Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2016

Open Access 01-12-2016 | Primary research

Relationship of suicide rates with climate and economic variables in Europe during 2000–2012

Authors: Konstantinos N. Fountoulakis, Isaia Chatzikosta, Konstantinos Pastiadis, Prodromos Zanis, Wolfram Kawohl, Ad J. F. M. Kerkhof, Alvydas Navickas, Cyril Höschl, Dusica Lecic-Tosevski, Eliot Sorel, Elmars Rancans, Eva Palova, Georg Juckel, Goran Isacsson, Helena Korosec Jagodic, Ileana Botezat-Antonescu, Janusz Rybakowski, Jean Michel Azorin, John Cookson, John Waddington, Peter Pregelj, Koen Demyttenaere, Luchezar G. Hranov, Lidija Injac Stevovic, Lucas Pezawas, Marc Adida, Maria Luisa Figuera, Miro Jakovljević, Monica Vichi, Giulio Perugi, Ole A. Andreassen, Olivera Vukovic, Paraskevi Mavrogiorgou, Peeter Varnik, Peter Dome, Petr Winkler, Raimo K. R. Salokangas, Tiina From, Vita Danileviciute, Xenia Gonda, Zoltan Rihmer, Jonas Forsman, Anne Grady, Thomas Hyphantis, Ingrid Dieset, Susan Soendergaard, Maurizio Pompili, Per Bech

Published in: Annals of General Psychiatry | Issue 1/2016

Login to get access

Abstract

Background

It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate.

Methods

Data from 29 European countries covering the years 2000–2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression.

Results

The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female suicides correlated with low temperature.

