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Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 2, pp 241–251 | Cite as

Attempted suicide among immigrants in European countries: an international perspective

  • Cendrine Bursztein LipsicasEmail author
  • Ilkka Henrik Mäkinen
  • Alan Apter
  • Diego De Leo
  • Ad Kerkhof
  • Jouko Lönnqvist
  • Konrad Michel
  • Ellinor Salander Renberg
  • Isik Sayil
  • Armin Schmidtke
  • Cornelis van Heeringen
  • Airi Värnik
  • Danuta Wasserman
Original Paper

Abstract

Purpose

This study compares the frequencies of attempted suicide among immigrants and their hosts, between different immigrant groups, and between immigrants and their countries of origin.

Methods

The material, 27,048 persons, including 4,160 immigrants, was obtained from the WHO/EURO Multicentre Study on Suicidal Behaviour, the largest available European database, and was collected in a standardised manner from 11 European centres in 1989–2003. Person-based suicide-attempt rates (SARs) were calculated for each group. The larger immigrant groups were studied at each centre and compared across centres. Completed-suicide rates of their countries of origin were compared to the SARs of the immigrant groups using rank correlations.

Results

27 of 56 immigrant groups studied showed significantly higher, and only four groups significantly lower SARs than their hosts. Immigrant groups tended to have similar rates across different centres. Moreover, positive correlation between the immigrant SAR and the country-of-origin suicide rate was found. However, Chileans, Iranians, Moroccans, and Turks displayed high SARs as immigrants despite low suicide rates in the home countries.

Conclusions

The similarity of most immigrant groups’ SARs across centres, and the correlation with suicidality in the countries of origin suggest a strong continuity that can be interpreted in either cultural or genetic terms. However, the generally higher rates among immigrants compared to host populations and the similarity of the rates of foreign-born and those immigrants who retained the citizenship of their country of origin point to difficulties in the acculturation and integration process. The positive correlation found between attempted and completed suicide rates suggests that the two are related, a fact with strong implications for suicide prevention.

