Psychiatrist density and risk of suicide: a multilevel case-control study based on a national sample in Taiwan.
Psychiatry Clin Neurosci
; 78(1): 69-76, 2024 Jan.
Article
en En
| MEDLINE
| ID: mdl-37812045
ABSTRACT
AIM:
No previous studies, to our knowledge, have investigated the association between psychiatrist density and suicide, accounting for individual- and area-level characteristics.METHODS:
We investigated all suicide cases in 2007-2017 identified from the national cause-of-death data files, with each suicide case matched to 10 controls by age and sex and each suicide case/control assigned to one of the 355 townships across Taiwan. Our primary outcome was the odds ratio (OR) of suicide and its 95% confidence interval (CI) estimated via multilevel models, which included both individual- and area-level characteristics. Townships with no psychiatrists were compared with the quartiles of townships with psychiatrists (density per 100,000 population) quartile 1 (Q1) (0.01-3.02); quartile 2 (Q2) (3.02-7.20); quartile 3 (Q3) (7.20-13.82); and quartile 4 (Q4) (>13.82).RESULTS:
A total of 40,930 suicide cases and 409,300 age- and sex-matched controls were included. We found that increased psychiatrist density was associated with decreased suicide risk (Q1 adjusted OR [aOR], 0.95 [95% CI, 0.90-1.01]; Q2 aOR, 0.90 [95% CI, 0.85-0.96]; Q3 aOR, 0.89 [95% CI, 0.83-0.94]; Q4 aOR, 0.89 [95% CI, 0.83-0.95]) after adjusting for individual-level characteristics (employment state, monthly income, physical comorbidities, and the diagnosis of psychiatric disorders) and area socioeconomic characteristics.CONCLUSIONS:
The psychiatrist density-suicide association suggests an effect of increased availability of psychiatric services on preventing suicide. Suicide prevention strategies could usefully focus on enhancing local access to psychiatric services.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Suicidio
/
Psiquiatras
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Psychiatry Clin Neurosci
Asunto de la revista:
NEUROLOGIA
/
PSIQUIATRIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Taiwán