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ABSTRACT: In addition to implementing a depression screening program, conducting a survey beforehand might contribute to suicide risk reduction for the elderly.
This study evaluates outcomes of a community-based program to prevent suicide among individuals aged 60 and over, using a quasiexperimental design with an intervention region (41,337 residents, 35.1% aged 60 and over) and a neighboring reference region.
Our 2-year intervention program included an anonymous survey by random sample in the entire intervention region and, in the second year, a depression screening with follow-up by a psychiatrist in the higher-risk districts. Changes in the risk of completed suicide were estimated by the incidence-rate ratio (IRR).
The risk for men in the intervention region was reduced by 61% (age-adjusted IRR = 0.39; 90% CI = 0.18-0.87), whereas there was a (statistically insignificant) 51% risk reduction for women in the intervention region, and no risk reduction for either men or women in the reference region. The ratio of the crude IRR for elderly men in the intervention region to that for all elderly men in Japan was estimated at 0.42 (90% CI = 0.18-0.92), showing that the risk reduction was greater than the national change.
The management of depression through a combination of an initial survey and subsequent screening holds clear promise for prompt effectiveness in the prevention of suicide for elderly men, and potentially for women.
Crisis The Journal of Crisis Intervention and Suicide Prevention 01/2010; 31(2):100-8. · 1.09 Impact Factor
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Yutaka Ono,
Shuichi Awata,
Hideharu Iida,
Yasushi Ishida,
Naoki Ishizuka,
Hiroto Iwasa,
Yuichi Kamei,
Yutaka Motohashi,
Atsuo Nakagawa,
Jun Nakamura, [......],
Hirofumi Oyama,
Akio Sakai,
Hironori Sakai,
Yuriko Suzuki,
Miyuki Tajima,
Eriko Tanaka,
Hidenori Uda,
Naohiro Yonemoto,
Toshihiko Yotsumoto, Naoki Watanabe
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ABSTRACT: To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community.
This study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals).
The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas.
UMIN Clinical Trials Registry (UMIN-CTR) UMIN000000460.
BMC Public Health 10/2008; 8:315. · 2.00 Impact Factor
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Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica 02/2008; 110(9):731-8.
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Hiroshi Ono,
Shuichi Awada,
Hideharu Iida,
Yasushi Ishida,
Naoki Ishizuka,
Hiroto Iwasa,
Yuichi Kamei,
Yutaka Motohashi,
Atsuo Nakagawa,
Jun Nakamura, [......],
Kotaro Otsuka,
Hiroshi Oyama,
Akio Sakai,
Hironori Sakai,
Yuriko Suzuki,
Miyuki Tajima,
Eriko Tanaka,
Eisuke Uda,
Naohiro Yonemoto, Naoki Watanabe
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica 01/2008; 110(3):216-21.
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ABSTRACT: Little is known about the association between depression and the buffering effects of social support in mid-life crisis. The aim of this study is to determine the buffering effects of social support on depression concerning middle-aged individuals, while also taking reciprocity and gender differences into careful consideration. A cross-sectional survey of all middle-aged individuals (40-69 years of age) using a large sample (n = 4558) from a community-living population, who resided in Rokunohe town, Aomori prefecture in northern Japan (response rate = 69.8%), was undertaken. This town recently had a lot of suicides. Two-way anova was used to analyze the effects of stressor and social support on the Center for Epidemiologic Studies Depression scale scores. The authors found a stress buffering effect of social support on the depressive symptoms occurring in middle age, however, a significant difference in the stress buffer effect was only observed in male subjects. Moreover, when the authors take reciprocity into account, the effect of the buffer on depression was found not only in males receiving support but in males providing support as well. In conclusion, pertaining to males, social support reduces depressive symptoms under stressful circumstances in middle age, not only when they receive such support but also when they provide it. Therefore, these findings suggest that reciprocal social support is important for males in relation to community mental health.
Psychiatry and Clinical Neurosciences 01/2007; 60(6):652-61. · 2.13 Impact Factor
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Hirofumi Oyama,
Yutaka Ono, Naoki Watanabe,
Eriko Tanaka,
Seijiro Kudoh,
Tomoe Sakashita,
Shinji Sakamoto,
Keiko Neichi,
Kyoko Satoh,
Kenji Nakamura,
Kimio Yoshimura
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ABSTRACT: This study aims to evaluate outcomes of a community-based program to prevent suicide among the elderly (>or=65 years old) using a quasi-experimental design with two neighboring references. During 1999-2004, the program including depression screening and group activity was conducted by the public health nurses in the Minami district (population 1685) of Nagawa town, rural Japan. Pre-post changes in the risk of completing suicide were estimated by the incidence rate ratios (IRR). The risk for Minami's elderly females was reduced by 74% (age-adjusted IRR, 0.26; 90% CI, 0.07-0.98) more than the historical trend, while there was no change in the risk of Minami's males and nor in the male or female references. The local intervention using public health nursing would be effective against suicide for elderly females without diffusing to the surroundings.
Psychiatry and Clinical Neurosciences 02/2006; 60(1):110-4. · 2.13 Impact Factor
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ABSTRACT: The lack of social support is the most common risk factor for late-life suicide. Few previous community-based interventions against the lack of social relationships reduced suicide. This study aims to evaluate outcomes of a community-based prevention program against suicide amongst the elderly in rural Japan. During 1995-2002, the program based on population strategy including group activity, psychoeducation and self-assessment of depression but no screening for depression, was implemented for elderly residents in Yuri town, Japan (5-year average population 6817; 5-year average suicide rate [> or =65 years old] 291.4/10(5)). Changes in the relative risk of suicide for individuals (> or =65 years old) before and after the 8-year implementation were estimated by the incidence rate ratio (IRR), using a quasi-experimental design with a neighboring reference, Chokai town, Japan (5-year average population 8136; 5-year average suicide rate [> or =65 years old] 216.5/10(5)). The risk of elderly females in Yuri completing suicide was reduced by 76% (age-adjusted IRR, 0.24; 95% CI, 0.10-0.58), while there was no change in the risks for Yuri's elderly males and both Chokai's elderly males and females. General loglinear analysis estimated a ratio of the female IRR in Yuri to that in its Akita prefecture of 0.35 (95% CI, 0.14-0.84), showing that the reduction of the risk in the intervention area was greater than a historical trend. A community-based suicide prevention through a group intervention designed to increase knowledge and to cultivate social relationships would be effective for elderly females but not males.
Psychiatry and Clinical Neurosciences 07/2005; 59(3):337-44. · 2.13 Impact Factor
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Geriatrics & Gerontology International 09/2004; 4(s1):S235 - S236.
