Background The Republic of Korea has reported the highest suicide rate globally since 2018. Previous studies have highlighted disability as a significant risk factor for suicide. However, comprehensive examination on the association between suicide mortality and severities and types of disabilities, and on how these associations vary according to sociodemographic characteristics, health behaviours and comorbidity profiles has never been performed. Methods We performed a retrospective cohort study of a nationally representative sample of 3 591 398 individuals subject to the health check-up provided by the Korean National Health Insurance in 2009, including individuals with (n = 126 508) and without (n = 3 734 890) disabilities, and followed-up until December 2021 Results Overall, the presence of disability was associated with an increased risk of suicide mortality [hazard ratio (HR), 1.38; 95% confidence interval (CI), 1.30–1.47] compared to the absence of disability. This risk was more pronounced in individuals with Grade 1–3 disabilities (HR, 1.68; 95% CI, 1.52–1.85) than those with Grade 4–6 disabilities (HR, 1.28; 95% CI, 1.20–1.47). Among various types of disabilities, individuals with a disability associated with a mental disorder had the highest HR (HR, 4.49; 95% CI, 3.38–5.97), followed by those with visual impairment (HR, 1.47; 95% CI, 1.26–1.73), brain damage (HR, 1.45; 95% CI, 1.18–1.79), hearing impairment (HR, 1.35; 95% CI, 1.15–1.58) and extremity disability (HR, 1.30; 95% CI, 1.21–1.40). Stratified analyses revealed that the suicide risk associated with disabilities was more pronounced in individuals with specific sociodemographic characteristics and health behaviours. Conclusion Our findings highlight the need to prioritize policy efforts to address suicide mortality among people with disabilities, considering the distinct risks associated with disability types and severity.

中文翻译：

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大韩民国残疾与自杀死亡率之间的纵向关联


背景 自 2018 年以来，韩国的自杀率是全球最高的。以前的研究强调残疾是自杀的重要危险因素。然而，从未对自杀死亡率与残疾严重程度和类型之间的关联，以及这些关联如何根据社会人口学特征、健康行为和合并症概况而变化进行过全面检查。方法 我们对 2009 年接受韩国国民健康保险提供的健康检查的 3 591 398 名具有全国代表性的样本进行了回顾性队列研究，包括患有 （n = 126 508） 和没有 （n = 3 734 890） 残疾的个体，并随访至 2021 年 12 月结果 总体而言，残疾的存在与自杀死亡率风险增加相关 [风险比 （HR）， 1.38;95% 置信区间 （CI），1.30-1.47] 与无残疾相比。这种风险在 1-3 级残疾个体中更明显（HR，1.68;95% CI，1.52-1.85）比 4-6 级残疾个体（HR，1.28;95% CI，1.20-1.47）更明显。在各种类型的残疾中，与精神障碍相关的残疾个体的 HR 最高（HR，4.49;95% CI，3.38-5.97），其次是视力障碍者（HR，1.47;95% CI，1.26-1.73）、脑损伤（HR，1.45;95% CI，1.18-1.79）、听力障碍（HR，1.35;95% CI，1.15-1.58）和肢体残疾（HR， 1.30;95% CI，1.21-1.40）。分层分析显示，与残疾相关的自杀风险在具有特定社会人口学特征和健康行为的个体中更为明显。 结论考虑到与残疾类型和严重程度相关的不同风险，我们的研究结果强调了优先考虑解决残疾人自杀死亡率的政策努力的必要性。