title: Suicide in young adults: psychiatric and socio-economic factors from a case-control study.
abstract: BACKGROUND
  Suicide in young adults remains an important public health issue in Australia. The attributable risks associated with broader socioeconomic factors, compared to more proximal psychiatric disorders, have not been considered previously in individual-level studies of young adults. This study compared the relative contributions of psychiatric disorder and socio-economic disadvantage associated with suicide in terms of relative and attributable risk in young adults.
  
  
  METHODS
  A population-based case-control study of young adults (18-34 years) compared cases of suicide (n = 84) with randomly selected controls (n = 250) from population catchments in New South Wales (Australia), with exposure information collected from key informant interviews (for both cases and controls). The relative and attributable risk of suicide associated with ICD-10 defined substance use, affective, and anxiety disorder was compared with educational achievement and household income, adjusting for key confounders. Prevalence of exposures from the control group was used to estimate population attributable fractions (PAF).
  
  
  RESULTS
  Strong associations were evident between mental disorders and suicide for both males and females (ORs 3.1 to 18.7). The strongest association was for anxiety disorders (both males and females), followed by affective disorders and substance use disorders. Associations for socio-economic status were smaller in magnitude than for mental disorders for both males and females (ORs 1.1 to 4.8 for lower compared to high SES groups). The combined PAF% for all mental disorders (48% for males and 52% for females) was similar in magnitude to socio-economic status (46% for males and 58% for females).
  
  
  CONCLUSIONS
  Socio-economic status had a similar magnitude of population attributable risk for suicide as mental disorders. Public health interventions to reduce suicide should incorporate socio-economic disadvantage in addition to mental illness as a potential target for intervention.
authors.affiliation: School of Science and Health, University of Western Sydney, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia. a.page@uws.edu.au.
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; D001008:Anxiety Disorders / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000523:psychology* / Q000639:trends*; D055815:Young Adult