Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T12:04:54.277Z Has data issue: false hasContentIssue false
  • English
  • Français

The descriptive epidemiology of suicide in Tuscany, 1988-2002

Published online by Cambridge University Press:  18 May 2011

Michele Arcangelo Martiello ,
Francesco Cipriani ,
Fabio Voller ,
Eva Buiatti  and
Mariano Giacchi
Michele Arcangelo Martiello
Affiliation:
Dipartimento F.M.S. e S.P., Sezione di Sanità Pubblica, Università di Siena, Siena.
Francesco Cipriani
Affiliation:
UF Epidemiologia, Azienda USL 4 di Prato, Prato.
Fabio Voller
Affiliation:
Osservatorio Epidemiologia, Agenzia Regionale di Sanità della Toscana, Firenze.
Get access Rights & Permissions [Opens in a new window]

Summary

Aims – To describe the epidemiology of Suicide in Tuscany according to the triad of time, place and person. Methods – The 4, 764 cases of suicide, defined according to categories E950-E959 of ICD-9 in Tuscany over the period 1988–2002, were obtained from the Tuscan Mortality Register. Mortality indicators were calculated and analyzed. The spatial analysis was carried out by deriving Empirical Bayes Estimates for the 287 municipalities. Results – The crude mortality rate in the 2000–2002 is 7.8 per 100000 population (male: 12.4; female: 3.5). The age-standardized rate in the 2000–2002 is 5.8 per 100, 000 population (male: 9.6; female: 2.6). The highest risk for suicide, especially in the case of males, are concentrated in the southern hinterland Tuscany, in a cluster of rural municipalities that represent the old mining district of Tuscany. The SMRs according to residential municipality (population per square kilometre), confirm a greater risk of suicide for males residing in rural communities. Conclusions – The cluster of excessive mortality from suicide in Southern Tuscany could be the consequence of social determinants, related to the urban and social crisis following agriculture decline and mine closure.

Declaration of Interest: none.