Keywords

Suicide Suicide attempt Culture Migration Europe 

Notes

Acknowledgments

This study has been supported by the WHO/EU Network on suicide research and prevention monitoring study project No. 2003135, the Karolinska Institute PhD financing program (KID-funding), the National Prevention of Suicide and Mental Ill-Health (NASP) at Karolinska Institute, Stockholm.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    United Nations (UN), Report of the Department of Economic and Social Affairs, Population Division. International Migration (2009); http://www.un.org/esa/population/publications/2009Migration_Chart/ittmig_wallchart09.pdf. Accessed on 17 November 2010
  2. 2.
    Bhugra D (2005) Cultural identities and cultural congruency: a new model for evaluating mental distress in immigrants. Acta Psychiatr Scand 111:84–93PubMedCrossRefGoogle Scholar
  3. 3.
    Shoval G, Schoen G, Vardi N, Zalsman G (2007) Suicide in Ethiopian immigrants in Israel: a case for study of the genetic-environmental relation in suicide. Arch Suicide Res 11:247–253PubMedCrossRefGoogle Scholar
  4. 4.
    Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365:1309–1314PubMedCrossRefGoogle Scholar
  5. 5.
    Pumariega AJ, Rothe E, Pumariega JB (2005) Mental health of immigrants and refugees. Community Ment Health J 41:581–597PubMedCrossRefGoogle Scholar
  6. 6.
    Tinghög P, Hemmingsson T, Lundberg I (2007) To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors? Soc Psychiatry Psychiatr Epidemiol 42:990–996PubMedCrossRefGoogle Scholar
  7. 7.
    Westman J, Hasselstrom J, Johansson SE, Sundquist J (2003) The influences of place of birth and socioeconomic factors on attempted suicide in a defined population of 4.5 million people. Arch Gen Psychiatry 60:409–414PubMedCrossRefGoogle Scholar
  8. 8.
    Brent DA, Melhem N (2008) Familial transmission of suicidal behavior. Psychiatr Clin North Am 31:157–177PubMedCrossRefGoogle Scholar
  9. 9.
    Currier D, Mann JJ (2008) Stress, genes and the biology of suicidal behavior. Psychiatr Clin North Am 31:247–269PubMedCrossRefGoogle Scholar
  10. 10.
    Wasserman D, Terenius L, Wasserman J, Sokolowski M (2010) The 2009 Nobel conference on the role of genetics in promoting suicide prevention and the mental health of the population. Mol Psychiatry 15:12–17PubMedCrossRefGoogle Scholar
  11. 11.
    Sher L (1999) On the role of neurobiological and genetic factors in the etiology and pathogenesis of suicidal behavior among immigrants. Med Hypotheses 53:110–111PubMedCrossRefGoogle Scholar
  12. 12.
    Burvill PW, Woodings TL, Stenhouse NS, McCall NG (1982) Suicide during 1961–70 migrants in Australia. Psychol Med 12:295–308PubMedCrossRefGoogle Scholar
  13. 13.
    Kliewer EV, Ward RH (1988) Convergence of immigrant suicide rates to those in the destination country. Am J Epidemiol 127:640–653PubMedGoogle Scholar
  14. 14.
    Merrill J, Owens J (1988) Self-poisoning among four immigrant groups. Acta Psychiatr Scand 77:77–80PubMedCrossRefGoogle Scholar
  15. 15.
    Sainsbury P, Barraclough B (1968) Differences between suicide rates. Nature 220(5173):1252PubMedCrossRefGoogle Scholar
  16. 16.
    Sorenson SB, Golding JM (1988) Prevalence of suicide attempts in a Mexican-American population: prevention implications of immigration and cultural issues. Suicide Life Threat Behav 18:322–333PubMedGoogle Scholar
  17. 17.
    Whitlock FA (1971) Migration and suicide. Med J Aust 2:840–848PubMedGoogle Scholar
  18. 18.
    Greenfield B, Rousseau C, Slatkoff J et al (2006) Profile of a metropolitan North American immigrant suicidal adolescent population. Can J Psychiatry 51(3):155–159PubMedGoogle Scholar
  19. 19.
    Singh GK, Hiatt RA (2006) Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979–2003. Int J Epidemiol 35(4):903–919PubMedCrossRefGoogle Scholar
  20. 20.
    Neeleman J, Wessely S (1999) Ethnic minority suicide: a small area geographical study in south London. Psychol Med 29(2):429–436PubMedCrossRefGoogle Scholar
  21. 21.
    Patel SP, Gaw AC (1996) Suicide among immigrants from the Indian subcontinent: a review. Psychiatr Serv 47(5):517–521PubMedGoogle Scholar
  22. 22.
    Westman J, Sundquist J, Johansson LM, Johansson SE, Sundquist K (2006) Country of birth and suicide: a follow-up study of a national cohort in Sweden. Arch Suicide Res 10(3):239–248PubMedCrossRefGoogle Scholar
  23. 23.
    Burvill PW (1998) Migrant suicide rates in Australia and in country of birth. Psychol Med 28(1):201–208PubMedCrossRefGoogle Scholar
  24. 24.
    Morrell S, Taylor R, Slaytor E, Ford P (1999) Urban and rural suicide differentials in migrants and the Australian-born, New South Wales, Australia 1985–1994. Soc Sci Med 49(1):81–91PubMedCrossRefGoogle Scholar
  25. 25.
