4.4 Article

Direct Effect of Sunshine on Suicide

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JAMA PSYCHIATRY
卷 71, 期 11, 页码 1231-1237

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AMER MEDICAL ASSOC
DOI: 10.1001/jamapsychiatry.2014.1198

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IMPORTANCE It has been observed that suicidal behavior is influenced by sunshine and follows a seasonal pattern. However, seasons bring about changes in several other meteorological factors and a seasonal rhythm in social behavior may also contribute to fluctuations in suicide rates. OBJECTIVE To investigate the effects of sunshine on suicide incidence that are independent of seasonal variation. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of data on all officially confirmed suicides in Austria between January 1,1970, and May 6, 2010 (n = 69 462). Data on the average duration of sunshine per day (in hours) were calculated from 86 representative meteorological stations. Daily number of suicides and daily duration of sunshine were differentiated to remove variation in sunshine and variation in suicide incidence introduced by season. Thereafter, several models based on Pearson correlation coefficients were calculated. MAIN OUTCOMES AND MEASURES Correlation of daily number of suicides and daily duration of sunshine after mathematically removing the effects of season. RESULTS Sunshine hours and number of suicides on every day from January 1, 1970, to May 6, 2010, were highly correlated (r = 0.4870; P < 10(-9)). After differencing for the effects of season, a mathematical procedure that removes most of the variance from the data, a positive correlation between number of suicides and hours of daily sunshine remained for the day of suicide and up to 10 days prior to suicide (r(maximum) = 0.0370; P < 10(-5)). There was a negative correlation between the number of suicides and daily hours of sunshine for the 14 to 60 days prior to the suicide event (r(minimum) = -0.0383; P < 10(-5)). These effects were found in the entire sample and in violent suicides. CONCLUSIONS AND RELEVANCE Duration of daily sunshine was significantly correlated with suicide frequency independent of season, but effect sizes were low. Our data support the hypothesis that sunshine on the day of suicide and up to 10 days prior to suicide may facilitate suicide. More daily sunshine 14 to 60 days previously is associated with low rates of suicide. Our study also suggests that sunshine during this period may protect against suicide.

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