Respiratory function and other biological risk factors for completed suicide: 40 years of follow-up of European cohorts of the Seven Countries Study

Erik J. Giltay; Frans G. Zitman; Alessandro Menotti; Aulikki Nissinen; David R. Jacobs; Hisashi Adachi; Antony Kafatos; Daan Kromhout

doi:10.1016/j.jad.2009.03.022

Respiratory function and other biological risk factors for completed suicide: 40 years of follow-up of European cohorts of the Seven Countries Study

Erik J. Giltay, Frans G. Zitman, Alessandro Menotti, Aulikki Nissinen, David R. Jacobs, Hisashi Adachi, Antony Kafatos, Daan Kromhout

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background: Prospective cohort studies on biological risk factors of completed suicide are scarce. We aimed to test which biological risk factors independently identify subjects at increased risk of suicidal death. Methods: In the prospective cohort of the Seven Countries Study, 5,321 middle-aged men from Finland, Serbia, Italy, and Greece were included. Completed suicide (ICD-8 codes E950-959) was assessed during 40 years of follow-up. Biological cardiovascular risk factors (including forced vital capacity [FVC] and height) were tested for their role as predictors in multivariable Cox models stratified by country. Results: There were 4518 deaths during follow-up, with 64 from suicide (1.4%). In univariable models, only FVC and height were strongly inversely related with suicide. Socio-economic status and being unmarried were potential confounders. In multivariable models taking these confounders into account, both a low FVC (0.30 for top vs. lowest quartile; 95% CI: 0.12-0.76; P = 0.006 for trend) and a low FVC/height ratio (0.37 for top vs. lowest quartile; 95% CI: 0.17-0.82; P = 0.004 for trend) were strongly inversely related with completed suicide. Limitations: Information on proximal causes, such as prior suicidal ideation, emotional distress and depression, was lacking at baseline. Conclusions: Poor respiratory function in middle-aged men was an independent risk factor for completed suicide.

Original language	English (US)
Pages (from-to)	249-253
Number of pages	5
Journal	Journal of Affective Disorders
Volume	120
Issue number	1-3
DOIs	https://doi.org/10.1016/j.jad.2009.03.022
State	Published - Jan 2010

Bibliographical note

Funding Information:
The Seven Countries Study was funded by grants HE 04697, HE 6090, and HE 00278 from the National Heart, Lung, and Blood Institute, Bethesda, Md, US. The funding source had no role in the design, data collection, interpretation and writing of the manuscript.

Keywords

Forced vital capacity
Middle-aged men
Respiratory function
Risk factors
Socio-economic status
Suicide
Violence

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1016/j.jad.2009.03.022

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@article{be94bceba0e048f291f777c8fbe3ea77,

title = "Respiratory function and other biological risk factors for completed suicide: 40 years of follow-up of European cohorts of the Seven Countries Study",

abstract = "Background: Prospective cohort studies on biological risk factors of completed suicide are scarce. We aimed to test which biological risk factors independently identify subjects at increased risk of suicidal death. Methods: In the prospective cohort of the Seven Countries Study, 5,321 middle-aged men from Finland, Serbia, Italy, and Greece were included. Completed suicide (ICD-8 codes E950-959) was assessed during 40 years of follow-up. Biological cardiovascular risk factors (including forced vital capacity [FVC] and height) were tested for their role as predictors in multivariable Cox models stratified by country. Results: There were 4518 deaths during follow-up, with 64 from suicide (1.4%). In univariable models, only FVC and height were strongly inversely related with suicide. Socio-economic status and being unmarried were potential confounders. In multivariable models taking these confounders into account, both a low FVC (0.30 for top vs. lowest quartile; 95% CI: 0.12-0.76; P = 0.006 for trend) and a low FVC/height ratio (0.37 for top vs. lowest quartile; 95% CI: 0.17-0.82; P = 0.004 for trend) were strongly inversely related with completed suicide. Limitations: Information on proximal causes, such as prior suicidal ideation, emotional distress and depression, was lacking at baseline. Conclusions: Poor respiratory function in middle-aged men was an independent risk factor for completed suicide.",

keywords = "Forced vital capacity, Middle-aged men, Respiratory function, Risk factors, Socio-economic status, Suicide, Violence",

