Predictors of suicide in rural and remote areas: A psychological autopsy study in Queensland

The aims of the study are to: assess suicide predictors in rural and urban regions by comparing suicides to sudden-death controls; and, compare the differences between rural and urban suicides.

The Psychological Autopsy method was utilised to investigate suicides over the age of 35 in QLD by interviewing next-of-kin in 2006-2008. A case-control study design was applied using sudden-deaths as controls. The study involved 50 suicides and 26 sudden-death controls from rural and 150 suicides and 108 sudden-deaths from urban regions.

No significant differences were found between the urban and rural suicides and their controls by gender, age, ethnicity or language. In both areas, suicides were more frequently separated, living alone and unemployed, compared to the sudden-deaths.

There were no significant differences in marital status, living arrangements, education, and employment status between two suicide groups. Previous suicide attempt(s) and having any psychiatric disorder were significant suicide predictors in both urban and rural regions. Compared to the urban suicides, there was a significantly higher prevalence of psychiatric diagnoses in rural suicides.

Suicides had significantly higher neuroticism and lower agreeableness in both areas. Neuroticism was also higher in rural suicides compared to urban suicides. Aggression scores were significantly higher in suicides, compared to sudden-deaths; aggression score was significantly higher in rural than in urban suicides. No remarkable differences in physical health were found. While geographical location alone may not be a risk factor, life events and living conditions that are more likely to be found in rural environments may increase vulnerability to suicide.

In the present study, similarities in the predicting factors of suicide in rural and urban areas were found. However, some of the predictors were more prevalent in rural areas. For example, aggression, neuroticism and alcohol dependence were higher in rural suicides.

Dr Kairi Kolves, Australian Insitute for Suicide Research and Prevention, Griffith University
Co- Author: Prof Diego De Leo, Australian Insitute for Suicide Research and Prevention, Griffith University

Dr Kolves will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 – 21 November 2012, Adelaide, South Australia.
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