ArticleAnnals of internal medicine2014
Social integration and suicide mortality among men: 24-year cohort study of U.S. health professionals.
Article in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed, 83 citations in OpenAlex.
- A Pilot Randomized Trial of Engage Psychotherapy to Increase Social Connection and Reduce Suicide Risk in Later Life.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2021Trial
- Domains of Functional Impairment and Their Associations with Thwarted Belonging and Perceived Burden in Older Adults.Clinical gerontologistTrial
- Social cohesion, social capital and mental health: current evidence and future research directions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Development and validation of a computerized adaptive testing for borderline personality disorder.BMC psychiatry · 2026Article
- Marital Status, Social Integration, and Suicidal Thoughts and Behaviors in the Military Health and Well-Being Project.Journal of clinical psychology · 2026Article
- Childhood experiences and adult community participation in secular and religious contexts in 22 countries.Scientific reports · 2025Article
- The 5D indicators of suicide risk in older adults who are lonely.Annals of the New York Academy of Sciences · 2025Article
- Suicide without warning: Results from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS).Journal of mood and anxiety disorders · 2024Article
- Article
- Associations of Suicide Risk and Community Integration Among Patients With Treatment-Resistant Depression.Frontiers in psychiatry · 2022Article
- Social Disconnection in Late Life Suicide: An NIMH Workshop on State of the Research in Identifying Mechanisms, Treatment Targets, and Interventions.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2021Review
- Marital status, educational attainment, and suicide risk: a Norwegian register-based population study.Population health metrics · 2021Article
- Correlates of attendance at community engagement meetings held in advance of bio-behavioral research studies: A longitudinal, sociocentric social network study in rural Uganda.PLoS medicine · 2021Article
- How Is the Suicide Ideation in the Korean Armed Forces Affected by Mental Illness, Traumatic Events, and Social Support?Journal of Korean medical science · 2021Article
- Exposure to Suicidal Behavior and Social Support Among Sexual- and Gender-Minority Youth.Pediatrics · 2021Article
- Assessing the Determinants of the Wish to Die among the Elderly Population in Ghana.Geriatrics (Basel, Switzerland) · 2021Article
- Article
- Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region.Diagnostics (Basel, Switzerland) · 2020Article
- Anxiety, Depression, and Colorectal Cancer Survival: Results from Two Prospective Cohorts.Journal of clinical medicine · 2020Article
- The neural correlates of low social integration as a risk factor for suicide.European archives of psychiatry and clinical neuroscience · 2020Article
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundSuicide is a major public health problem. Current thinking about suicide emphasizes the study of psychiatric, psychological, or biological determinants. Previous work in this area has largely relied on surrogate outcomes or samples enriched for psychiatric morbidity.
objectiveTo evaluate the relationship between social integration and suicide mortality.
designProspective cohort study initiated in 1988.
settingUnited States.
participants34,901 men aged 40 to 75 years. MEASUREMENTS: Social integration was measured with a 7-item index that included marital status, social network size, frequency of contact, religious participation, and participation in other social groups. Vital status of study participants was ascertained through 1 February 2012. The primary outcome of interest was suicide mortality, defined as deaths classified with codes E950 to E959 from the International Classification of Diseases, Ninth Revision.
resultsOver 708,945 person-years of follow-up, there were 147 suicides. The incidence of suicide decreased with increasing social integration. In a multivariable Cox proportional hazards regression model, the relative hazard of suicide was lowest among participants in the highest (adjusted hazard ratio [AHR], 0.41 [95% CI, 0.24 to 0.69]) and second-highest (AHR, 0.52 [CI, 0.30 to 0.91]) categories of social integration. Three components (marital status, social network size, and religious service attendance) showed the strongest protective associations. Social integration was also inversely associated with all-cause and cardiovascular-related mortality, but accounting for competing causes of death did not substantively alter the findings. LIMITATIONS: The study lacked information on participants' mental well-being. Some suicides could have been misclassified as accidental deaths.
conclusionMen who were socially well-integrated had a more than 2-fold reduced risk for suicide over 24 years of follow-up. PRIMARY FUNDING SOURCE: National Institutes of Health and Robert Wood Johnson Foundation.
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