The High Suicide Rates at High Altitudes May Be Related to Divorce

Öz

Aim: Many studies have found that high altitudes are associated with suicide. Despite numerous studies in the literature, the mechanism by which high altitude increases suicide rates is not known. In this study, we investigated whether divorce affects the suicide rate at high altitudes. Material and Method: Using publicly available data from the Turkish Statistical Institute (TUIK), the average altitude above sea level, suicide rate, and divorce rate of each province over the last 14 years were calculated. Divorce rates, suicide rates, and altitudes were statistically compared at the end of the study. Results: The mean suicide rate did not differ according to altitude (r=0.112; p=0.322). The mean divorce rate differed according to altitude. The highest mean divorce rate was observed in the group with an altitude of less than 500 m (p<0.001). In the correlation analysis, it was found that altitude was negatively correlated with the divorce rate, divorce, and suicide rates were positively correlated, and in the regression analysis, high altitude and divorce rate increased the suicide rate (<0.05). Conclusion: Our study suggests that divorced people in high-altitude areas are in the high-risk group for suicide and that mental health protective interventions, especially for this group, may be appropriate for prevention. In conclusion, this study is important, as it is the first to investigate the relationship between altitude, divorce, and suicide. Larger-scale studies in which individual factors were excluded are required.

Anahtar Kelimeler

• Altitude
• divorce
• suicide
• family ties
• geographical region

Etik Beyan

Çalışma için etik onay, Karamanoğlu Mehmetbey Üniversitesi Etik Kurulu'nun 27.02.2024 tarihli 01-2024/04 sayılı izni ile alınmıştır.

Kaynakça

1. WHO. Suicide in the world: global health estimates. 2019 https://www.who.int/publications/i/item/9789240026643 access date: 06.05.2024
2. Baldessarini RJ, Tondo L, Pinna M, et al . Suicidal risk factors in major affective disorders. Br J Psychiatry. 2019;215:621-6.
3. Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Dan Med Bull. 2007;54:306-69.
4. Poyraz T, Çalışkan A. A sociological analysis of Turkey's suicide phenomenon. itobiad. 2019;8:2957-74.
5. Asirdizer M, Kartal E, Etli Y, et al. The effect of altitude and climate on the suicide rates in Turkey. J Forensic Leg Med. 2018;54:91-5.
6. Brown A, Hellem T, Schreiber J, et al. Suicide and altitude: a systematic review of global literature. Public Health Nurs. 2022;39:1167-79.
7. Øien-Ødegaard C, Hauge LJ, Reneflot A. Marital status, educational attainment, and suicide risk: a Norwegian register-based population study. Popul Health Metr. 2021;19:33.
8. Yang X, Liu L, Li R. How marital events explain the suicide rate among Chinese. Plos one. 2023;18:e0286961.

9. TUIK. Turkish Statistical Institute (TUIK) of the Republic of Turkey. https://www.tuik.gov.tr/ access date 06.05.2024.
10. Turkish Statistical Institute (TUIK). Ölüm ve ölüm nedeni istatistikleri, 2022. https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2022-49679 access date 09.02.2024.
11. Turkish Statistical Institute (TUIK). Evlenme ve boşanma istatistikleri, 2022. https://data.tuik.gov.tr/Bulten/Index?p=Evlenme-ve-Bosanma-Istatistikleri-2022-49437 access date 09.02.2024.
12. Blogarti. Türkiye’deki illerin rakım sıralaması. https://www.blogarti.com/illerin-rakim-siralamasi.html access date 09.02.2024.
13. Sümbüloğlu K, Akdağ B. Regresyon Yöntemleri ve Korelasyon Analizi, Hatiboğlu Yayınları, Ankara, 2007;12.
14. Gong S LC, Xiao K. Spatial-temporal characteristics and relations with economy of suicide phenomenon in China from 2000 to 2018. Tropical Geography. 2023;43:1760-76.
15. Kim J, Choi N, Lee Y-J, et al. High altitude remains associated with elevated suicide rates after adjusting for socioeconomic status: A study from South Korea. Psychiatry Investig. 2014;11:492-4.
16. Aksoy T, Yerlikaya B. Divorce and suicide: a subnational analysis in Turkey. Topics in Middle Eastern & North African Economies: Proceedings of the Middle East Economic Association. 2021;23:54-77.
17. Rihmer Z, Rihmer A, Beltezcki Z. Psycho-social correlates of suicidal behaviour. Neuropsychopharmacol Hung. 2022;24:162-9.
18. Jimenez A, Santed-Germán M-A, Ramos V. Google searches and suicide rates in Spain, 2004-2013: correlation study. JMIR Public Health Surveill. 2020;6:e10919.
19. Edwards AC, Ohlsson H, Salvatore JE, et al. Divorce and risk of suicide attempt: a Swedish national study. Psychol Med. 2023 Dec 12. doi: 10.1017/S0033291723003513. [Epub ahead of print].