20% of suicides preceded by intimate partner problems

Key takeaways:

• Issues with an intimate partner were associated with 20% of suicides.
• Partner issues were more likely to precede suicide if mental health issues, life stressors and legal problems were involved.

From 2003 to 2020, one of every five suicides were associated with problems with an intimate partner, according to findings published in the American Journal of Preventive Medicine.

“Although the association between intimate partner problems and suicide is well established, few studies have explicitly examined differences in circumstances that preceded suicide between suicide decedents who reportedly experienced intimate partner problems vs. those who did not,” Ayana Stanley, DrPH, a public health adviser in the division of violence prevention at the CDC, and colleagues wrote. “Current studies are typically narrow in terms of the geographic distribution of their sample or the population examined, thus limiting their generalizability.”

Stanley and colleagues analyzed data from the National Violent Death Reporting System (NVDRS) to identify 402,391 suicides among adults from 2003 to 2020. In 2003, only seven states reported suicides in the NVDRS. By 2020, there were 48 states and two territories reporting these data.

The primary outcome was whether suicide was precipitated by intimate partner problems (IPP), which included divorce, separation, romantic break-up, arguments with a partner, jealousy, conflict and intimate partner violence (IPV) as indicated on the NVDRS.

In total, 80,717 (20%) suicides were related to IPP. The largest proportions of IPP-related suicides occurred in people aged 25 to 44 years (49%), white people (80.2%), men (78.7%) and people who had at least a high school diploma (85.3%).

Suicides not related to IPP more often occurred in older people compared with IPP-related suicides (45.4 vs. 40.9 years).

Analyses of precipitating factors revealed IPP-related suicide was associated with mental health problems (adjusted OR = 1.2; 95% CI, 1.2-1.2), depressed mood (aOR = 2.1; 95% CI, 2.1-2.2), history of suicidal ideation (aOR = 2.7; 95% CI, 2.6-2.7), history of suicide attempt (aOR = 1.6; 95% CI, 1.6-1.7) and alcohol problems (aOR = 2; 95% CI, 1.9-2).

IPP-related suicide was preceded by life stressors more often than non-IPP suicide, with perpetration of interpersonal violence (aOR = 6.5; 95% CI, 6.1-6.8), arguments (aOR = 4.1; 95% CI, 4-4.2), interpersonal violence victimization (aOR = 2.2; 95% CI, 2-2.4) and financial problems (aOR = 2; 95% CI, 1.9-2) associated with greatest odds of IPP-related suicide.

Legal problems were also associated with IPP-related suicide compared with non-IPP suicide (aOR = 1.6; 95% CI, 1.6-1.7).

Compared with IPP-related suicide, non-IPP suicide was more frequently preceded by physical health problems (10.1% vs. 18.1%; aOR = 0.6; 95% CI, 0.6-0.6). Additionally, criminal issues were more common precipitating factors for non-IPP suicide (10.7%) compared with IPP-related suicide (5.5%; aOR, 0.6; 95% CI, 0.6-0.6).

“This study advances the scientific understanding of suicides involving IPP and informs possible prevention strategies in several ways,” Stanley and colleagues wrote.