Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations. We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide. Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide. Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention.

中文翻译：

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瑞士各行各业的躯体和精神疾病发病率及其与自杀死亡率的关系：瑞士国家队列研究的结果（1990-2014年）。

自杀是一个重大而复杂的公共卫生问题。在瑞士，自杀每年造成约1000例死亡，是导致死亡的第四大原因。在瑞士进行的第一项全国性自杀研究确定，与瑞士总人口相比，有八项男性和四项女性职业具有统计上的自杀过量。工作时间，自雇者身份，较低的社会经济地位和职业所需的低技能水平与自杀风险增加相关。目前，我们的目标是将瑞士各职业年龄段成年人的自杀风险分布与躯体和精神疾病的患病率进行比较。我们假设某些疾病会聚集在特定的职业中，这表明在这些职业中发现的自杀可能与工作有关。我们使用了瑞士国家队列（SNC），其中包括1990年至2014年自杀身亡的10575名男性和2756名女性。我们使用国家死亡率记录估算了每个职业中16种伴随疾病的患病率，并评估了疾病分布的同质性跨职业。对于各职业的患病率显着不同的疾病，我们分析了与自杀风险分布的相关性，估计为自杀的标准死亡率（SMR）。精神和行为障碍是我们人口中最常报告的伴随疾病。在男性中，这些疾病的患病率，尤其是与物质有关的疾病和成瘾性疾病的患病率，精神病和不同职业之间的差异显着，并且与自杀的SMR相关。在男性职业中，恶性肿瘤的患病率以及肌肉骨骼系统和结缔组织疾病的患病率也有显着差异，而在女性中，对于行为不确定或未知的肿瘤以及神经系统和感觉器官疾病，则观察到这种变化，与自杀的SMR无关。某些已确定的发病率可能与职业有关，可能会对工作能力和就业能力产生负面影响，而这又可能与自杀有关。根据工作相关性以及与自杀风险的关系来区分伴随疾病对于识别与职业有关的自杀非常重要，