Discussion

The current study reports that the climatic effect (cold climate) is stronger than the economic one, but both are present. It seems that in Europe suicidality follows the climate/temperature cline which interestingly is not from south to north but from south to north-east. This raises concerns that climate change could lead to an increase in suicide rates. The current study is essentially the first successful attempt to explain the differences across countries in Europe; however, it is an observational analysis based on aggregate data and thus there is a lack of control for confounders.
Appendix
Available only for authorised users
Literature
1.
World Health Organization. Financial crisis and global health: report of a high-level consultation. Geneva: WHO; 2009.
2.
3.
Milner A, Page A, LaMontagne AD. Duration of unemployment and suicide in Australia over the period 1985–2006: an ecological investigation by sex and age during rising versus declining national unemployment rates. J Epidemiol Community Health. 2013;67(3):237–44.CrossRefPubMed
4.
Morrell S, Taylor R, Quine S, Kerr C. Suicide and unemployment in Australia 1907–1990. Soc Sci Med. 1993;36(6):749–56.CrossRefPubMed
5.
Lester D, Yang B. The relationship between divorce, unemployment and female participation in the labour force and suicide rates in Australia and America. Aust N Z J Psychiatry. 1991;25(4):519–23.CrossRefPubMed
6.
Kentikelenis A, Karanikolos M, Papanicolas I, Basu S, McKee M, Stuckler D. Health effects of financial crisis: omens of a Greek tragedy. Lancet. 2011;378(9801):1457–8.CrossRefPubMed
7.
Luo F, Florence CS, Quispe-Agnoli M, Ouyang L, Crosby AE. Impact of business cycles on US suicide rates, 1928–2007. Am J Public Health. 2011;101(6):1139–46.CrossRefPubMedPubMedCentral
8.
9.
Economou M, Madianos M, Theleritis C, Peppou LE, Stefanis CN. Increased suicidality amid economic crisis in Greece. Lancet. 2011;378(9801):1459.CrossRefPubMed
10.
Stuckler D, Basu S, Suhrcke M, Coutts A, McKee M. Effects of the 2008 recession on health: a first look at European data. Lancet. 2011;378(9786):124–5.CrossRefPubMed
11.
Gili M, Roca M, Basu S, McKee M, Stuckler D. The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010. Eur J Pub Health. 2013;23(1):103–8.CrossRef
12.
De Vogli R, Marmot M, Stuckler D. Excess suicides and attempted suicides in Italy attributable to the great recession. J Epidemiol Community Health. 2013;67(4):378–9.PubMed
13.
De Vogli R, Marmot M, Stuckler D. Strong evidence that the economic crisis caused a rise in suicides in Europe: the need for social protection. J Epidemiol Community Health. 2013;67(4):298.CrossRefPubMed
14.
15.
Reeves A, Stuckler D, McKee M, Gunnell D, Chang SS, Basu S. Increase in state suicide rates in the USA during economic recession. Lancet. 2012;380(9856):1813–4.CrossRefPubMed
16.
Barr B, Taylor-Robinson D, Scott-Samuel A, McKee M, Stuckler D. Suicides associated with the 2008–10 economic recession in England: time trend analysis. BMJ. 2012;345:e5142.CrossRefPubMedPubMedCentral
17.
Fountoulakis KN, Koupidis SA, Grammatikopoulos IA, Theodorakis PN. First reliable data suggest a possible increase in suicides in Greece. BMJ. 2013;347:f4900.CrossRefPubMed
18.
Economou M, Madianos M, Peppou LE, Theleritis C, Patelakis A, Stefanis C. Suicidal ideation and reported suicide attempts in Greece during the economic crisis. World Psychiatry. 2013;12(1):53–9.CrossRefPubMedPubMedCentral
19.
Chang SS, Gunnell D, Sterne JA, Lu TH, Cheng AT. Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Soc Sci Med. 2009;68(7):1322–31.CrossRefPubMed
20.
Chang SS, Sterne JA, Huang WC, Chuang HL, Gunnell D. Association of secular trends in unemployment with suicide in Taiwan, 1959–2007: a time-series analysis. Public Health. 2010;124(1):49–54.CrossRefPubMed
21.
Fountoulakis KN, Siamouli M, Grammatikopoulos IA, Koupidis SA, Siapera M, Theodorakis PN. Economic crisis-related increased suicidality in Greece and Italy: a premature overinterpretation. J Epidemiol Community Health. 2013;67(4):379–80.CrossRefPubMed
22.
Fountoulakis KN, Savopoulos C, Siamouli M, Zaggelidou E, Mageiria S, Iacovides A, Hatzitolios AI. Trends in suicidality amid the economic crisis in Greece. Eur Arch Psychiatry Clin Neurosci. 2013;263(5):441–4.CrossRefPubMed
23.
