N.2. Mental health 1

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3Local Health Authority 7 of Tuscany Region, Medical Direction, Siena, Italy. 4Department of Earth ... Economics, Institute of. Health and Society, University of Oslo, Oslo, Norway ... European Journal of Public Health, Vol. 23, Supplement 1 ...
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European Journal of Public Health, Vol. 23, Supplement 1, 2013

N.2. Mental health 1 40 years of Italian suicide history: women are not the weak gender Andrea Serafini G Messina1,2, A Serafini2, C Quercioli1,3, AM Gentile1, PL Fantozzi4, N Nante1,2 1 Health Services Research Laboratory, University of Siena, Siena, Italy 2 Post Graduate School of Public Health, University of Siena, Siena, Italy 3 Local Health Authority 7 of Tuscany Region, Medical Direction, Siena, Italy 4 Department of Earth Sciences, University of Siena, Siena, Italy Contact: [email protected]

Background Suicide is a leading cause of death in the world which involves high economic and social costs. In Europe the death rate from suicide in 2010 (deaths per 100.000) varies from 5.2 (Greece) and 52.9 (Latvia) in males, and from 0.9 (Greece) and 9.3 (Lithuania) in females; it is higher in northern countries and in males. Italy because of its history and its morphology shows deep socio-economic and cultural differences, so it is of great interest to study such events epidemiology over time and different territories. The purpose of this study is to describe 40 years of suicide mortality in Italy comparing regions and gender. Methods We conducted a descriptive analysis of suicide mortality (SM) in Italy from 1969 to 2010 analyzing data from ISTAT (Italian STATistics bureau), and conducted a spatial analysis with ArcGIS 10. We evaluated: i) the rates of deaths/100.000 inhabitants by suicide in Italy from 1969 to 2010 divided by gender and age groups; ii) the annual spatial distribution of SM in the Italian; iii) the rate trends of SM in each Italian region. Results For both genders, the SM rate increases with age. For men there is an exponential increase from the age of 65+, whilein women itgrows linearly. The rate of SM has a strong geographical variability, with rates generally higher in the northern regions, for example, in 2010, Piemonte (13.2 in males and 4.0 in females), Emilia Romagna (13.8 in males and 4.0 in females) and lower in the southern regions: Campania (6.1 in males and 1,5 in females), Lazio (8.1 in males and 1,6 in females) and Apulia (7.2 in males and 1,9 in females). Interesting founds: Liguria until 1982 had one of the highest rate of suicide, then started to drop and now has one of the lowest rates; in Sardinia islandthe SM rate constantly increased over time. Conclusions According with European stats, men and women act in a radically different way in suicide: men commit suicide about 3 times more than women. With few exceptions, the difference between the regions remain fairly constant over time: higher rate of suicide in the north, like in Piemonte and Emilia Romagna and lower rate in the south, like Campania and Apulia. Key messages  There is a great difference between gender: males commit suicide about 3 times more than women; the ratio between males and females suicide rates grows with age and it is higher after 65+ years.  The rate of suicide mortality has a strong geographical pattern in Italy: it is higher in northern regions and lower in southern regions. Changes in Lifetime Prevalence of Suicidal Feelings among Norwegian Doctors from 2000 to 2010: A longitudinal Study based on National Samples Judith Rosta J Rosta1, OG Aasland1,2 1 Institute for Studies of the Medical Profession, Norwegian Medical Association, Oslo, Norway

2 Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway Contact: [email protected]

Background Since various suicidal feelings constitute important determinants in the multifactorial background of suicide, monitoring such expressions are important for lowering the suicidal risk. Suicide rates are higher among doctors than in the population. The aims of the study are to describe the changes in the lifetime prevalence of suicidal feelings (felt life was not worth living, suicidal ideations and suicidal thoughts) from 2000 to 2010, and predictors of serious suicidal thoughts in 2010 among Norwegian doctors. Methods Longitudinal study based on questionnaire data from 2000 (n = 1253) and 2010 (n = 962) from an unbalanced cohort of doctors (n = 715). Main outcome measure is the Paykel‘s Suicidal Feelings Questionnaire. Results The prevalences in 2000 and 2010 of ever having feelings of life not worth living were 48 (44 to 52) % and 45 (41 to 49) %, of suicidal ideation 27 (23 to 30) % and 23 (20 to 26) %, and of suicidal thoughts 29 (16 to 33) % and 24 (21 to 27) %. Paired t-tests among those who responded both in 2000 and 2010 show significant reductions for felt life not worth living (t = 3.4; p = 0.001), suicidal ideation (t = -3.1; p = 0.002) and suicidal thoughts (t = -3.5; p = 0.0001). In 2010, significant predictors of serious suicidal thoughts in a multivariate model were subjective well-being (OR 0.70; 95 % CI 0.51-0.97), poor or average self-rated health (OR 2.96; 1.42-6.16) and high psychosocial work stress (OR 2.16; 95% CI 1.09-4.31), controlled for age, gender, speciality and job satisfaction. Conclusions Suicidal feelings among Norwegian doctors decreased from 2000 to 2010. Individual and work-related factors may to a certain explain these findings. Compared with other professionals in Norway and doctors in Germany, Norwegian doctors showed no higher risk of suicidal thoughts. Key message  The lifetime prevalence of suicidal feelings among Norwegian doctors decreased from 2000 to 2010, suggesting decrease in suicidal risk. Patterns in mortality among people with severe mental disorders in 1982-2006 across Finnish and Danish birth cohorts Mika Gissler ¨ sby5,6, M Nordentoft7, M Gissler1,2,3, T Munk Laursen1,4, U O K Wahlbeck1,2 1 Nordic School of Public Health, Gothenburg, Sweden 2 THL National Institute for Health and Welfare, Helsinki, Finland 3 University of Turku, Department of Child Psychiatry, Turku, Finland 4 National Centre for Register-based Research, Aarhus University, Aarhus, Denmark 5 Department of Psychiatry, Tiohundra AB, Norrta¨lje, Sweden 6 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden 7 Psychiatric Centre Bispebjerg, Copenhagen University, Faculty of Health Sciences, Copenhagen, Denmark Contact: [email protected]

Background Mortality among patients with mental disorders is higher than in the general population. By using national longitudinal registers, we studied mortality changes and excess mortality across birth cohorts among people with severe mental disorders in Denmark and Finland. Methods A cohort of all patients admitted with a psychiatric disorder in 1982-2006 was followed until death or 31 December 2006. Total mortality rates were calculated for five-year birth cohorts from 1918-1922 until 1983-1987 for people with mental