Keywords

suicideepidemiologygeographyminingrural populations.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 15 , Issue 3 , September 2006 , pp. 202 - 210
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Angotzi, G., Cassito, M.G., Camerino, D., Cioni, R., Desideri, E., Franzinelli, A., Gori, R., Loi, F. & Sartorelli, E. (1980). Rapporti tra esposizione a Mercurio e condizioni di salute in un gruppo di lavoratori addetti alla distillazione di Mercurio in uno stabilimento della Provincia di Siena. La Medicina del Lavoro 6, 463–480.Google Scholar
Angst, J., Angst, F. & Stossen, H.M. (1999). Suicide risk in patient with major depressive disorders. Journal of Clinical Psychiatry 60, 57–62.Google Scholar
Arnetz, B.B., Hörte, L.G., Hedberg, A. & Malker, H. (1987). Suicide among Swedish dentists. A ten-year follow-up study. Scandinavian Journal of Social Medicine 15, 243–246.CrossRefGoogle ScholarPubMed
Barraclough, B., Bunch, J., Nelson, B. & Sainsbury, P. (1974). A hundred cases of suicide: clinical aspects. British Journal of Psychiatry 125, 355–373.CrossRefGoogle ScholarPubMed
Baxter, D. & Appleby, L. (1999). Case register study of suicide risk in mental disorders. British Journal of Psychiatry 175, 322–326.CrossRefGoogle ScholarPubMed
Biggeri, A., Massimo, C., Ferrara, M. & Stefanini, P. (1991). Epidemiologia descrittiva del suicidio in Italia. Epidemiologia e Prevenzione 48–49, 208–212.Google Scholar
Bostwick, J.M. & Pankratz, V.S. (2000). Affective disorders and suicide risk: a re-examination. American Journal of Psychiatry 157, 1925–1932.CrossRefGoogle Scholar
Cantor, C.H., Slater, P.J. (1997). A regional profile of suicide in Queensland. Australian Journal of Public Health 21, 181–186.CrossRefGoogle ScholarPubMed
Carballeira, R.C., Vazquez, F.E., Castro, L.P., Seoane, D.B. & Brana, R.N. (1989). Descriptive study of suicide in Galicia, 1987. Gaceta Sanitaria 3, 551–559.CrossRefGoogle Scholar
Cattel, H. (2000). Suicide in the elderly. Advances in Psychiatric Treatment 6, 102–108.CrossRefGoogle Scholar
Centers for Disease Control and Prevention (1997). Regional variations in suicide rates - United States, 1990–1994. Morbidity and Mortality Weekly Report 46, 789–793.Google Scholar
Clayton, D. & Kaldor, J. ( 1987). Empirical Bayes Estimates of Age-standardized relative risks for use in disease mapping. Biometrics 43, 671–681.CrossRefGoogle ScholarPubMed
Conti, L. & Toschi, D. (1994). Suicidio e tentato suicidio. In Manuale di Psichiatria (ed. Cassano, G.B., Cioni, P., Perugi, G. e Poli, E.), pp. 531–538. UTET: Torino.Google Scholar
Conwell, Y., Duberstein, P.R., Cox, C., Herrmann, J.H., Forbes, N.T. & Caine, E.D. (1996). Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. American Journal of Psychiatry 153. 1001–1008.Google ScholarPubMed
De Leo, D. & Carello, G. (1996). Relationship between suicide and undetermined causes of death among the elderly: analysis of Italian data from 1951 to 1988. Omega Journal of Death and Dying 33, 215–231.Google Scholar
De Leo, D., Pavan, L. & Baconcini, C. (2002). Suicidio. In Trattato Italiano dl Psichiatria (ed. Cassano, G.B., Pancheri, P., Pavan, L., Pazzagli, A., Ravizza, L., Rossi, R., Smeraldi, E. e Volterra, V.), pp. 2393–2423. Masson: Milano.Google Scholar
Del Prato, M. (2004). Sistema VS Italia. Retrieved January 4, 2006, from http://www.sistemavsitalia.itGoogle Scholar
Guaiana, G., D'Avanzo, B. & Barbui, C. (2002). Update of suicide trends in Italy from 1986 to 1996. Social Psychiatry and Psychiatric Epidemiology 37, 267–270.CrossRefGoogle ScholarPubMed
Guohua, L. (1995). The interaction effect of bereavement and sex on the risk of suicide in the elderly: an historical cohort study. Social Science and Medicine 40, 825–828.Google Scholar
Harris, E.C. & Barraclough, B. (1997). Suicide as an outcome for mental disorders: a meta-analysis. British Journal of Psychiatry 170, 205–228.CrossRefGoogle ScholarPubMed
Istituto Nazionale di Statistica (1958). Circoscrizioni Statistiche. Metodi e Norme. Serie e, n.1. ISTAT: Roma.Google Scholar
Istituto Nazionale di Statistica (1994). Popolazione Residente dei Comuni. Censimenti dal 1861 al 1991. ISTAT: Roma.Google Scholar
Judd, F., Cooper, A.M., Fraser, C. & Davis, J. (2006). Rural suicide-people or place effects? Australian and New Zealand Journal of Psychiatry 40, 208–216.Google ScholarPubMed
Lester, D. (1997). Suicide in Italy: The North versus South. Italian Journal of Suicidology 1, 19–21.Google Scholar
Levi, F., La Vecchia, C., Lucchini, F., Negri, E., Saxena, S., Maulik, P.K. & Saraceno, B. (2003). Trends in mortality from suicide, 1965–99. Acta Psychiatrlca Scandinavica 108, 341–349.CrossRefGoogle ScholarPubMed
Levin, K.A. & Leyland, A.H. (2005). Urban/rural inequalities in suicide in Scotland, 1981–1999. Social Science & Medicine 60, 2877–2890.CrossRefGoogle ScholarPubMed
Majori, S., Zanin, G., Benvenuti, K., Mirisola, D.M., Tardivo, S. & Baldo, V. (2001 ). Epidemiology of suicide in Verona municipality (Veneto region): results of a retrospective study (1996–2000). Journal of Hygiene and Preventive Medicine 42, 53–57.Google Scholar
Martello, M.A., Cipriani, F., Voller, F., Giacchi, M. & Buiatti, E. (2005a). Mortalità per traumatismi e avvelenamenti in Toscana. Documenti Agenzia Regionale di Sanità della Toscana [online] 17. Retrieved January 4. 2006, from http://www.mad.it/ars/imgarticoli/Traumatismixweb.pdf.Google Scholar
