Divorce and suicide risk

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چکیده

There is accumulating evidence that divorced and separated people have much higher suicide rates than their married counterparts. In a previous paper published in this journal, it was observed that divorced and separated men were nearly 2.4 times more likely to kill themselves than their married counterparts. That study, however, failed to directly compare divorced men and women. While it informed us that divorced people are at higher risk of suicide than the married, it said nothing about the suicide risk of divorced men relative to divorced women. The purpose of this communication is to assess the magnitude of the differentials in suicide risk between the two groups, and explore possible reasons that might explain the disparities. Data were obtained from the US National Longitudinal Mortality Study (NLMS), 1979– 1989, and covariates used were taken from Kposowa. The response variable was the risk of suicide, and analysis was restricted to divorced and separated non-Hispanic white men and women. Proportional hazards regression models were fitted to the data, and relevant results are in table 1. Model 1 presents the age adjusted effects of sex on the risk of suicide. Divorced men were over eight times more likely to commit suicide than divorced women (RR = 8.36, 95% CI = 4.24 to16.38). After taking into account other factors that have been reported to contribute to suicide, divorced men still experienced much increased risks of suicide than divorced women. They were nearly 9.7 times more likely to kill themselves than comparable divorced women (RR = 9.68, 95% CI = 4.87 to 19.22). Put another way, for every divorced woman that committed suicide, over nine divorced men killed themselves. These results dramatise the terrible consequences of being a divorced man in America, and lead to the question: why are divorced men killing themselves? Some analysts argue that the research community has ignored a plausible explanation for the excess suicide risks experienced by divorced men. As Perrault and Farrell observe, while social, psychological, and even personal problems facing women are readily denounced, societal institutions tend to ignore or minimise male problems as evident in suicide statistics. For instance, in many jurisdictions in the US there seems to be an implicit assumption that the bond between a woman and her children is stronger than that between a man and his children. As a consequence, in a divorce settlement, custody of children is more likely to be given to the wife. In the end, the father loses not only his marriage, but his children. The result may be anger at the court system especially in situations wherein the husband feels betrayed because it was the wife that initiated the divorce, or because the courts virtually gave away everything that was previously owned by the ex-husband or the now defunct household to the former wife. Events could spiral into resentment (toward the spouse and ‘‘the system’’), bitterness, anxiety, and depression, reduced self esteem, and a sense of ‘‘life not worth living’’. As depression and poor mental health are known markers of suicide risk, it may well be that one of the fundamental reasons for the observed association between divorce and suicide in men is the impact of post divorce (court sanctioned) ‘‘arrangements’’. Clearly this is an issue that needs further investigation.

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تاریخ انتشار 2003