Self-reported happiness in life and suicide in ensuing 20 years

  • H. Koivumaa-Honkanen
  • R. Honkanen
  • M. Koskenvuo
  • J. Kaprio

DOI: 10.1007/s00127-003-0625-4

Cite this article as:
Koivumaa-Honkanen, H., Honkanen, R., Koskenvuo, M. et al. Soc Psychiatry Psychiatr Epidemiol (2003) 38: 244. doi:10.1007/s00127-003-0625-4


Objective: The aim of this study was to investigate the relationship between self-reported unhappiness and suicide. Methods: A sample of adult Finns unselected for health status (N = 29,067) responded to a question on happiness in life with five alternatives: very happy (15.9 %), fairly happy (63.4 %), cannot say (12.9 %), fairly unhappy (6.9 %), very unhappy (1 %). Cox regression was used to study the suicide risk. Results: From 1976 to 1995, 182 suicides occurred. At baseline, unhappiness was associated with older age, male gender, sickness, living alone, smoking, heavy alcohol consumption, physical inactivity and belonging to intermediate social class. The risk of suicide increased with decreasing happiness. The very unhappy compared with the very happy had an age-adjusted hazard ratio (HR) of 10.84 (95 % CI 3.93–29.94) for suicide. After adjusting for the above-mentioned factors this HR was 7.01 (95% CI 2.44–20.08). Conclusion: Self-reported unhappiness is strongly associated with subsequent suicide in a long follow-up. Moreover, it seems to indicate also cumulative health hazards.

Key words happiness – quality of life – suicide – mortality – cohort studies 

Copyright information

© Steinkopff Verlag 2003

Authors and Affiliations

  • H. Koivumaa-Honkanen
    • 1
  • R. Honkanen
    • 2
  • M. Koskenvuo
    • 3
  • J. Kaprio
    • 4
  1. 1.Department of Psychiatry, 4977, Kuopio University Hospital, P. O. Box 1777, 70211 Kuopio, Finland. heli.koivumaa@kuh.fiFI
  2. 2.Research Institute of Public Health, University of Kuopio, Kuopio, FinlandFI
  3. 3.Dept. of Public Health, University of Turku Turku, FinlandFI
  4. 4.Dept. of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland¶Dept. of Public Health, University of Helsinki, Helsinki, Finland¶Dept. of Public Health and General Practice, University of Oulu, Oulu, FinlandFI

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