Poor psychological health and 5-year suicide mortality: A population-based prospective cohort study

Objective: The objective was to investigate associations between the General Health Questionnaire with twelve sub-items (GHQ-12) and prospective five-year suicide mortality. The two commonly used GHQ-12 cut-offs (2/3 and 3/4) were analyzed. Method: The 2008 public health survey, which was conducted in the autumn of 2008 in Scania, southern Sweden, is based on a postal questionnaire answered by 28,198 participants, aged 18 to 80. GHQ-12 was assessed from the baseline questionnaire, and five-year prospective register data on causes of death were connected to the baseline survey. In total, 21 persons died from intentional self-inflicted injuries, and twenty of them had complete answers regarding GHQ-12. Hazard rate ratios (HRR) were analyzed in survival (Cox-) regression analyses, adjusted for age, sex, marital status and socioeconomic status (SES). Results: The prevalence of poor psychological health according to GHQ-12 with the 2/3 cut-off was 14% among men and 18% among women, and with the 3/4 cut-off it was 11% among men and 15% among women. The 2/3 cut-off yielded a HRR of 3.02 (1.14–7.98, 95% CI) which decreased to 2.44 (0.92–6.49) when adjusted for marital status and SES, and a 3/4 cut-off HRR of 3.97 (1.51–10.47) which decreased to 3.23 (1.22-1.22-8.56) when adjusted for marital status and SES. Conclusion: The results indicate high effect measures (HRRs) between GHQ12 with both cut offs and five-year suicide mortality.