High and low suicidality in Europe: A fine-grained comparison of France and Spain within the ESEMeD surveys

V. Kovess-Masfety, A. Boyd, J. M. Haro, R. Bruffaerts, G. Villagut, J. P. Lépine, I. Gasquet, J. Alonso

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32 Citations (Scopus)

Abstract

Background: Suicidality risk-factors between countries with similar economic and religious background have been rarely compared, especially within genders. Methods: Lifetime prevalence of suicide ideation, plans, and attempts in the ESEMeD surveys were stratified on four separate groups: French women, Spanish women, French men, and Spanish men. Outcome odds-ratios (OR) were modelled within each group using logistic regression including demographic characteristics, lifetime mood/anxiety disorders, parental bonding, marital status, and health service-use. Results: Lifetime prevalence of suicide attempts was 3.4% in France (1.1% men, 5.4% women) and 1.5% in Spain (1.2% men, 1.7% women), with a significantly greater gender difference in France (p = 0.001). Regarding risk-factors, French women reported suicide attempt more commonly with authoritarian mothers (OR = 1.51; 95%CI = 1.04-2.18), unlike Spanish women (OR = 0.77; 95%CI = 0.51-1.15) (p < 0.001). Spanish men showed more than eight-times higher odds of suicide attempt with overprotecting mothers than French men (p = 0.03). General practitioner-(GP)-use was significantly protective of suicide attempt among Spanish women (OR = 0.08; 95%CI = 0.02-0.35) with no effect in French women (OR = 1.03; 95%CI = 0.54-2.00) (p = 0.01). No significant differences in the effect of marital status, any lifetime antidepressant use, mental disorders, or religiosity on suicide attempt were observed between France and Spain within gender-stratum. Limitations: Parental bonding is retrospective and potentially influenced by mental state. Response rate was considerably lower in France than in Spain. Conclusions: Suicidality risk-factors play different roles across genders between France and Spain. Parental bonding dimensions may be interpreted differently according to country, underlining cultural importance. As recommended by WHO, mental health decisions must involve GPs in conjunction with psychiatrists or psychologists. © 2011 Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)247-256
Number of pages10
JournalJournal of affective disorders
Volume133
Issue number1-2
DOIs
Publication statusPublished - 2011
Externally publishedYes

Keywords

  • Adult
  • Anxiety Disorders/epidemiology
  • Europe
  • Female
  • France/epidemiology
  • General Practitioners
  • Health Surveys
  • Humans
  • Male
  • Mental Disorders/epidemiology
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Retrospective Studies
  • Risk
  • Risk Factors
  • Sex Factors
  • Spain/epidemiology
  • Suicidal Ideation
  • Suicide, Attempted/ethnology
  • Suicide/psychology
  • Young Adult

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