OBJECTIVE: Assess whether general social and religious participation moderate the impact of depression/anxiety, anti-social behavior, and alcohol abuse on suicide. METHODS: Data come from the 1993 National Mortality Followback Survey, a nationally representative 10% sample of U.S. residents aged 15+ who died in 1993 of all causes. Information on each decedent was obtained from death certificates and proxy respondent interviews (response rate=83%). The study sample included decedents who had valid proxy data and resided outside an institution during the last year of life (N=11,305). Using logistic regression, analyses were adjusted for decedent and proxy demographic characteristics and weighted for the complex sampling design. RESULTS: Overall, social isolation and psychiatric symptoms contributed independently to suicide. When assessed interactively, however, results revealed that depression/anxiety, anti-social behavior, and alcohol abuse were not uniformly associated with suicide under all social circumstances. Frequent religious participation lowered suicide risk for all three types of symptoms, particularly among the most severely impaired. Additionally, for those with few symptoms, increasing general social participation consistently lowered risk. But, among individuals who were severely depressed or abusing alcohol, moderate general participation offered the most protection against suicide. Impaired individuals who were highly integrated had the greatest risk of suicide, greater even than those who were very isolated. CONCLUSION: Social relationships play an important, though varied, role in how psychiatric symptoms impact suicide. Among people experiencing significant internalizing or externalizing symptoms, too many relationships may be burdensome and too few may be isolating. Both conditions increase suicide risk.
Learning Objectives: Assess how the presence or absence of key social relationships influence the impact of depression, aggressive behaviors, and alcohol abuse on suicide
Keywords: Suicide, Risk Factors
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.