[Suicide attempts in Brittany (France). Distribution at the regional level]

A prospective study on para-suicide has been conducted in all 4 "départements" of a french region, Brittany. This paper analyses the distribution of the sociodemographic data collected in one of the "département" of the region, Ille-et-Vilaine. The comparison between urban and rural areas is presented.

Parasuicide was defined as any autoaggressive act which required to be taken in charge either medically or surgically, independently of the nature and seriousness of the somatic consequences. Patients included in the study were over ten years of age.

Three types of ratios have been calculated: the crude incidence ratios obtained by dividing the total number of events of parasuicide (including repeated admissions for the same individual) by the number of individuals in the catchment area; the age-specific ratios, for which the denominator consists of all the persons of particular age-group in the area and the standardized ratios, for which the total number of parasuicide events in each "département" has been reported to the french population (general population census 1990) taken as a reference, in order to eliminate the influence of the age structure. Comparisons between the general population and the one of parasuicidal patients in the area, were done using a chi-square test. GEOGRAPHICAL COMPARISON: Crude incidence rates of parasuicides calculated for each "département" in Brittany are compared with recent figures published for other parts of France.

2,040 persons domiciled in the "département" were admitted in one of the emergency wards of Ille-et-Vilaine during the year 1990. The crude incidence rates of parasuicides in Ille-et-Villaine was of 2.4/1,000 for men and 3.8/1,000 for women, 3.7/1,000 for men and 5.4/1,000 for women residing in the town of Rennes. The sex ratio is 1.8 female/male in the "département" and 1.7 in town. DEMOGRAPHIC DATA: In the male group, the incidence ratio was maximum for the 25-34 years old (4.2/1,000). In the female group, there was no significant difference between the ratio for the 15-24 and the 25-34 years old (5.9/1,000). For each age group, the ratios are higher for the women. The specific rates of parasuicide calculated in the breton towns of more than 50,000 inhabitants are twice as high as those calculated for the whole region. MARITAL STATUS: The marital status is correlated to the incidence rates of parasuicide events for both sexes (p < 0.001). The incidence of parasuicide is higher for married, single and/or divorced women than for men. One notes the high impact of divorce on parasuicide events for men (10.1/1/1,000) and women (11.8/1,000). The correlation is significative (p < 0.001). In contrast, rates of parasuicides are higher for widows than for widowers. OCCUPATION: The incidence rate of parasuicide is 8 times higher for unemployed men and twice as high for unemployed women than for those having an occupation (regular or temporary). Unemployment is significatively linked with the occurrence of parasuicides (p < 0.001). PLACE OF ABODE: Comparative rates in towns (calculated for both sexes together) and twice as high as those observed in rural districts. GEOGRAPHICAL COMPARISON: The crude incidence rates in various french "département" vary from 0.8 to 2.4/1,000 for men and from 1.7 to 3.8/1,000 for women. The highest rates are observed for both sexes in Ille-et-Vilaine. In Rennes, the standardized ratios of parasuicide among men are maximum for the 35-44 years old (7.68/1,000) and decrease drastically after the age of 45. Among the women, the ratios are nearly identical for the 25-34 and the 35-44 years old (9.90 and 9.87/1,000).

The survey conducted in 1990 confirms the overall conclusions drawn in previous surveys on parasuicide in France or in other countries. The distribution of the incidence rates of parasuicide among single and unemployed and the percentages of single or unemployed persons is weak but not at random. An increase of the incidence rates among single women and unemployed men is concomitant with higher percentages of single women and unemployed men in the general population. One cannot infer the existence of a cause effect relationship, and these indicators may only be confounding factors.