    Hjern A, Allebeck P (2002) Suicide in first- and second-generation immigrants in Sweden: a comparative study. Soc Psychiatry Psychiatr Epidemiol 37:423–429PubMedCrossRefGoogle Scholar
  26. 26.
    Mäkinen IH, Wasserman D (2003) Suicide mortality among immigrant Finnish Swedes. Arch Suicide Res 7:93–106CrossRefGoogle Scholar
  27. 27.
    Canetto SS (2008) Women and suicidal behavior: a cultural analysis. Am J Orthopsychiatry 78:259–266PubMedCrossRefGoogle Scholar
  28. 28.
    Mäkinen IH (1997) Are there social correlates to suicide? Soc Sci Med 44:1919–1929PubMedCrossRefGoogle Scholar
  29. 29.
    Mäkinen IH (2009) Social theories of suicide. In: Wasserman D, Wasserman C (eds) Oxford textbook of suicidology and suicide prevention a global perspective. Oxford University Press, Oxford, pp 139–147Google Scholar
  30. 30.
    Canetto SS (1997) Gender and suicidal behavior: theories and evidence. In: Maris RW, Silverman MM, Canetto SS (eds) Review of suicidology. Guilford Press, New York, pp 138–167Google Scholar
  31. 31.
    Canetto SS (1997) Meanings of gender and suicidal behavior during adolescence. Suicide Life Threat Behav 27:339–351PubMedGoogle Scholar
  32. 32.
    Canetto SS, Lester D (1998) Gender, culture, and suicidal behavior. Transcult Psychiatry 35:163–190CrossRefGoogle Scholar
  33. 33.
    Voracek M, Loibl LM (2008) Consistency of immigrant and country-of-birth suicide rates: a meta-analysis. Acta Psychiatr Scand 118(4):259–271PubMedCrossRefGoogle Scholar
  34. 34.
    Kondrichin SV (1995) Suicide among Finno-Ugrians. Lancet 346:1632–1633PubMedCrossRefGoogle Scholar
  35. 35.
    Marušič A (2005) History and geography of suicide: could genetic risk factors account for the variation in suicide rates? Am J Med Genet C Semin Med Genet 133C:43–47PubMedCrossRefGoogle Scholar
  36. 36.
    Pfeffer GR (1985) Self destructive behavior in children and adolescents. Psychiatr Clin North Am 8:215–226PubMedGoogle Scholar
  37. 37.
    Apter A, King RA, Bleich A, Fluck A, Kotler M, Kron S (2008) Fatal and non-fatal suicidal behavior in Israeli adolescent males. Arch Suicide Res 12(1):20–29PubMedCrossRefGoogle Scholar
  38. 38.
    Bebbington PE, Minot S, Cooper C, Dennis M, Meltzer H, Jenkins R, Brugha T (2010) Suicidal ideation, self-harm and attempted suicide: results from the British psychiatric morbidity survey 2000. Eur Psychiatry 25:427–431PubMedCrossRefGoogle Scholar
  39. 39.
    Hawton K, Arensman E, Wasserman D et al (1998) Relation between attempted suicide and suicide rates among young people in Europe. J Epidemiol Community Health 52(3):191–194PubMedCrossRefGoogle Scholar
  40. 40.
    Owens D, Horrocks J, House A (2002) Fatal and non-fatal repetition of self-harm. Systematic review. Br J Psychiatry 181:193–199PubMedCrossRefGoogle Scholar
  41. 41.
    Westman J, Hasselstrom J, Johansson SE, Sundquist J (2003) The influences of place of birth and socioeconomic factors on attempted suicide in a defined population of 4.5 million people. Arch Gen Psychiatry 60(4):409–414PubMedCrossRefGoogle Scholar
  42. 42.
    Devrimci-Özguven H, Sayil I, Baskak B, Bille-Brahe U (2004) Immigrants and attempted suicide in Europe. In: De Leo D, Bille-Brahe U, Kerkhof AD, Schmidtke A (eds) Suicidal behaviour: theories and research findings. Hogrefe & Huber Publishers, Ashland, pp 287–298Google Scholar
  43. 43.
    Carta MG, Bernal M, Hardoy MC, Haro-Abad JM (2005) Report on the Mental Health in Europe Working Group. Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1). Clin Pract Epidemol Ment Health 1:13CrossRefGoogle Scholar
  44. 44.
    Schmidtke A, Bille-Brahe U, De Leo D et al (1996) Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results from the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand 93:327–338PubMedCrossRefGoogle Scholar
  45. 45.
    Schmidtke A, Weinacker B, Löhr C et al (2004) Suicide and suicide attempts in Europe—An overview. In: Schmidtke A, Bille-Brahe U, De Leo D, Kerkhof A (eds) In Suicidal Behaviour in Europe: results from the WHO/EURO Multicentre Study on Suicidal Behaviour. Hogrefe & Huber, Göttingen, pp 15–28Google Scholar
  46. 46.
    Platt S, Bille-Brahe U, Kerkhof A et al (1992) Parasuicide in Europe: the WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatr Scand 85:97–104PubMedCrossRefGoogle Scholar
  47. 47.
    Bertolote J, Wasserman D (2009) Development of definitions of suicidal behaviour: from suicidal thoughts to completed suicide. In: Wasserman D, Wasserman C (eds) The Oxford textbook of suicidology and suicide prevention—a global perspective. Oxford University Press, New York, pp 87–90Google Scholar
  48. 48.
    Renberg ES (2001) Self-reported life-weariness, death-wishes, suicidal ideation, suicidal plans and suicide attempts in general population surveys in the north of Sweden 1986 and 1996. Soc Psychiatry Psychiatr Epidemiol 36:429–436PubMedCrossRefGoogle Scholar
  49. 49.