Fountoulakis KN, Koupidis SA, Siamouli M, Grammatikopoulos IA, Theodorakis PN. Suicide, recession, and unemployment. Lancet. 2013;381(9868):721–2.CrossRefPubMed
24.
Fountoulakis KN, Grammatikopoulos IA, Koupidis SA, Siamouli M, Theodorakis PN. Health and the financial crisis in Greece. Lancet. 2012;379(9820):1001–2 (author reply 1002).CrossRefPubMed
25.
Nordt C, Warnke I, Seifritz E, Kawohl W. Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000–11. Lancet Psychiatry. 2015;2(3):239–45.CrossRefPubMed
26.
Fountoulakis KN, Kawohl W, Theodorakis PN, Kerkhof AJ, Navickas A, Hoschl C, Lecic-Tosevski D, Sorel E, Rancans E, Palova E, et al. Relationship of suicide rates to economic variables in Europe: 2000–2011. Br J Psychiatry. 2014;205(6):486–96.CrossRefPubMed
27.
Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294(16):2064–74.CrossRefPubMed
28.
Tondo L, Albert MJ, Baldessarini RJ. Suicide rates in relation to health care access in the United States: an ecological study. J Clin Psychiatry. 2006;67(4):517–23.CrossRefPubMed
29.
Rihmer Z, Kantor Z, Rihmer A, Seregi K. Suicide prevention strategies–a brief review. Neuropsychopharmacol Hung. 2004;6(4):195–9.PubMed
30.
Fountoulakis KN, Kawohl W, Theodorakis PN, Kerkhof AJ, Navickas A, Hoschl C, Lecic-Tosevski D, Sorel E, Rancans E, Palova E, et al. Relationship of suicide rates to economic variables in Europe: 2000-2011. Br J Psychiatry. 2014;205(6):486–96.CrossRefPubMed
31.
Christodoulou C, Douzenis A, Papadopoulos FC, Papadopoulou A, Bouras G, Gournellis R, Lykouras L. Suicide and seasonality. Acta Psychiatr Scand. 2012;125(2):127–46.CrossRefPubMed
32.
Yip PS, Yang KC. A comparison of seasonal variation between suicide deaths and attempts in Hong Kong SAR. J Affect Disord. 2004;81(3):251–7.CrossRefPubMed
33.
Valtonen H, Suominen K, Partonen T, Ostamo A, Lonnqvist J. Time patterns of attempted suicide. J Affect Disord. 2006;90(2–3):201–7.CrossRefPubMed
34.
Baydin A, Yardan T, Aygun D, Doganay Z, Nargis C, Incealtin O. Retrospective evaluation of emergency service patients with poisoning: a 3-year study. Adv Ther. 2005;22(6):650–8.CrossRefPubMed
35.
Kordic M, Babic D, Petrov B, Kordic J, Jelavic B, Pivic G. The meteorological factors associated with suicide. Coll Antropol. 2010;34(Suppl 1):151–5.PubMed
36.
Preti A, Miotto P. Influence of method on seasonal distribution of attempted suicides in italy. Neuropsychobiology. 2000;41(2):62–72.CrossRefPubMed
37.
Hiltunen L, Ruuhela R, Ostamo A, Lonnqvist J, Suominen K, Partonen T. Atmospheric pressure and suicide attempts in Helsinki, Finland. Int J Biometeorol. 2012;56(6):1045–53.CrossRefPubMed
38.
Jessen G, Jensen BF, Arensman E, Bille-Brahe U, Crepet P, De Leo D, Hawton K, Haring C, Hjelmeland H, Michel K, et al. Attempted suicide and major public holidays in Europe: findings from the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1999;99(6):412–8.CrossRefPubMed
39.
Mergl R, Havers I, Althaus D, Rihmer Z, Schmidtke A, Lehfeld H, Niklewski G, Hegerl U. Seasonality of suicide attempts: association with gender. Eur Arch Psychiatry Clin Neurosci. 2010;260(5):393–400.CrossRefPubMed
40.
Aydin A, Gulec M, Boysan M, Selvi Y, Selvi F, Kadak MT, Besiroglu L. Seasonality of self-destructive behaviour: seasonal variations in demographic and suicidal characteristics in Van, Turkey. Int J Psychiatry Clin Pract. 2013;17(2):110–9.CrossRefPubMed
41.
Bjorksten KS, Bjerregaard P, Kripke DF. Suicides in the midnight sun—a study of seasonality in suicides in West Greenland. Psychiatry Res. 2005;133(2–3):205–13.CrossRefPubMed
42.
Kalediene R, Starkuviene S, Petrauskiene J. Seasonal patterns of suicides over the period of socio-economic transition in Lithuania. BMC Public Health. 2006;6:40.CrossRefPubMedPubMedCentral
43.
Kposowa AJ, D’Auria S. Association of temporal factors and suicides in the United States, 2000–2004. Soc Psychiatry Psychiatr Epidemiol. 2010;45(4):433–45.CrossRefPubMed
44.
Lambert G, Reid C, Kaye D, Jennings G, Esler M. Increased suicide rate in the middle-aged and its association with hours of sunlight. Am J Psychiatry. 2003;160(4):793–5.CrossRefPubMed
45.
Heerlein A, Valeria C, Medina B. Seasonal variation in suicidal deaths in Chile: its relationship to latitude. Psychopathology. 2006;39(2):75–9.CrossRefPubMed
46.
