Psychiatric Quarterly

, Volume 79, Issue 4, pp 275–285

Suicide and Marital Status in Italy

  • Maria Masocco
  • Maurizio Pompili
  • Monica Vichi
  • Nicola Vanacore
  • David Lester
  • Roberto Tatarelli
Original Paper

Abstract

Background

Completed suicide has been reported as being linked to marital status, with being unmarried associated with a higher suicide rate as compared with being married or living with a partner.

Method

Data were obtained from the Italian Data Base on Mortality, collected by the Italian Census Bureau (ISTAT) and processed by the Italian National Institute of Health-Statistics Unit. The Italian population in the last Italian census (October 2001) was used to estimate age-standardized mortality rates from suicide by marital status (ICD-9 revision: E950–E959) and “natural” causes (ICD-9 revision: 0–280; 320–799). Rate ratios and 95% confidence intervals were calculated using married individuals as a reference. All analyses were conducted separately for men and women and for three different age groups (25–44 years, 45–64 years and 65 years and over) for 2000–2002, the most recent years with data available. Logistic regression analysis was used to compare differences by marital status for suicide versus death from natural causes.

Results

Being married appears to be a protective factor for suicide, but the impact of being never-married, divorced/separated or widowed varies with age and gender. It is noteworthy that the differences between married and non-married women were less consistent than those among men, especially for elderly women. The results confirm that the protective impact of marriage is higher for suicide than for natural causes of death, and the comparison between the risks of suicide and natural causes of death reveals that the groups relatively more at risk for suicide are divorced/separated women, divorced/separated men (under the age of 64) and widowed men.

Conclusions

Both among men and women, being unmarried, widowed or divorced/separated is associated with a higher suicide rate. This study, however, adds information on suicide mortality in specific age-groups compared to mortality from natural causes of death. Overall, these findings support the notion that marital status may dramatically influence the risk of suicide.