author = "Giltay, {Erik J.} and Zitman, {Frans G.} and Alessandro Menotti and Aulikki Nissinen and Jacobs, {David R.} and Hisashi Adachi and Antony Kafatos and Daan Kromhout",

note = "Funding Information: The Seven Countries Study was funded by grants HE 04697, HE 6090, and HE 00278 from the National Heart, Lung, and Blood Institute, Bethesda, Md, US. The funding source had no role in the design, data collection, interpretation and writing of the manuscript. ",

year = "2010",

month = jan,

doi = "10.1016/j.jad.2009.03.022",

language = "English (US)",

volume = "120",

pages = "249--253",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier B.V.",

number = "1-3",

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TY - JOUR

T1 - Respiratory function and other biological risk factors for completed suicide

T2 - 40 years of follow-up of European cohorts of the Seven Countries Study

AU - Giltay, Erik J.

AU - Zitman, Frans G.

AU - Menotti, Alessandro

AU - Nissinen, Aulikki

AU - Jacobs, David R.

AU - Adachi, Hisashi

AU - Kafatos, Antony

AU - Kromhout, Daan

N1 - Funding Information: The Seven Countries Study was funded by grants HE 04697, HE 6090, and HE 00278 from the National Heart, Lung, and Blood Institute, Bethesda, Md, US. The funding source had no role in the design, data collection, interpretation and writing of the manuscript.

PY - 2010/1

Y1 - 2010/1

N2 - Background: Prospective cohort studies on biological risk factors of completed suicide are scarce. We aimed to test which biological risk factors independently identify subjects at increased risk of suicidal death. Methods: In the prospective cohort of the Seven Countries Study, 5,321 middle-aged men from Finland, Serbia, Italy, and Greece were included. Completed suicide (ICD-8 codes E950-959) was assessed during 40 years of follow-up. Biological cardiovascular risk factors (including forced vital capacity [FVC] and height) were tested for their role as predictors in multivariable Cox models stratified by country. Results: There were 4518 deaths during follow-up, with 64 from suicide (1.4%). In univariable models, only FVC and height were strongly inversely related with suicide. Socio-economic status and being unmarried were potential confounders. In multivariable models taking these confounders into account, both a low FVC (0.30 for top vs. lowest quartile; 95% CI: 0.12-0.76; P = 0.006 for trend) and a low FVC/height ratio (0.37 for top vs. lowest quartile; 95% CI: 0.17-0.82; P = 0.004 for trend) were strongly inversely related with completed suicide. Limitations: Information on proximal causes, such as prior suicidal ideation, emotional distress and depression, was lacking at baseline. Conclusions: Poor respiratory function in middle-aged men was an independent risk factor for completed suicide.

AB - Background: Prospective cohort studies on biological risk factors of completed suicide are scarce. We aimed to test which biological risk factors independently identify subjects at increased risk of suicidal death. Methods: In the prospective cohort of the Seven Countries Study, 5,321 middle-aged men from Finland, Serbia, Italy, and Greece were included. Completed suicide (ICD-8 codes E950-959) was assessed during 40 years of follow-up. Biological cardiovascular risk factors (including forced vital capacity [FVC] and height) were tested for their role as predictors in multivariable Cox models stratified by country. Results: There were 4518 deaths during follow-up, with 64 from suicide (1.4%). In univariable models, only FVC and height were strongly inversely related with suicide. Socio-economic status and being unmarried were potential confounders. In multivariable models taking these confounders into account, both a low FVC (0.30 for top vs. lowest quartile; 95% CI: 0.12-0.76; P = 0.006 for trend) and a low FVC/height ratio (0.37 for top vs. lowest quartile; 95% CI: 0.17-0.82; P = 0.004 for trend) were strongly inversely related with completed suicide. Limitations: Information on proximal causes, such as prior suicidal ideation, emotional distress and depression, was lacking at baseline. Conclusions: Poor respiratory function in middle-aged men was an independent risk factor for completed suicide.

KW - Forced vital capacity

KW - Middle-aged men

KW - Respiratory function

KW - Risk factors

KW - Socio-economic status

KW - Suicide

KW - Violence

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