Separation as a suicide risk factor

Background: Marital separation (as distinct from divorce) is rarely researched in the suicidological literature. Studies usually report on the statuses of 'separated' and 'divorced' as a combined category, possibly because demographic registries are not able to identify separation reliably. However, in most countries divorce only happens once the process of separation has settled which, in most cases, occurs a long time after the initial break-up. Aim: It has been hypothesised that separation might carry a far greater risk of suicide than divorce. The present study investigates the impact of separation on suicide risk by taking into account the effects of age and gender. Methods: The incidence of suicide associated with marital status, age and gender was determined by comparing the Queensland Suicide Register (a large dataset of all suicides in Queensland from 1994 to 2004) with the QLD population through two different census datasets: the Registered Marital Status and the Social Marital Status. These two registries permit the isolation of the variable 'separated' with great reliability. Results: During the examined period, 6062 persons died by suicide in QLD (an average of 551 cases per year), with males outnumbering females by four to one. For both males and females separation created a risk of suicide at least 4 times higher than any other marital status. The risk was particularly high for males aged 15 to 24 (RR 91.62). Conclusions: This study highlights a great variation in the incidence of suicide by marital status, age and gender, which suggests that these variables should not be studied in isolation. Furthermore, particularly in younger males, separation appears to be strongly associated with the risk of suicide. (C) 2008 Elsevier B.V. All rights reserved.