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. METHODS: A semi-structured interview was administered by a psychiatrist and other mental health professionals for the closest bereaved of 76 suicide completers. RESULTS: Suicide completers with a history of psychiatric treatment (n = 38) were significantly younger than those without (n = 38) (P < 0.01), and a significantly higher proportion of cases in the treatment group were estimated to be suffering from schizophrenia. Further, in 57.9% of the treatment group, the fatal suicidal behavior involved overdose with prescribed psychotropic drugs. In addition, female suicide completers in the treatment group were more likely to have a history of self-harm or non-fatal suicidal behavior. CONCLUSION: Many suicide completers who received psychiatric treatment were young adults. It was common for suicide completers to overdose on prescribed drugs as a supplementary means of suicide, and many experienced self-harming behavior before death. In addition, a higher proportion of the treatment cases suffered from schizophrenia.

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.

[Psychosocial classification of suicide completers by employment situation: a psychological autopsy study].

OBJECTIVE: This study sought to clarify psychosocial and psychiatric differences of suicide-completers dependent on their employment situation. METHODS: Since December 2007, we have been conducting a Japan-wide study on suicide-completers using a psychological autopsy method, a semi-structured interview by a psychiatrist and a mental health professional including a public health nurse with the closest bereaved. Items questioned included family environment, suicide situation, life history f, labor situation, economic problems, and psychiatric diagnosis according to DSM-IV criteria at the time of death. As of July 2009, we had collected psychosocial and psychiatric information for 46 Japanese suicide cases. RESULTS: More than half of 31 suicide-completers with a job at the time of their death were married men aged 40-59 (mean age 48.1 +/- 12.6). Many had social difficulties such as alcohol-related problems or debt (38.7% and 41.9%, respectively). More than sixty percent of the 15 unemployed suicide-completers were unmarried and aged 20-39 (mean age 43.4 +/- 19.9). The percentage of women in the unemployed suicide-completers was significantly higher than that for women with a job. Although social problems were not confirmed in the unemployed, the prevalence of alcohol use disorders was significantly higher in suicide-completers with ajob than in those who were unemployed. However, the prevalence of schizophrenia was significantly higher in the unemployed. CONCLUSIONS: Our findings suggest that to prevent suicide of those with ajob, enhanced mental health support in the workplace and a better understanding of the association between alcohol use disorders and suicide are required. To prevent suicide of those who are unemployed, mental health support for the younger generation, particularly in cases with schizophrenia, is recommended.

[Psychosocial features of suicide cases with alcohol problem: a psychological autopsy study].

AIMS: Alcohol use disorder is a well-known risk factor for suicide, as alcohol problems can deteriorate the medical and psychosocial conditions of individuals. Furthermore, the pharmacological effect of alcohol can cause impulsive behavior in individuals. However, few studies have investigated the association of alcohol problems with suicide in Japan. The purpose of the present study was to investigate psychosocial and psychiatric features of suicide-completers with alcohol problems in last one year before their death. METHODS: Since December 2007, we have been conducting a Japan-wide study on suicide-completers using a psychological autopsy method, a semi-structured interview by a psychiatrist and a mental health professional including a public health nurse with the closest bereaved. Items questioned included family environment, suicide situation, history of life, labor situation, economic problems, and psychiatric diagnosis according to DSM-IV criteria at the time of death. As of December 2009, we had collected psychosocial and psychiatric information about 76 Japanese suicide cases. RESULTS: 16 suicide-completers with alcohol problems ("Alcohol problem" group 21.1%) were all males and almost middle-aged workers. The percentages of debt and accident proneness in "Alcohol problem" group were significantly higher than "Non-alcohol problem" group. In "Alcohol problem group", none of them have had treatment of alcohol dependence. The prevalence of alcohol use disorders in "Alcohol problem group" was significantly higher than in "Nonalcohol problem" group (81.2% vs. 0%). CONCLUSION: The findings of the present study suggest that it is important to improvement of psychiatric care in alcohol dependence for prevention future suicides among alcoholics. Furthermore, enlightenment the association between alcohol problems and suicide to the public and medical doctors is required.

Electronic media use and suicidal ideation in Japanese adolescents.

The present study found that a lifetime history of suicidal ideation may be significantly associated with a history of searching the Internet for information about suicide or self-injury, experiences of anxiety or emotional pain related to the use of electronic media, and adolescents' distrust of the people around them. The impact of experiences using electronic media on suicidal ideation among Japanese adolescents is discussed.

Analgesia during self-cutting: clinical implications and the association with suicidal ideation.

The present study examined the association of suicidal ideation in self-cutters with clinical features of self-cutting, using a sample of subjects from juvenile correctional institutions. Multivariate analysis revealed that male self-cutters and analgesia during self-cutting were significantly associated with a history of suicidal ideation. These results suggest that male analgesic self-cutters should be regarded as a high-risk subgroup for suicide.

Prevalences of lifetime histories of self-cutting and suicidal ideation in Japanese adolescents: differences by age.

We examined differences in the prevalence of a lifetime history of self-cutting and suicidal ideation by age among junior and senior high-school students. Histories of self-cutting and suicidal ideation were reported by 9.9% and 40.4% of the students. Among early teens, females were more likely to report suicidal ideation than males, and among late teens, females were more likely than males to report self-cutting.