Divorce and risk of suicide attempt : A Swedish national study
(2023) In Psychological Medicine- Abstract
Background Prior research has reported an association between divorce and suicide attempt. We aimed to clarify this complex relationship, considering sex differences, temporal factors, and underlying etiologic pathways. Methods We used Swedish longitudinal national registry data for a cohort born 1960-1990 that was registered as married between 1978 and 2018 (N = 1 601 075). We used Cox proportional hazards models to estimate the association between divorce and suicide attempt. To assess whether observed associations were attributable to familial confounders or potentially causal in nature, we conducted co-relative analyses. Results In the overall sample and in sex-stratified analyses, divorce was associated with increased risk of... (More)
Background Prior research has reported an association between divorce and suicide attempt. We aimed to clarify this complex relationship, considering sex differences, temporal factors, and underlying etiologic pathways. Methods We used Swedish longitudinal national registry data for a cohort born 1960-1990 that was registered as married between 1978 and 2018 (N = 1 601 075). We used Cox proportional hazards models to estimate the association between divorce and suicide attempt. To assess whether observed associations were attributable to familial confounders or potentially causal in nature, we conducted co-relative analyses. Results In the overall sample and in sex-stratified analyses, divorce was associated with increased risk of suicide attempt (adjusted hazard ratios [HRs] 1.66-1.77). Risk was highest in the year immediately following divorce (HRs 2.20-2.91) and declined thereafter, but remained elevated 5 or more years later (HRs 1.41-1.51). Divorcees from shorter marriages were at higher risk for suicide attempt than those from longer marriages (HRs 3.33-3.40 and 1.20-1.36, respectively). In general, HRs were higher for divorced females than for divorced males. Co-relative analyses suggested that familial confounders and a causal pathway contribute to the observed associations. Conclusions The association between divorce and risk of suicide attempt is complex, varying as a function of sex and time-related variables. Given evidence that the observed association is due in part to a causal pathway from divorce to suicide attempt, intervention or prevention efforts, such as behavioral therapy, could be most effective early in the divorce process, and in particular among females and those whose marriages were of short duration.
(Less)
- author
- Edwards, Alexis C. LU ; Ohlsson, Henrik LU ; Salvatore, Jessica E. ; Stephenson, Mallory E. ; Crump, Casey LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Kendler, Kenneth S.
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- divorce, familial confounding, suicide attempt, survival model
- in
- Psychological Medicine
- publisher
- Cambridge University Press
- external identifiers
-
- pmid:38084643
- scopus:85179959697
- ISSN
- 0033-2917
- DOI
- 10.1017/S0033291723003513
- language
- English
- LU publication?
- yes
- id
- 96990c3c-1a47-4b82-a612-006eda5b8ddc
- date added to LUP
- 2024-01-10 11:32:29
- date last changed
- 2024-04-25 07:31:29
@article{96990c3c-1a47-4b82-a612-006eda5b8ddc,
abstract = {{<p>Background Prior research has reported an association between divorce and suicide attempt. We aimed to clarify this complex relationship, considering sex differences, temporal factors, and underlying etiologic pathways. Methods We used Swedish longitudinal national registry data for a cohort born 1960-1990 that was registered as married between 1978 and 2018 (N = 1 601 075). We used Cox proportional hazards models to estimate the association between divorce and suicide attempt. To assess whether observed associations were attributable to familial confounders or potentially causal in nature, we conducted co-relative analyses. Results In the overall sample and in sex-stratified analyses, divorce was associated with increased risk of suicide attempt (adjusted hazard ratios [HRs] 1.66-1.77). Risk was highest in the year immediately following divorce (HRs 2.20-2.91) and declined thereafter, but remained elevated 5 or more years later (HRs 1.41-1.51). Divorcees from shorter marriages were at higher risk for suicide attempt than those from longer marriages (HRs 3.33-3.40 and 1.20-1.36, respectively). In general, HRs were higher for divorced females than for divorced males. Co-relative analyses suggested that familial confounders and a causal pathway contribute to the observed associations. Conclusions The association between divorce and risk of suicide attempt is complex, varying as a function of sex and time-related variables. Given evidence that the observed association is due in part to a causal pathway from divorce to suicide attempt, intervention or prevention efforts, such as behavioral therapy, could be most effective early in the divorce process, and in particular among females and those whose marriages were of short duration.</p>}},
author = {{Edwards, Alexis C. and Ohlsson, Henrik and Salvatore, Jessica E. and Stephenson, Mallory E. and Crump, Casey and Sundquist, Jan and Sundquist, Kristina and Kendler, Kenneth S.}},
issn = {{0033-2917}},
keywords = {{divorce; familial confounding; suicide attempt; survival model}},
language = {{eng}},
publisher = {{Cambridge University Press}},
series = {{Psychological Medicine}},
title = {{Divorce and risk of suicide attempt : A Swedish national study}},
url = {{http://dx.doi.org/10.1017/S0033291723003513}},
doi = {{10.1017/S0033291723003513}},
year = {{2023}},
}