Martiello, M.A., Cipriani, F., Lazzeri, G., Voller, F., Giacchi, M. & Buiatti, E. (2005b). Injury Mortality in Tuscany, 1987–2001. Journal of Preventive Medicine and Hygiene 46, 78–84.Google Scholar
Marusic, A. (1998). Suicide mortality in Slovenia: regional variation. Crisis 19(4), 159–166.CrossRefGoogle ScholarPubMed
McClure, G.M. (2000). Changes in suicide in England and Wales, 1960–1997. British Journal of Psychiatry 176, 64–67.CrossRefGoogle ScholarPubMed
Meel, B.L. (2003). Determinants of Suicide in the Transkey sub-region of South Africa. Journal of Clinical Forensic Medicine 10, 71–76.CrossRefGoogle ScholarPubMed
Meneghel, S.N., Victora, C.G., Faria, N., de Carvalho, L.A. & Falk, J.W. (2004). Epidemiological aspects of suicide in Rio Grande do Sul, Brazil. Revista de Saude Publica 38, 1–6.CrossRefGoogle Scholar
Moller, J. (1994). The spatial distribution of injury deaths in Australia: urban, rural and remote areas. Australian Injury Bulletin [online] 8. Retrieved January 4, 2006, from http://www.nisu.flinders.edu.au/pubs/bulletin8/Google Scholar
Monk, M. (1987). Epidemiology of suicide. Epidemiologie Reviews 9, 51–69.CrossRefGoogle ScholarPubMed
Pavia, M., Nicotera, G., Scaramuzza, G. & Angelino, I.F. (2005). Suicide mortality in Southern Italy: 1998–2002. Psychiatry Research 134, 275–279.CrossRefGoogle ScholarPubMed
Pearson, V.A. (1993). Suicide in North and West Devon: a comparative study using Coroner's inquest records. Journal of Public Health Medicine 15, 320.CrossRefGoogle Scholar
Peden, M., McGee, K. & Sharma, G. (2002). The Injury Chart Book: A Graphical Overview of the Global Burden of Injuries. World Health Organization: Geneva.Google Scholar
Platt, S. (1984). Unemployment and suicidal behaviour: a review of the literature. Social Science & Medicine 19, 93–115.CrossRefGoogle ScholarPubMed
Platts, S. & Bille-Braha, U. (1992). Parasuicide in Europe: the WHO/EURO multicentre study on parasuicide. Introduction and preliminary analysis for 1989. Acta Psychiatrlca Scandinavica 85, 97–104.CrossRefGoogle Scholar
Preti, A. & Miotto, P. (1999). Suicide and unemployment in Italy, 1982–1994. Journal of Epidemiology and Community Health 53, 694–701.CrossRefGoogle ScholarPubMed
Pridemore, W.A. & Spivak, A.L. (2003). Patterns of suicide mortality in Russia. Suicide and Life Threatening Behaviour 33, 132–150.CrossRefGoogle ScholarPubMed
Qin, P., Agerbo, E. & Mortensen, P.B. (2003). Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981–1997. American Journal of Psychiatry 160, 765–772.CrossRefGoogle ScholarPubMed
Regione Toscana - CSPO (2005). Morti per Causa: Anno 2002. Edizioni Regione Toscana: Firenze.Google Scholar
Rost, K., Smith, G.R. & Taylor, J.L. (1993). Rural-urban differences in stigma and the use of care for depressive disorders. Journal of Rural Health 9, 57–62.CrossRefGoogle ScholarPubMed
Sartorelli, E., Angotzi, G., Battista, G., Innocenti, A., Loi, F. & Sartorelli, P. (1986). Elementi di Medicina del Lavoro. Arti Grafiche Ticci: Siena.Google Scholar
Saunderson, T., Haynes, R. & Langford, I.H. (1998). Urban-rural variations in suicides and undetermined deaths in England and Wales. Journal of Public Health Medicine 20, 261–267.CrossRefGoogle ScholarPubMed
Schapira, K., Linsley, K.R., Linsley, A., Kelly, T.P. & Kay, D.W. (2001). Relationship of suicide rates to social factors and availability of lethal methods: comparison of suicide in Newcastle uponTyne 1961–1965 and 1985–1994. British Journal of Psychiatry 178, 458–464.CrossRefGoogle Scholar
Segi, M. (1960). Cancer Mortality for Selected Sites in 24 Countries (1950–57). Department of Public Health - Taboku University School of Medicine: Saudai.Google Scholar
Selvin, H. (1958). Durkheim's suicide and problems of empirical research. American Journal of Sociology 63, 607–619.CrossRefGoogle Scholar
Società Italiana di Mineralogia e Petrologia (1971). La Toscana Meridionale:Fondamenti Geologico-Minerari per una Prospettiva di Valorizzazione delle Risorse Naturali. Editrice Succ. Fusi: Pavia.Google Scholar
Stark, C., Hopkins, P., Gibbs, D., Rapson, T., Belbin, A. & Hay, A. (2004). Trends in suicide in Scotland 1981–1999: age, method and geography. Public Health 20, 4–49.Google Scholar
van de Voorde, H., Hooft, P. & Mulkers, U. (1993). On the influence of data source in aggregated data studies: a comparative study of suicide information based on death certificates and judicial files. Journal of Epidemiology and Community Health 47, 73–75.CrossRefGoogle ScholarPubMed
Vigotti, M.A., Biggeri, A., Dreassi, E., Protti, M.A. & Cislaghi, C. (2001). Atlante della Mortalità in Toscana dal 1971 al 1994. Edizioni Plus dell'Università di Pisa: Pisa.Google Scholar
World Health Organization (2001). The World Health Report 2001. Mental Health: New Understanding, New Hope. World Health Organization: Geneva.Google Scholar
World Health Organization (2002). Suicide prevention. Retrieved January 4, 2006, from http://www.who.int/mental_health/preven-tion/suicide/suicideprevent/en/Google Scholar
World Health Organization - Regional Office for Europe (2005). Mortality by leading causes of death, age and sex. Supplement to the European health for all database (HFA-MDB). Retrieved January 4, 2006, from http://www.euro.who.int/hfadbGoogle Scholar