Sociodemographic factors, health behaviors predict young adult suicide risk

Suicide mortality among young adults was linked to sociodemographic factors, health behaviors and biological indicators, according to results of a nationwide cohort study published in Journal of Clinical Psychiatry.

“Although numerous studies have focused solely on psychiatric risk factors for suicide, the role of sociodemographic factors, health behaviors and biological indicators as potential risk factors for suicide is relatively understudied,” Yoosun Cho, MD, PhD, of Sungkyunkwan University School of Medicine in South Korea, and colleagues wrote. “Accordingly, schemes for anticipating suicide risk have targeted mostly psychiatric risk factors instead of health behaviors and biological factors.”

The investigators sought to assess the association of these variables with the risk for death by suicide among more than 15.5 million individuals aged 20 to 39 years who were included in the Korean National Health Insurance Service. They evaluated sociodemographic factors linked to death by suicide between 2006 and 2015. Separately, they assessed nearly four million individuals who underwent health examinations between 2002 and 2005 for health behaviors and biological indicators linked to death by suicide. Cho and colleagues used Cox proportional hazards regression analysis to determine hazard ratios and 95% confidence intervals for suicide mortality based on sociodemographic factors, including age, household income, job status, residence and Charlson comorbidity index score; health behaviors, including physical activity, smoking and alcohol consumption; and biological indicators, including blood pressure, total cholesterol level, BMI and fasting serum glucose level.

Results showed increased risk for death by suicide among young adults was associated with low household income, self- and non-employment, increased comorbidity, smoking and normal weight. Although older age was linked to increased risk for death by suicide among men (adjusted HR [aHR] = 2.11; 95% CI, 2.02-2.2 for men aged 35 to 39 years), it reduced the risk for death by suicide among women (aHR = 0.72; 95% CI, 0.69-0.75 for women aged 35 to 39 years). Other factors for this increased risk among men included elevated blood pressure (aHR = 1.16; 95% CI, 1.05-1.28) and fasting serum glucose level (aHR = 1.48; 95% CI, 1.26-1.75). High total cholesterol levels were linked to increased risk for death by suicide among women (aHR = 1.59; 95% CI, 1.19-2.13).

“In light of the increasing social burden of suicide, future studies are needed to investigate the underlying mechanisms in the association of sociodemographic factors, health behaviors and biological indicators with death by suicide,” Cho and colleagues wrote.