暴露于自杀与更高的死亡率相关,对健康的影响取决于亲属关系的类型。然而,亲属关系的调节作用尚不清楚。因此,这项研究旨在比较暴露于配偶的个体之间的死亡原因,父母,以及那些自然或非自然死亡的人自杀。在这项研究中,1,929,872人被登记,其中1,726,846人自然死亡,141,206人暴露于非自然死亡,和61,820个人暴露于自杀。为了比较亲属之间的死亡原因,采用Cox比例风险模型和特定原因风险模型进行分层分析和适度分析.尽管特定原因导致的死亡率较高,比如自杀,凶杀案,血管性和未指明的痴呆症,与暴露于自然和非自然死亡的个体相比,在暴露于自杀的个体中观察到(调整后的危险比:1.69至23.26),与暴露于非自然死亡的人群相比,我们没有观察到更高的全因死亡率.一些死亡原因是由亲属关系缓和的。与非自然死亡相比,父母或配偶自杀与自杀和凶杀的死亡率高于儿童自杀(调整后的危险比:1.70至15.67),与配偶自杀相比,父母自杀与更高的意外死亡率相关(校正风险比:1.81).这些发现为亲属在自杀暴露对死亡原因的影响中的作用提供了完整的理解。
Exposure to suicide is associated with higher mortality, and the health impact varies depending on the types of
kinship. However, the moderating role of
kinship remains unclear. Therefore, this
study aimed to compare causes of death between individuals exposed to spousal, parental, and child suicide to those exposed to natural or unnatural death. In this
study, 1,929,872 individuals were enrolled, of whom 1,726,846 individuals were exposed to natural death, 141,206 individuals were exposed to unnatural death, and 61,820 individuals were exposed to suicide. To compare causes of death between kinship, stratified analysis and moderation analysis were conducted by using the Cox proportional hazard model and the cause-specific hazard model. Although higher mortality from specific causes, such as suicide, homicide, and vascular and unspecified dementia, was observed in individuals exposed to suicide compared to those exposed to natural and unnatural death (adjusted hazard ratio: 1.69 to 23.26), we did not observe higher all-cause mortality when compared to those exposed to unnatural death. Some causes of death were moderated by
kinship. When compared to unnatural death, parental or spousal suicide was associated with higher mortality from suicide and homicide than child suicide (adjusted hazard ratio: 1.70 to 15.67), and parental suicide was associated with higher mortality from accidents than spousal suicide (adjusted hazard ratio: 1.81). These findings provide an integral understanding of the role of kinship in the impacts of suicide exposure on causes of death.