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Suicide attempt and suicide in refugees in Sweden - a nationwide population-based cohort study
Karolinska Institutet.ORCID iD: 0000-0002-4491-3990
Karolinska Institutet.
Karolinska Institutet.
The Swedish Red Cross University College, Department of Health Sciences.ORCID iD: 0000-0001-6138-6427
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2019 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, p. 1-10Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Despite a reported high rate of mental disorders in refugees, scientific knowledge on their risk of suicide attempt and suicide is scarce. We aimed to investigate (1) the risk of suicide attempt and suicide in refugees in Sweden, according to their country of birth, compared with Swedish-born individuals and (2) to what extent time period effects, socio-demographics, labour market marginalisation (LMM) and morbidity explain these associations.

METHODS: Three cohorts comprising the entire population of Sweden, 16-64 years at 31 December 1999, 2004 and 2009 (around 5 million each, of which 3.3-5.0% refugees), were followed for 4 years each through register linkage. Additionally, the 2004 cohort was followed for 9 years, to allow analyses by refugees' country of birth. Crude and multivariate hazard ratios (HRs) with 95% confidence intervals (CIs) were computed. The multivariate models were adjusted for socio-demographic, LMM and morbidity factors.

RESULTS: In multivariate analyses, HRs regarding suicide attempt and suicide in refugees, compared with Swedish-born, ranged from 0.38-1.25 and 0.16-1.20 according to country of birth, respectively. Results were either non-significant or showed lower risks for refugees. Exceptions were refugees from Iran (HR 1.25; 95% CI 1.14-1.41) for suicide attempt. The risk for suicide attempt in refugees compared with the Swedish-born diminished slightly across time periods.

CONCLUSIONS: Refugees seem to be protected from suicide attempt and suicide relative to Swedish-born, which calls for more studies to disentangle underlying risk and protective factors.

Place, publisher, year, edition, pages
Cambridge University Press, 2019. p. 1-10
Keywords [en]
Labour market marginalisation, migration, refugees, sick leave, suicide, suicide attempt
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-3123DOI: 10.1017/S0033291719003167PubMedID: 31858922OAI: oai:DiVA.org:rkh-3123DiVA, id: diva2:1382527
Available from: 2020-01-03 Created: 2020-01-03 Last updated: 2020-01-07Bibliographically approved

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Tinghög, Petter

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