    McManus S, Meltzer H, Brugha T, Bebbington P, Jenkins R (2009) Adult psychiatric morbidity in England, 2007: results of a household survey. The NHS Information Centre for Health and Social Care by the National Centre for Social Research and the Department of Health Sciences, University of Leicester, London, pp 71–81Google Scholar
  50. 50.
    Arensman E, Kerkhof AJ, Hengeveld MW, Mulder JD (1995) Medically treated suicide attempts: a four year monitoring study of the epidemiology in The Netherlands. J Epidemiol Community Health 49:285–289PubMedCrossRefGoogle Scholar
  51. 51.
    World Health Organization (2008) Figures and facts about suicide (updated country charts at http://www.who.int/mental_health/prevention/suicide/country_reports/en/index.html. Accessed 16 March 2009
  52. 52.
    Bertolote J, Fleischmann A (2009) A global perspective on the magnitude of suicide mortality. In: Wasserman D, Wasserman C (eds) The Oxford textbook of suicidology and suicide prevention—a global perspective. Oxford University Press, New York, pp 91–98Google Scholar
  53. 53.
    Lindert J, Schouler-Ocak M, Heinz A et al (2008) Mental health, health care utilization of migrants in Europe. Eur Psychiatry 23(Suppl 1):14–20PubMedCrossRefGoogle Scholar
  54. 54.
    Israel Health Ministry (2008) Suicidality in Israel. Information and Computer Services. Health Information Department. JerusalemGoogle Scholar
  55. 55.
    Youngmann R, Pugachova I, Zilber N (2008) Utilization patterns of ambulatory psychiatric services for Jewish Ethiopian immigrants in Israel. Paper presented at the International Conference: Ethiopian Jewry: Identity, Heritage, History and Society. Bar-Ilan UniversityGoogle Scholar
  56. 56.
    Värnik A, Kõlves K, Wasserman D (2005) Suicide among Russians in Estonia: database study before and after independence. BMJ 330(7484):176–177PubMedCrossRefGoogle Scholar
  57. 57.
    Vijayakumar L, Nagaraj K, Pirkis J, Whiteford H (2005) Suicide in developing countries (1): frequency, distribution, and association with socioeconomic indicators. Crisis 26:104–111PubMedCrossRefGoogle Scholar
  58. 58.
    Johansson LM, Sundquist J, Johansson SE, Bergman B, Qvist J, Träskman-Bendz L (1997) Suicide among foreign-born minorities and Native Swedes: an epidemiological follow-up study of a defined population. Soc Sci Med 44(2):181–187PubMedCrossRefGoogle Scholar
  59. 59.
    Mirsky J, Kohn R, Dolberg P, Levav I (2010) Suicidal behavior among immigrants. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-010-0280-5
  60. 60.
    Orbach I, Rabinowitz A (2009) Suicide in the Jewish scriptures. In: Wasserman D, Wasserman C (eds) The Oxford textbook of suicidology and suicide prevention—a global perspective. Oxford University Press, New York, pp 43–47Google Scholar
  61. 61.
    Burger I, van Hemert AM, Schudel WJ, Middelkoop BJ (2009) Suicidal behavior in four ethnic groups in The Hague, 2002–2004. Crisis 30(2):63–67PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Cendrine Bursztein Lipsicas
    • 1
    Email author
  • Ilkka Henrik Mäkinen
    • 2
  • Alan Apter
    • 3
  • Diego De Leo
    • 4
  • Ad Kerkhof
    • 5
  • Jouko Lönnqvist
    • 6
  • Konrad Michel
    • 7
  • Ellinor Salander Renberg
    • 8
  • Isik Sayil
    • 9
  • Armin Schmidtke
    • 10
  • Cornelis van Heeringen
    • 11
  • Airi Värnik
    • 12
  • Danuta Wasserman
    • 1
  1. 1.National Prevention of Suicide and Mental Ill-Health (NASP) at Karolinska Institute and Stockholm County Council’s Centre for Suicide Research and Prevention, WHO Lead Collaborating Centre of Mental Health Problems and Suicide across EuropeStockholmSweden
  2. 2.Stockholm Centre on Health of Societies in Transition (SCOHOST), School of Social SciencesSödertörn UniversityStockholmSweden
  3. 3.Feinberg Child Study Center and the Department of Child and Adolescent PsychiatrySchneider Children Medical CenterPetah-TikvaIsrael
  4. 4.Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, and Life Promotion Clinic Mt Gravatt campusGriffith UniversityBrisbaneAustralia
  5. 5.Department of Clinical PsychologyVrije UniversiteitAmsterdamThe Netherlands
  6. 6.Department of Mental Health and Substance Abuse ServicesNational Institute for Health and Welfare (THL)HelsinkiFinland
  7. 7.University Psychiatric Services (UPD)BernSwitzerland
  8. 8.Department of Clinical Sciences, Division of PsychiatryUmeå UniversityUmeåSweden
  9. 9.Ankara University Crisis Intervention CenterAnkaraTurkey
  10. 10.Unit for Clinical Psychology, Department of Psychiatry and PsychotherapyUniversity of WuerzburgWürzburgGermany
  11. 11.Unit for Suicide ResearchUniversity Department of Psychiatry and Medical Psychology, University HospitalGhentBelgium
  12. 12.Estonian-Swedish Mental Health and Suicidology InstituteTallinnEstonia

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