Suicide under the Nazi-regime: A case-control study among Amsterdam Jews

Objective: Jewish suicides increased heavily under Nazi-rule. This research investigated risk factors for dying from suicide according to sociodemographic characteristics, local context, and time periods. Methods: Nazi-registration of Amsterdam residents of Jewish origin in 1941 linked to death and suicide lists. The added suicides after the Nazi-invasion (1940, n = 115) and the suicides when deportation trains ran (1942/1943, n = 182) were each matched to 25 controls using sex and age. Suicide was compared across migrant, occupational, marital, and religious status and neighborhood religiosity. Conditional logistic regression was applied, stratified by time period. Results: In 1940, immigrant (cf. native born, odds ratio (OR) 1.89, 95%CI 1.21-2.96, p = .005) and married Jews (cf. previously married) showed higher suicide risk; members of Israelite Congregations (cf. nonmembers, OR 0.35, 95%CI 0.22-0.56, p < .001) showed reduced risk. Jews living in low synagogue rate neighborhoods showed higher risk compared to those living in neighborhoods without any synagogues (OR 2.48, 95%CI 1.65-3.72, p < .001) while those living in high synagogue rate neighborhoods showed no increased risk (OR 0.58, 95%CI 0.30-1.11, p = .10). In 1942/1943, the association between religious status (OR 1.07, 95%CI 0.67, 1.72, p = .77), synagogue rate (OR 1.27, 95%CI 0.91-1.77, p = .16), immigrant status (OR 1.30, 95%CI 0.92-1.84, p = .14) and suicide attenuated; Jews in managerial/professional occupations (cf. workers) or unmarried (cf. married) showed higher risk. Conclusions: In 1940, immigrants' higher suicide risk likely indicates greater fear of Nazis while religious affiliation's lower risk might indicate a protective effect of religious belief. In 1942/1943, risk differences markedly attenuated likely indicating increased fear of Nazis among all Jews. Highlights: Religiously affiliated Jews showed reduced risk of dying from suicide after the Nazi-invasion. Jewish immigrants showed higher risk of dying from suicide after the Nazi-invasion. By 1942/1943, these risks attenuated indicating fear of the Nazis spread and nullified religion's protection.