The effect of altitude and climate on the suicide rates in Turkey

https://doi.org/10.1016/j.jflm.2017.12.012Get rights and content

Highlights

  • Altitude is one of the factors that increase suicide rates in females.

  • Cold affects female suicide rates.

  • Seasonal temperature changes exceeding 25 °C increases female suicide rates.

Abstract

Suicide is one of the most important public health problems. There was an association between suicide and several factors such as psychiatric diseases and psychological characteristics, somatic illness, cultural, socioeconomic, familial, occupational and individual risk factors. Also, high altitude and climatic factors including high temperature, cloudiness, more sunshine and low rainfalls were defined as some of these risk factors in the literature.

In this study, we aimed to investigate correlation between suicide rates and altitudes of all cities in Turkey and between suicide rates and climatic factors including Rainfall Activity Index, Winter Mean Temperatures, Summer Mean Temperatures and Temperature Difference between January and July previously defined by several authors in the broad series in Turkey.

In Turkey, 29865 suicidal deaths occurred in 10 years period between 2006 and 2015. Of them, 21020 (70.4%) were males and 8845 (29.6%) were females. In this study, we found that high altitude above 1500 m, winter median temperature lower than −10 °C and hard temperature changes above 25 °C between winter and summer of settlements were important factors that affected on female suicide rates appropriate to knowledge which defined in previous studies.

In conclusion, we suggested that the associations among suicide rates with altitudes and climate should be studied in wider series obtained from different countries for reaching more reliable results.

Introduction

Suicide is one of the most important public health problems. According to the estimation of World Health Organization, approximately 804000 people died of suicide worldwide in 2012, and an annual global age-standardized suicide rate was calculated as 11.4 per 100000 population.1

The association between suicide and several factors such as psychiatric diseases and psychological characteristics [mood disorders (major depressive episode and dysthymia), anxiety disorders (panic disorder, agoraphobia, post-traumatic stress disorder, generalized anxiety disorder, specific phobia, social phobia) and alcohol or drug abuse and dependence, the loss of a loved one, etc.],2., 3., 4., 5. somatic illness, cultural (honor, religion, political factors and cultural attitudes, etc.), socioeconomic (economic problems, poor financial status, insufficient social support, low gross domestic product per capita, unemployment, etc.), familial (divorce, familial conflicts, infertility and fertility, inequalities, etc.), occupational (employment and problems at work) and individual (gender, age, region, country) risk factors were well-defined in the previous studies.5,6

In the literature, strong positive correlation between high altitudes and suicide rates was recorded. It was reported that depression and suicide rates increase in high altitude due to hypoxia. Additionally, depression, panic disorder and anxiety disorders are associated with high altitudes and they are important risk factors of suicides.7., 8., 9.

Also it was reported in many studies that there was a positive or negative correlation between suicide rates and several components of climatic effect such as high temperature or temperature alteration,10., 11., 12., 13., 14., 15., 16., 17., 18., 19., 20., 21. sunshine,10,11,14,16,18., 19., 20., 22., 23.,22,23 cloudiness,10,11 rainfalls,10,11,18,19 etc.

In this study, we aimed to investigate correlation between suicide rates and altitudes of all cities in Turkey and between suicide rates and climate factors including Rainfall Activity Index, Winter Mean Temperatures, Summer Mean Temperatures and Temperature Difference between January and July were previously defined by several authors in broad series in Turkey.

Section snippets

Material and methods

In this study, the data were extracted for “suicide number for each years and each city” and “population number for each years and each city” between 2006 and 2015 years from web pages of the Turkish Statistical Institute (TURKSTAT) of the Republic of Turkey.24 Crude suicide rates for per 100000 population for each years and each of 81 cities in Turkey were calculated and mean suicide rates was found for 10 years.

After mean altitudes were calculated for every city on the basis of city altitude

Results

In Turkey, 29865 suicidal deaths occurred in 10 years period between 2006 and 2015. Of them, 21020 (70.4%) were males and 8845 (29.6%) were females. Mean suicidal death rates for 10 years were calculated as 5.6 (per 100000 population) in males, 2.4 (per 100000 population) in females and 4.0 (per 100000 population) totally. When we investigated the changes of suicide rates annually, it was seen that it increased 1.1 per 100000 population in males, decreased 0.6 per 100000 population in females

Discussion

In Turkey, the suicide rates (per 100000 population) were reported as 3.5 in 1996 and 4.8 in 2005 for males, 2.2 in 1996 and 2.7 in 2005 for females and 2.9 in 1996 and 3.8 in 2005 for total population in previous decade.5 In the present study, it was found that these rates increased from 4.8 to 5.9 in males, decreased from 2.8 to 2.2 in females and increased from 3.8 to 4.1 in total population between 2006 and 2015. Also, 70.4% of the suicides was males whilst this rate was 61.1% in previous

Conclusion

Suicides, one of the most serious actions against human life, are associated with multiple risk factors. High altitude and climatic factors including high temperature, cloudiness, more sunshine and low rainfalls were defined as some of these risk factors in the literature. In this study, we found that high altitude above 1500 m, winter median temperature lower than −10 °C and hard temperature changes above 25 °C between winter and summer of settlements were important factors that affected on

References (37)

  • World Health Organization

    Preventing Suicide: A Global Imperative

    (2014)
  • B. Foote et al.

    Dissociative disorders and suicidality in psychiatric outpatients

    J Nerv Ment Dis

    (2008 Jan)
  • L. Brådvik et al.

    Long-term suicide risk of depression in the Lundby cohort 1947-1997–severity and gender

    Acta Psychiatr Scand

    (2008 Mar)
  • M. Asirdizer et al.

    Suicides in Turkey between 1996 and 2005: general perspective

    Am J Forensic Med Pathol

    (2010 Jun)
  • M. Asirdizer et al.

    Do regional risk factors affect the crude suicidal mortality rates in Turkey?

    J Med

    (2009)
  • M. Ishikawa et al.

    Community-based study among elderly high-altitude residents in the himalayan regions

    Cult Med Psychiatr

    (2016 Mar)
  • K.K. Fiedler et al.

    Cocaine use in the past year is associated with altitude of residence

    J Addiction Med

    (2012 Jun)
  • W.T. Roth et al.

    High altitudes, anxiety, and panic attacks: is there a relationship?

    Depress Anxiety

    (2002)
  • Cited by (12)

    • Evaluation of the effects of altitude on biological signatures of inflammation and anxiety- and depressive-like behavioral responses

      2021, Progress in Neuro-Psychopharmacology and Biological Psychiatry
      Citation Excerpt :

      Living at altitude has been associated with increased reward benefits of drugs of abuse, including cocaine (Fiedler et al., 2012) and methamphetamine (Kim et al., 2014), as well as opioid overdose in both males and females (Ombach et al., 2019). Altogether, animal and human data are consistent with the hypothesis that hypobaric hypoxia associated with living at altitude alters hedonic behavior, including dopaminergic reward signaling, contributing to increased drug reward and risk of depression (Grover et al., 1986; DelMastro et al., 2011; Gamboa et al., 2011) and suicidal behavior (Asirdizer et al., 2018; Alameda-Palacios et al., 2015; Brenner et al., 2011; Haws et al., 2009; Helbich et al., 2013; Kim et al., 2011; Ortiz-Prado et al., 2017). In contrast to previous studies (Kanekar et al., 2015), we did not observe consistent depressive-like behavioral responses in female Sprague Dawley rats exposed to lower partial pressures of inspired oxygen.

    • Suicides in Turkey: 25-year trend (1995–2019)

      2022, Journal of Forensic Sciences
    View all citing articles on Scopus
    View full text