title: The effects of involuntary job loss on suicide and suicide attempts among young adults: evidence from a matched case-control study.
abstract: OBJECTIVE
  To assess the influence of involuntary job loss on suicide and attempted suicide in young adults.
  
  
  METHODS
  A population-based case-control study of young adults (18-34 years) was conducted in New South Wales, Australia. Cases included both suicides (n=84) and attempts (n=101). A structured interview was conducted with next of kin (for suicide cases) and suicide attempters admitted to hospital. Controls selected from the general population were matched to cases by age and sex. Job dismissal or redundancy (involuntary job loss) in the 12 months before suicide or attempt was the main study variable of interest. Suicide and attempts were modelled separately and in combination as outcomes using conditional logistic regression modelling. The analysis was also adjusted for marital status, socio-economic status and diagnosis of an affective or anxiety disorder.
  
  
  RESULTS
  Following adjustment for other variables, involuntary job loss was associated with an odds ratio of 1.82 for suicide and attempted suicide (combined) (95% CI 0.98 to 3.37; p=0.058). Low socio-economic status was associated with an odds ratio of 3.80 for suicide and attempted suicide (95% CI 2.16 to 6.67; p<0.001) compared to high socio-economic status (after adjustment). Diagnosis of a mental disorder was associated with a 7.87 (95% CI 5.16 to 12.01; p<0.001) odds ratio of suicide and attempted suicide compared to no diagnosis (after adjustment). Involuntary job loss was associated with increased odds of suicide and attempts when these were modelled separately, but results did not reach statistical significance.
  
  
  CONCLUSIONS
  Involuntary job loss was associated with increased odds of suicide and attempted suicide. The strength of this relationship was attenuated after adjustment for socio-economic status and mental disorders, which indicates that these may have a stronger influence on suicide than job loss.
authors.affiliation: 1McCaughey VicHealth Centre for Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Milner
authors.forename: Andrew
authors.initials: A
authors.lastname: Page
authors.forename: Stephen
authors.initials: S
authors.lastname: Morrell
authors.forename: Coletta
authors.initials: C
authors.lastname: Hobbs
authors.forename: Greg
authors.initials: G
authors.lastname: Carter
authors.forename: Michael
authors.initials: M
authors.lastname: Dudley
authors.forename: Johan
authors.initials: J
authors.lastname: Duflou
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000523:psychology*; D012959:Socioeconomic Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014478:Unemployment / Q000523:psychology*; D055815:Young Adult
keywords: Depression; job loss; mental disorder; redundancy; suicide; unemployment