Corcoran P, Reilly M, Salim A, Brennan A, Keeley HS, Perry IJ. Temporal variation in Irish suicide rates. Suicide Life Threat Behav. 2004;34(4):429–38.CrossRefPubMed
47.
Doganay Z, Sunter AT, Guz H, Ozkan A, Altintop L, Kati C, Colak E, Aygun D, Guven H. Climatic and diurnal variation in suicide attempts in the ED. Am J Emerg Med. 2003;21(4):271–5.CrossRefPubMed
48.
Holopainen J, Helama S, Bjorkenstam C, Partonen T. Variation and seasonal patterns of suicide mortality in Finland and Sweden since the 1750s. Environ Health Prev Med. 2013;18(6):494–501.CrossRefPubMedPubMedCentral
49.
Lee HC, Lin HC, Tsai SY, Li CY, Chen CC, Huang CC. Suicide rates and the association with climate: a population-based study. J Affect Disord. 2006;92(2–3):221–6.CrossRefPubMed
50.
Lester D, Moksony F. The seasonality of suicide in Hungary in the 1930s. Percept Mot Skills. 2007;105(3 Pt 1):714.PubMed
51.
Likhvar V, Honda Y, Ono M. Relation between temperature and suicide mortality in Japan in the presence of other confounding factors using time-series analysis with a semiparametric approach. Environ Health Prev Med. 2011;16(1):36–43.CrossRefPubMed
52.
Lin HC, Chen CS, Xirasagar S, Lee HC. Seasonality and climatic associations with violent and nonviolent suicide: a population-based study. Neuropsychobiology. 2008;57(1–2):32–7.CrossRefPubMed
53.
Rocchi MB, Sisti D, Cascio MT, Preti A. Seasonality and suicide in Italy: amplitude is positively related to suicide rates. J Affect Disord. 2007;100(1–3):129–36.CrossRefPubMed
54.
Davis GE, Lowell WE. Evidence that latitude is directly related to variation in suicide rates. Can J Psychiatry. 2002;47(6):572–4.PubMed
55.
Nejar KA, Bensenor IM, Lotufo PA. Sunshine and suicide at the tropic of Capricorn, Sao Paulo, Brazil, 1996–2004. Rev Saude Publica. 2007;41(6):1062–4.CrossRefPubMed
56.
Bando DH, Scrivani H, Morettin PA, Teng CT. Seasonality of suicide in the city of Sao Paulo, Brazil, 1979–2003. Rev Bras Psiquiatr. 2009;31(2):101–5.PubMed
57.
Parker G, Gao F, Machin D. Seasonality of suicide in Singapore: data from the equator. Psychol Med. 2001;31(3):549–53.CrossRefPubMed
58.
Ajdacic-Gross V, Bopp M, Sansossio R, Lauber C, Gostynski M, Eich D, Gutzwiller F, Rossler W. Diversity and change in suicide seasonality over 125 years. J Epidemiol Community Health. 2005;59(11):967–72.CrossRefPubMedPubMedCentral
59.
Rock D, Greenberg DM, Hallmayer JF. Increasing seasonality of suicide in Australia 1970–1999. Psychiatry Res. 2003;120(1):43–51.CrossRefPubMed
60.
61.
Souetre E, Wehr TA, Douillet P, Darcourt G. Influence of environmental factors on suicidal behavior. Psychiatry Res. 1990;32(3):253–63.CrossRefPubMed
62.
Dixon PG, Sinyor M, Schaffer A, Levitt A, Haney CR, Ellis KN, Sheridan SC. Association of weekly suicide rates with temperature anomalies in two different climate types. Int J Environ Res Public Health. 2014;11(11):11627–44.CrossRefPubMedPubMedCentral
63.
Deisenhammer EA, Kemmler G, Parson P. Association of meteorological factors with suicide. Acta Psychiatr Scand. 2003;108(6):455–9.CrossRefPubMed
64.
65.
Preti A, Lentini G, Maugeri M. Global warming possibly linked to an enhanced risk of suicide: data from Italy, 1974–2003. J Affect Disord. 2007;102(1–3):19–25.CrossRefPubMed
66.
Muller H, Biermann T, Renk S, Reulbach U, Strobel A, Kornhuber J, Sperling W. Higher environmental temperature and global radiation are correlated with increasing suicidality—a localized data analysis. Chronobiol Int. 2011;28(10):949–57.CrossRefPubMed
67.
Ishii N, Terao T, Araki Y, Kohno K, Mizokami Y, Arasaki M, Iwata N. Risk factors for suicide in Japan: a model of predicting suicide in 2008 by risk factors of 2007. J Affect Disord. 2013;147(1–3):352–4.CrossRefPubMed
68.
Inoue K, Nishimura Y, Fujita Y, Ono Y, Fukunaga T. The relationship between suicide and five climate issues in a large-scale and long-term study in Japan. West Indian Med J. 2012;61(5):532–7.CrossRefPubMed
69.
Grjibovski AM, Kozhakhmetova G, Kosbayeva A, Menne B. Associations between air temperature and daily suicide counts in Astana, Kazakhstan. Medicina. 2013;49(8):379–85.PubMed
70.
Oravecz R, Czigler B, Moore M. The transformation of suicide fluctuation in Slovenia. Arch Suicide Res. 2006;10(1):69–76.CrossRefPubMed
71.
Helama S, Holopainen J, Partonen T. Temperature-associated suicide mortality: contrasting roles of climatic warming and the suicide prevention program in Finland. Environ Health Prev Med. 2013;18(5):349–55.CrossRefPubMedPubMedCentral
