Intended for healthcare professionals


Risk of suicide related to income level in mental illness

BMJ 2001; 323 doi: (Published 28 July 2001) Cite this as: BMJ 2001;323:232

Psychiatric disorders are more severe among suicide victims of higher occupational level

  1. Markku Timonen, general practitioner (,
  2. Kaisa Viilo, student of mathematical sciences,
  3. Helinä Hakko, statistician,
  4. Erkki Väisänen, professor of psychiatry,
  5. Pirkko Räsänen, professor of psychiatry,
  6. Terttu Särkioja, doctor in forensic medicine
  1. Department of Psychiatry, BOX 5000, 90014 University of Oulu, Finland
  2. Department of Forensic Medicine, University of Oulu
  3. Department of Tropical Hygiene and Public Health, Heidelberg University, D-69120 Heidelberg, Germany
  4. University of Georgia, Athens, GA 30602, USA
  5. Universidad Peruana Cayetano Heredia, Apartado 4314, Lima-100, Peru
  6. University of Alabama at Birmingham, Birmingham, AL 35294, USA

    EDITOR—Agerbo et al reported that people with a history of mental illness and a high income are at greater risk of committing suicide than their counterparts with a lower income.1 The authors, and Gunnell in a commentary on their paper, suggested that possible explanatory factors for this finding were the presence of a more severe mental illness or the stigmatising effects of psychiatric admission; they called for further studies measuring the severity of the psychiatric illness.

    Because Finland has one of the world's highest death rates from suicide2 and most of the population is treated in public hospitals (regardless of socioeconomic status) we examined this issue. We explored whether suicide victims with senior occupations or higher socioeconomic status, or both, more commonly had mental disorders or psychoses or misused alcohol or drugs than did other people. We also investigated whether the method of suicide was somehow related to the occupation.

    We used a large, prospectively collected, 13 year database of all suicides (1296 males, 289 females) during 1988-2000 in northern Finland (the province of Oulu). Details of the database and study protocols have been reported.3 The lifetime diagnoses of the suicide …

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