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Meta-Analysis
. 2013;8(1):e51333.
doi: 10.1371/journal.pone.0051333. Epub 2013 Jan 16.

Long-term unemployment and suicide: a systematic review and meta-analysis

Allison Milner  1 , Andrew Page, Anthony D LaMontagne
Affiliations
Meta-Analysis

Long-term unemployment and suicide: a systematic review and meta-analysis

Allison Milner et al. PLoS One. 2013.

Abstract

Purpose: There have been a number of reviews on the association+ between unemployment and suicide, but none have investigated how this relationship is influenced by duration of unemployment.

Method: A systematic review and meta-analysis was conducted of those studies that assessed duration of unemployment as a risk factor for suicide. Studies considered as eligible for inclusion were population-based cohort or case-control designs; population-based ecological designs, or hospital based clinical cohort or case-control designs published in the year 1980 or later.

Results: The review identified 16 eligible studies, out of a possible 10,358 articles resulting from a search of four databases: PubMed, Web of Knowledge, Scopus and Proquest. While all 16 studies measured unemployment duration in different ways, a common finding was that longer duration of unemployment was related to greater risk of suicide and suicide attempt. A random effects meta-analysis on a subsample of six cohort studies indicated that the pooled relative risk of suicide in relation to average follow-up time after unemployment was 1.70 (95% CI 1.22 to 2.18). However, results also suggested a possible habituation effect to unemployment over time, with the greatest risk of suicide occurring within five years of unemployment compared to the employed population (RR = 2.50, 95% CI 1.83 to 3.17). Relative risk appeared to decline in studies of those unemployed between 12 and 16 years compared to those currently employed (RR = 1.21, 95% CI 1.10 to 1.33).

Conclusion: Findings suggest that long-term unemployment is associated with greater incidence of suicide. Results of the meta-analysis suggest that risk is greatest in the first five years, and persists at a lower but elevated level up to 16 years after unemployment. These findings are limited by the paucity of data on this topic.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Search strategy following PRISMA guidelines.
Figure 2
Figure 2. Forest plot of suicide risk following unemployment, follow up over time, results of meta-analysis.
Reference is the employed population.
See this image and copyright information in PMC

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