Higher status boosts psych patients' suicide risk

NEW YORK (Reuters Health) - Money, marriage and education make a lethal mix for people with psychiatric problems, a Danish researcher reports this month.

People who had been admitted to a hospital for psychiatric care were more likely to commit suicide later on if they had higher incomes, more years of education, were fully employed, and married, Esben Agerbo of the University of Aarhus found.

"Suicide risk is generally associated with low income, unemployment, educational underachievement, and singleness, but this study suggests that the opposite is true among psychiatric patients," he notes in the current issue of the medical journal Archives of General Psychiatry.

Evidence on the relationship between social and economic factors and suicide among psychiatric patients has been mixed. Agerbo looked at data on 96,369 psychiatric patients who had been admitted to a Danish hospital for the first time between 1981 and 1998.

The risk of committing suicide within five years of hospital admission rose steadily with income, Agerbo found. People who made the least money were 32 percent less likely to kill themselves than those who made the most.

The same pattern occurred with education; people with only a primary school education were 46 percent less likely to commit suicide than those who had attended graduate school.

While widows and widowers were at slightly greater suicide risk than married people, divorced and never-married individuals were at lower risk. The unemployed were at 15 percent lower risk of suicide than those with full-time jobs.

However, losing income, employment or a spouse through death or divorce all increased suicide risk. And people who had been admitted to the hospital more frequently and spent more time there were less likely to kill themselves.

People who become mentally ill often experience a decline in their social status, Agerbo notes. "Richer, employed, educated, and married psychiatric patients may feel more stigmatized and shameful about having a psychiatric illness," the researcher suggests.

SOURCE: Archives of General Psychiatry, December 2007.