Researchers from Tri-Service General Hospital Report Details of New Studies and Findings in the Area of Managed Care (Suicide risk among low-income household members suffering from depression: A population-based retrospective cohort study): Managed Care

2025 OCT 23 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Managed Care is the subject of a report. According to news reporting from Taipei, Taiwan, by NewsRx journalists, research stated, “Depression and suicide risk among low-income individuals not only share common epidemiological patterns but may also be driven by underlying bidirectional mechanisms. On one hand, the social causation hypothesis suggests that financial stress, food insecurity, and unstable housing significantly increase the risk of developing depression.”

The news correspondents obtained a quote from the research from Tri-Service General Hospital, “On the other hand, the social drift hypothesis indicates that depression often leads to impaired occupational functioning, job loss, and financial decline, creating a feedback loop where poverty exacerbates depression, and depression, in turn, perpetuates poverty. In this context, we hypothesized that depressed patients from low-income backgrounds would have a higher propensity for suicide, as the risk may arise both because of poverty and as a consequence of untreated or chronic depression. This is also consistent with behavioral economic evidence showing that clinical depression alters time and risk preferences and consumption-related dysfunction. We acknowledge the feedback loop where depression exacerbates poverty and vice versa, thus further increasing suicide risk among low-income individuals. To evaluate this, we utilized the Taiwan National Health Insurance Research Database to examine whether depression in low-income individuals is significantly associated with an elevated risk of suicide. The present cohort study obtained data from the National Health Insurance Research Database. From a total of 1,936,512 patients included in the Longitudinal Health Insurance Dataset between 2000 and 2015, 771 low-income participants who had suffered from depression and 3084 controls matched for gender and age were selected. Cox proportional hazard regression analysis was employed to explore the hazard ratio, and 95% confidence intervals (CIs) for low income being associated with the risk of developing psychiatric disorders during the 16-year follow-up period were calculated. Of the 771 low-income, depressed patients and 3084 control participants, 60 (8514.66 per 105 person-years) and 138 (36,269.29 per 105 person-years) developed suicidal thoughts, respectively. The Cox regression model revealed an adjusted hazard ratio (AHR) of 1.771 (95% CI = 1.289-2.432, P< .001) after adjusting for all the covariates. Depression among low-income individuals was associated with Charlson Comorbidity Index (AHR = 1.097; 95% CI = 1.004-1.186, P = 1.186). Factors of suicide methods by using Cox regression included other gases and vapors (AHR = 8.149; 95% CI = 5.926-11.196, P< .001), and cutting and piercing (AHR = 2.789; 95% CI = 2.021-3.864, P< .001). Depression and low income are independent risk factors for suicide. Depressed low-income patients are at higher risk of developing suicidal thoughts compared with depressed non-low-income patients. Among suicide methods, gases and vapors have the highest risk.”

According to the news reporters, the research concluded: “Therefore, clinicians should pay attention to the income level of depressed patients.”

For more information on this research see: Suicide risk among low-income household members suffering from depression: A population-based retrospective cohort study. Medicine, 2025;104(41). Medicine can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Elsevier - www.elsevier.com; Medicine - http://www.journals.elsevier.com/medicine/)

Our news journalists report that additional information may be obtained by contacting Chi-Hsiang Chung, Dept. of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Additional authors for this research include Chieh Sung, Chien-An Sun, Chang-Huei Tsao, Daphne Yih Ng, Tsu-Hsuan Weng, Li-Yun Fann, Fu-Huang Lin and Wu-Chien Chien.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/md.0000000000044953. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Medicine is: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.

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