72.
Tsai JF, Cho W. Temperature change dominates the suicidal seasonality in Taiwan: a time-series analysis. J Affect Disord. 2012;136(3):412–8.CrossRefPubMed
73.
Wang YT, Wang D, Wang XY. Suicide and meteorological factors in Huhhot, Inner Mongolia. Crisis. 1997;18(3):115–7.CrossRefPubMed
74.
Hanigan IC, Butler CD, Kokic PN, Hutchinson MF. Suicide and drought in New South Wales, Australia, 1970–2007. Proc Natl Acad Sci USA. 2012;109(35):13950–5.CrossRefPubMedPubMedCentral
75.
Preti A. The influence of climate on suicidal behaviour in Italy. Psychiatry Res. 1998;78(1–2):9–19.CrossRefPubMed
76.
Tsai JF. Socioeconomic factors outweigh climate in the regional difference of suicide death rate in Taiwan. Psychiatry Res. 2010;179(2):212–6.CrossRefPubMed
77.
Bjorksten KS, Kripke DF, Bjerregaard P. Accentuation of suicides but not homicides with rising latitudes of Greenland in the sunny months. BMC psychiatry. 2009;9:20.CrossRefPubMedPubMedCentral
78.
Vyssoki B, Praschak-Rieder N, Sonneck G, Bluml V, Willeit M, Kasper S, Kapusta ND. Effects of sunshine on suicide rates. Compr Psychiatry. 2012;53(5):535–9.CrossRefPubMed
79.
Dixon PG, McDonald AN, Scheitlin KN, Stapleton JE, Allen JS, Carter WM, Holley MR, Inman DD, Roberts JB. Effects of temperature variation on suicide in five US counties, 1991–2001. Int J Biometeorol. 2007;51(5):395–403.CrossRefPubMed
80.
Casey P, Gemmell I, Hiroeh U, Fulwood C. Seasonal and socio-demographic predictors of suicide in Ireland: a 22 year study. J Affect Disord. 2012;136(3):862–7.CrossRefPubMed
81.
Bourque F, Willox AC. Climate change: the next challenge for public mental health? Int Rev Psychiatry. 2014;26(4):415–22.CrossRefPubMed
82.
Kapusta ND, Tran US, Rockett IR, De Leo D, Naylor CP, Niederkrotenthaler T, Voracek M, Etzersdorfer E, Sonneck G. Declining autopsy rates and suicide misclassification: a cross-national analysis of 35 countries. Arch Gen Psychiatry. 2011;68(10):1050–7.CrossRefPubMed
83.
Moniruzzaman S, Andersson R. Relationship between economic development and suicide mortality: a global cross-sectional analysis in an epidemiological transition perspective. Public health. 2004;118(5):346–8.CrossRefPubMed
84.
Lucey S, Corcoran P, Keeley HS, Brophy J, Arensman E, Perry IJ. Socioeconomic change and suicide: a time-series study from the Republic of Ireland. Crisis. 2005;26(2):90–4.CrossRefPubMed
Metadata
Title
Relationship of suicide rates with climate and economic variables in Europe during 2000–2012
Authors
Konstantinos N. Fountoulakis
Isaia Chatzikosta
Konstantinos Pastiadis
Prodromos Zanis
Wolfram Kawohl
Ad J. F. M. Kerkhof
Alvydas Navickas
Cyril Höschl
Dusica Lecic-Tosevski
Eliot Sorel
Elmars Rancans
Eva Palova
Georg Juckel
Goran Isacsson
Helena Korosec Jagodic
Ileana Botezat-Antonescu
Janusz Rybakowski
Jean Michel Azorin
John Cookson
John Waddington
Peter Pregelj
Koen Demyttenaere
Luchezar G. Hranov
Lidija Injac Stevovic
Lucas Pezawas
Marc Adida
Maria Luisa Figuera
Miro Jakovljević
Monica Vichi
Giulio Perugi
Ole A. Andreassen
Olivera Vukovic
Paraskevi Mavrogiorgou
Peeter Varnik
Peter Dome
Petr Winkler
Raimo K. R. Salokangas
Tiina From
Vita Danileviciute
Xenia Gonda
Zoltan Rihmer
Jonas Forsman
Anne Grady
Thomas Hyphantis
Ingrid Dieset
Susan Soendergaard
Maurizio Pompili
Per Bech
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2016
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-016-0106-2

Other articles of this Issue 1/2016

Annals of General Psychiatry 1/2016 Go to the issue

Primary research

The impact of psychopathological subtypes on retention rate of patients with substance use disorder entering residential therapeutic community treatment

Primary research

Link of dysfunctional attitudes with the negative self-model

Primary research

Increased arterial stiffness parameters in panic disorder patients in long term treatment period

Primary research

Serum levels of brain-derived neurotrophic factor (BDNF), proBDNF and plasma 3-methoxy-4-hydroxyphenylglycol levels in chronic schizophrenia

Primary research

Resilience and burnout status among nurses working in oncology

Primary research

Analysis of personality traits and their influence on the quality of life of postmenopausal women with regard to genetic factors