Akiko Kameyama

Mental disorders and suicide in Japan: a nation-wide psychological autopsy case-control study.

BACKGROUND The purpose of the present nationwide psychological autopsy case-control study is to identify the association between mental disorders and suicide in Japan, adjusting for physical conditions. METHODS A semi-structured interview was conducted of the closest family members of 49 suicide completers and 145 gender-, age-, and municipality-matched living controls. The interview included sections of socio-demographic characteristics, physical conditions, and a psychiatric interview producing DSM-IV diagnoses of mental disorders prior to suicide (or at survey). We compared prevalences of mental disorders between the two groups, using conditional logistic regression. RESULTS A significantly higher proportion with any mental disorder was found in the suicide group (65.3%) compared to the control group (4.8%) (p=0.003, odds ratio [OR]=7.5). The population attributable risk proportion associated with mental disorder was 0.24. Mood disorder, particularly major depressive disorder, was the most strongly associated with suicide (p<0.001). Anxiety disorder, alcohol-related disorder, and brief psychotic disorder were also significantly associated with suicide (p<0.05). These patterns were unchanged after adjusting for serious chronic physical conditions. LIMITATIONS The present study had some limitations, such as small sample size, sampling bias and information bias. CONCLUSIONS Most mental disorders, particularly mood disorder, were significantly associated with a greater risk of suicide in Japan, independent of physical conditions. Mental disorders are a major target of suicide prevention programs in Japan.

Psychosocial and psychiatric characteristics of suicide completers with psychiatric treatment before death: A psychological autopsy study of 76 cases

Aim:  The present study was conducted to examine differences in psychosocial and psychiatric characteristics between suicide completers with and without a history of psychiatric treatment within the year before death, using a psychological autopsy method.

Psychosocial and psychiatric aspects of suicide completers with unmanageable debt: A psychological autopsy study

This study examined the psychosocial and psychiatric features of 16 Japanese suicide completers with unmanageable debt compared with 23 suicide completers without such debt at time of death, using a psychological autopsy method. The individuals with unmanageable debt were more likely to have been self‐employed and to have experienced divorce. They were less likely to have engaged in help‐seeking behavior, despite having mental health problems. Our findings suggest that providing comprehensive support and promoting help‐seeking behavior may be important for suicide prevention in middle‐aged men.

The effects of suicide prevention measures reported through a psychoeducational video: a practice in Japan.

Background: As the suicide rate in Japan has remained high since 1998, various suicide prevention measures have been implemented in Japanese local communities. Aims: To report our findings on the effect of a psychoeducational video as a suicide prevention measure in a Japanese rural town. Methods: Questionnaires were randomly mailed to 2,000 residents aged between 30 and 79 years. Within 4 weeks, volunteers in the town visited the residents individually and collected the questionnaires. The variables reported in this study are demographics, awareness of suicide prevention measures available in the town, whether the residents watched the video, help-seeking from advisers regarding suicidal ideation and financial problems and attitudes towards suicide. Results: We analysed data collected from 1,118 people who reported their demographics (i.e. sex, age, and job) and whether they had watched the video. By conducting a series of logistic regression and multiple regression analyses and controlling for demographic variables, we found that watching the video had substantial psychoeducational effects. Conclusion: Despite conducting a cross-sectional study, our new suicide prevention measures were considered effective for psychoeducation. However, further studies using a longitudinal design are needed.