Regional Variation and Socio-Economic Determinants of Suicide Mortality in Greece before and during Economic Crisis

Background. Suicide mortality increased in Greece after the 2008 financial crisis. This study aimed to explore the regional variation of suicide mortality before and after the economic crisis, and its correlation with socio-economic and mental health-related variables factors. Methods. This is a quasi-experimental ecological study. Data from the national mortality statistics were analyzed, and standardized death rates and age-specific mortality rates were calculated. The effect of economic crisis was explored by comparing mortality rates before and after crisis onset. Pearson's and Spearman's correlation coefficients and multiple linear regression were used to assess the impact of socioeconomic and mental health-related factors on suicide mortality. Results. Trends of suicide mortality showed a rise during 2011-2014, followed by a decline during 2015-2016. Significant differences were observed between regions, ranging from 27.6% lower to 54% higher than the national average. Unemployment, income, and change of gross domestic product were significantly correlated with regional variation. No association was found with mental disorder mortality rates and psychotropic drug consumption. Conclusions. Socio-economic factors explained only a part of the suicide mortality variation. Mental health-related factors were not significantly correlated with suicide mortality. More research is needed to investigate other possible determinants of suicides.