National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Italian National Institute of Health (ISS), Rome, Italy. maria.masocco@iss.it
Pompili
Maurizio
M
Vichi
Monica
M
Vanacore
Nicola
N
Lester
David
D
Tatarelli
Roberto
R
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009026:Mortality; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*