title: A 10-year follow-up study on suicidal mortality after 1999 Taiwan earthquake.
abstract: The long-term impact of natural disasters on suicide in general population and survivors remains uncertain. The present report examined the direction and the length of the influence of an earthquake over suicide across age groups.
  
  
  
  We used an interrupted time-series design with non-equivalent no-treatment group to evaluate post-earthquake changes in suicide rates by the standardized mortality ratio.
  
  
  
  The time trend changes in suicide rates before and after the earthquake were similar for males and females but different between senior and junior age groups. Gender-specific relative ratios were 0.85 (95%CI: 0.81-0.90) for males and 0.79 (95% CI: 0.72-0.86) for females. Age-gender-stratified relative ratios were 0.61 (95% CI: 0.53-0.70) and 0.69 (95% CI: 0.64-0.75) for males and females aged less than 45 years, respectively. Although the overall suicide mortality increased after the earthquake, the relative suicide risk ratio decreased 31-39% for those aged less than 45 years, which persisted for nearly 10 years after earthquake.
  
  
  
  Our study demonstrated that a severe earthquake resulted in a significant decrease in standardized suicide mortality ratios in exposed areas for 10 years compared to unexposed area, particularly in a younger population.
authors.affiliation: School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Sam Li-Sheng
authors.initials: SL
authors.lastname: Chen
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chau-Shoun
authors.initials: CS
authors.lastname: Lee
authors.affiliation: School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Amy Ming-Fang
authors.initials: AM
authors.lastname: Yen
authors.affiliation: Division of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Hsiu-Hsi
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Chang-Chuan
authors.initials: CC
authors.lastname: Chan
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Sherry Yueh-Hsia
authors.initials: SY
authors.lastname: Chiu
authors.affiliation: Department of Health Industry Management, College of Healthcare Management, Kainan University, Taoyuan, Taiwan.
authors.forename: Jean Ching-Yuan
authors.initials: JC
authors.lastname: Fann
authors.affiliation: School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: jungchenchang@ntu.edu.tw.
authors.forename: Jung-Chen
authors.initials: JC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000367:Age Factors; D004190:Disasters / Q000706:statistics & numerical data; D055866:Earthquakes / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D013405:Suicide / Q000706:statistics & numerical data / Q000639:trends*; D013624:Taiwan / Q000453:epidemiology
keywords: Mortality; Old age; Stress; Suicide; Trauma