Suicide in Castellon, 2009-2015: Do sociodemographic and psychiatric factors help understand urban-rural differences?

Studies have pointed to rurality as an important factor influencing suicide. Research so far suggests that several sociodemograpic and psychiatric factors might influence urban-rural differences in suicide. Also, their contribution appears to depend on sex and age. Unfortunately, studies including a comprehensive set of explanatory variables altogether are still scare and most studies have failed to present their analyses split by sex and age groups. Also, urban-rural differences in suicide in Spain have been rarely investigated. The present study aimed at explaining rural-urban differences in suicidality in the province of Castellon (Spain). A comprehensive set of sociodemographic and psychiatric factors was investigated and analyses were split by sex and age.

The sample comprised all suicides recorded in the province of Castellon from January 2009 to December 2015 (n=343). Sociodemographic data included sex, age, and suicide method. Psychiatric data included the history of mental health service utilization, psychiatric diagnosis, suicide attempts, and psychiatric hospitalization.

Consistent with past research, suicide rates were highest in rural areas, especially in men and older people. We also found that urban-rural differences in sociodemographic and psychiatric variables were sensitive to sex and age. Our results indicated that specialized mental health service use and accessibility to suicide means might help understand urban-rural differences in suicide, especially in men. When exploring urban-rural differences as a function of age, general practitioner visits for psychiatric reasons were more frequent in the older age group in rural areas.

Study implications for suicide prevention strategies in Spain are discussed.