Keywords

Suicide Marital status Italy 

References

  1. 1.
    Barbagli M: Provando e riprovando. Bologna, Il Mulino, 1990Google Scholar
  2. 2.
    Barbagli M, Castiglioni M, Dalla Zanna G: Fare famiglia in Italia. Un secolo di cambiamenti. Bologna, Il Mulino, 2004Google Scholar
  3. 3.
    Barefoot JC, Grønbæk M, Jensen G, Schnohr P, Prescott E: Social network diversity and risks of ischemic heart disease and total mortality: findings from the Copenhagen City Heart Study. American Journal of Epidemiology 161:960–967, 2005Google Scholar
  4. 4.
    Berkman LF, Breslow L: Health and Ways of Living: The Alameda County Study. New York, Oxford University Press, 1983 Google Scholar
  5. 5.
    Bernal M, Haro JM, Bernert S, et al.: Risk factors for suicidality in Europe: results from the ESEMED study. Journal of Affective Disorders, 2006 Oct 27; [Epub ahead of print]Google Scholar
  6. 6.
    Billari F, Ongaro F: Lasciare la famiglia d’origine: quando e perché? in Nuzialità e fecondità in trasformazione: percorsi e fattori del cambiamento. P. De Sandre, A. Pinnelli, A. Santini (a cura di). Bologna, Il Mulino, 1999Google Scholar
  7. 7.
    De Leon CF, Kasl SV, Jacobs S: A prospective study of widowhood and change in symptoms of depression in a community sample of the elderly. Psychological Medicine 24:613–624, 1994Google Scholar
  8. 8.
    De Sandre P, Pinnelli A, Santini A: Nuzialità e fecondità in trasformazione: percorsi e fattori del cambiamento. (a cura di). Bologna, Il Mulino, 1999Google Scholar
  9. 9.
    Durkheim E: (1897). Il suicidio. Milano, Biblioteca Universale Rizzoli, 1987Google Scholar
  10. 10.
    European Statistical System (Eurostat) Available at http://epp.eurostat.ec.europa.eu, last access 30 October 2007
  11. 11.
    Farr W: The influence of marriage on the mortality of the French people. In: Hastings GW (ed) Transactions of the National Association for the Promotion of Social Sciences. London, John W. Parker and Son, pp. 504–513, 1958Google Scholar
  12. 12.
    Fürnkranz-Prskawetz A, Vikat A, Philipov D, Engelhardt H: Pathways to stepfamily formation in Europe. Results from the FFS. Demographic Research 8:107–150, 2003Google Scholar
  13. 13.
    Gardner J, Oswald A: How is mortality affected by money, marriage, and stress? Journal of Health Economics 23:1181–1207, 2004Google Scholar
  14. 14.
    Goldman N, Hu Y: Excess mortality among the unmarried: a case study of Japan. Social Science and Medicine 36:533–546, 1993Google Scholar
  15. 15.
    Gove WR: Sex, marital status and suicide. Journal of Health and Social Behaviour 13:204–13, 1972Google Scholar
  16. 16.
    Harlow SD, Goldberg EL, Comstock GW: A longitudinal study of the prevalence of depression symptomatology in elderly windowed and married men. Archives of General Psychiatry 48:1065–1068, 1991Google Scholar
  17. 17.
    House JS, Robbins C, Metzner HL: The association of social relationship and activities with mortality: prospective evidence from the TECUMSEH community health study. American Journal of Epidemiology 116:123–140, 1982Google Scholar
  18. 18.
    Hu YR, Goldman N: Mortality differentials by marital status: an international comparison. Demography 27:233–250, 1990Google Scholar
  19. 19.
    ISTAT Separazioni, divorzi e affidamento dei minori Anno 2002. Available at http://www.istat.it/salastampa/comunicati/non_calendario/20040702_01/ [last accessed: Mar 22, 2007]
  20. 20.
    ISTAT. le statistiche di genere. Approfondimenti 2007. Available at http://www.istat.it/salastampa/comunicati/non_calendario/20070307_00 [last access 30 October 2007]
  21. 21.
    Johnson NJ, Backlund E, Sorlie PD: Loveless CA. Marital status and mortality: the national longitudinal mortality study. Annals of Epidemiology 10:224–238, 2000Google Scholar
  22. 22.
    Joutsenniemi KE, Martelin TP, Koskinen SV, Martikainen PT, Harkanen TT, Luoto RM, Aromaa AJ: Official marital status, cohabiting, and self-rated health—time trends in Finland, 1978–2001. European Journal of Public Health 16:476–483, 2006Google Scholar
  23. 23.
    Kolip P: The association between gender, family status and mortality. Journal of Public Health 13:309–312, 2005Google Scholar
  24. 24.
    Kposowa AJ: Divorce and suicide. Journal of Epidemiology and Community Health 57: 993–995, 2003Google Scholar
  25. 25.
    Kposowa AJ: Marital status and suicide in the National Longitudinal Mortality Study. Journal of Epidemiology and Community Health 54:254–261, 2000Google Scholar
  26. 26.
    Kreitman N: Suicide, age and marital status. Psychological Medicine 18:121–128, 1988Google Scholar
  27. 27.
    Lorant V, Kunst AE, Huisman M, Bopp M, Mackenbach J: The EU Working Group. A European comparative study of marital status and socio-economic inequalities in suicide. Social Science and Medicine 60:2431–2441, 2005Google Scholar
  28. 28.
    Lund R, Due P, Modvig J, Holstein BE, Damsgaard MT, Andersen PK: Cohabitation and marital status as predictors of mortality—an eight year follow-up study. Social Science and Medicine 55:673–679, 2005Google Scholar
  29. 29.
    Lund R, Holstein BE, Osler M: Marital history from age 15 to 40 years and subsequent 10-year mortality: a longitudinal study of Danish males born in 1953. International Journal of Epidemiology 33:389–397, 2004Google Scholar
  30. 30.
    Luoma JB, Pearson JL: Suicide and marital status in the United States, 1991–1996: is widowhood a risk factor? American Journal of Public Health 92:1518–1522, 2002Google Scholar
  31. 31.
    Martikainen P, Martelin T, Nihtila E, Majamaa K, Koskinen S: Differences in mortality by marital status in Finland from 1976 to 2000: analyses of changes in marital-status distributions, socio-demographic and household composition, and cause of death. Population Studies (Camb) 59:99–115, 2005Google Scholar
  32. 32.
    Micheli GA: Kinship, family and social network. The anthropological embedment of fertility change in southern Europe, Demographic Research, 2000, 3/13.Google Scholar
  33. 33.
    Morselli E: (1879) Il suicidio, saggio di statistica morale comparata. Milano, Dumolard, 1879Google Scholar
  34. 34.
    Nebot M, Lafuente JM, Tomás Z, Borrell C, Ferrando J: Efecto protector del apoyo social en la mortalidad en población anciana: un estudio longitudinal. Revista Española de Salud Pública 76:673–682, 2002Google Scholar
  35. 35.
    Nilsson PM, Nilsson JA, Ostergren PO, Berglund G: Social mobility, marital status, and mortality risk in an adult life course perspective: the Malmo Preventive Project. Scandinavian Journal of Public Health 33:412–423, 2005Google Scholar
  36. 36.
    Rosengren A, Wilhelmsena L, Orth-Gomer K: Coronary disease in relation to social support and social class in Swedish men. A 15 year follow-up in the study of men born in 1933. European Heart Journal 25:56–63, 2004Google Scholar
  37. 37.
    Smith JC, Mercy JA, Conn JM: Marital status and the risk of suicide. American Journal of Public Health 78:78–80, 1988Google Scholar
  38. 38.
    Trovato F: Sex, marital status, and suicide in Canada: 1951–1981. Sociological Perspectives 34:427–445, 1991Google Scholar
  39. 39.
    Van Poppel F, Joung I: Long-term trends in marital status mortality differences in The Netherlands 1850–1970. Journal of Biosocial Sciences 33:279–303, 2001Google Scholar
  40. 40.
    World Health Organization European health for all database (HFA-DB): (2006) Available at http://data.euro.who.int/hfadb/ [last accessed: Aug 29, 2007]
  41. 41.
    World Health Organization International Classification of Diseases: 9th Revision. Geneva, WHO, 1977Google Scholar
  42. 42.
    Yip PS, Thorburn J: Marital status and the risk of suicide: experience from England and Wales, 1982–1996. Psychological Reports 94:401–407, 2004Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Maria Masocco
    • 1
    • 2
  • Maurizio Pompili
    • 3
    • 4
  • Monica Vichi
    • 1
  • Nicola Vanacore
    • 1
  • David Lester
    • 5
  • Roberto Tatarelli
    • 3
  1. 1.National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS)Italian National Institute of Health (ISS)RomeItaly
  2. 2.National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Statistics UnitItalian National Institute of Health (ISS)RomeItaly
  3. 3.Department of Psychiatry, Sant’Andrea HospitalSapienza University of Rome RomeItaly
  4. 4.McLean HospitalHarvard Medical SchoolBostonUSA
  5. 5.The Richard Stockton College of New JerseyPomonaUSA

Personalised recommendations