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1.
Psychiatry Clin Neurosci ; 60(6): 676-86, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17109701

ABSTRACT

In response to the rise in suicide in Japan since 1998, some suicide prevention measures in local communities have been put into action. However, in the previous suicide prevention measures, sociopsychological factors were not fully taken into consideration. In the present study, the authors surveyed sociopsychological factors relating to suicide and depression (i.e. people's coping behavior and thoughts about depression and suicidal ideation, and their attitudes toward suicide and psychiatric treatment), and their differences in gender and generations. The present study was conducted in a rural area of Japan (Town A), where the suicide rate is much higher than the national average. The authors randomly selected 10% of the residents (i.e. 532 people) aged between 40 and 79 years on the basis of resident registration. Health promotion volunteers in Town A visited these 532 people individually, distributed questionnaires, and asked them to anonymously answer the questionnaire within 4 weeks. Data from 450 residents (193 men, 257 women) were analyzed in the present study. Although there were few gender differences, some significant differences were found between the younger (40-59 years) and older (60-79 years) residents. Generally, the younger were more pessimistic about their mental health than the elderly. It was also noteworthy that about 10% of the people thought that it was natural for them to have suicidal ideation, and about 18% reported that they had experienced suicidal ideation. Some suggestions were given to provide more effective suicide prevention measures.


Subject(s)
Adaptation, Psychological , Depressive Disorder/psychology , Suicide Prevention , Suicide/psychology , Adult , Age Factors , Attitude , Data Interpretation, Statistical , Depressive Disorder/epidemiology , Depressive Disorder/therapy , Female , Health Surveys , Humans , Japan/epidemiology , Male , Middle Aged , Psychiatry , Rural Population , Suicide/statistics & numerical data , Surveys and Questionnaires
2.
Psychiatry Clin Neurosci ; 60(1): 110-4, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16472368

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.


Subject(s)
Community Mental Health Services , Depressive Disorder/diagnosis , Mass Screening , Rural Population/statistics & numerical data , Suicide Prevention , Aged , Aged, 80 and over , Cohort Studies , Cross-Sectional Studies , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Female , Humans , Incidence , Japan , Male , Outcome and Process Assessment, Health Care/statistics & numerical data , Public Health Nursing , Reference Values , Risk , Sex Factors , Suicide/psychology
3.
Psychiatry Clin Neurosci ; 59(6): 634-8, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16401236

ABSTRACT

The early detection of depression and suicidal ideation is essential for the prevention of suicide in the community. This study therefore aimed to develop a brief screen for depression and suicidal ideation that can be easily administered in primary-care settings. The Self-rating Depression Scale (SDS), the Hospital Anxiety and Depression Scale (HADS) and a modified version of the Composite International Diagnostic Interview (CIDI) were administered by 353 residents of a single community aged 64 years and over. A five-item screen was derived from SDS and HADS, using CIDI as the external criterion (study 1). The scale was modified so that it was more appropriate for our use, and was labeled the Depression and Suicide Screen (DSS). Its validity and reliability were examined among a further 382 residents of the same community aged 64 years and over, using the Short-Form Geriatric Depression Scale (GDS-S) as the external criterion (study 2). The DSS was internally consistent (Cronbach's alpha=0.62). Its reliability in detecting depression (defined as >or= 6 in GDS-S) and suicidal ideation (screened out by the inquiry by our trained staff) was 0.768 and 0.721, respectively. For depression, the sensitivity was 0.705; specificity, 0.729; positive predictive value (PPV), 0.446; negative predictive value (NPV), 0.888; and the overall diagnostic power, 0.723. For suicidal ideation, its sensitivity was 0.698; specificity, 0.693; PPV, 0.317; NPV, 0.926; and overall diagnostic power, 0.694. The DSS demonstrated a reasonable level of sensitivity and specificity in identifying both depression and suicidal ideation among the elderly within a community.


Subject(s)
Aged/psychology , Depressive Disorder/psychology , Psychological Tests , Suicide/psychology , Female , Humans , Japan , Language , Male , Psychiatric Status Rating Scales , ROC Curve , Reproducibility of Results , Surveys and Questionnaires
4.
Psychiatry Clin Neurosci ; 58(5): 522-30, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15482584

ABSTRACT

Although suicide is increasingly becoming a social problem in Japan, especially among the elderly, little early intervention or suicide prevention is done. A project was begun which, since 1999, has aimed to detect depression at an early stage as a suicide prevention measure in a model area of Town A, which had a high suicide rate. In order to promote early intervention and prevention in a community, it is important to know where residents seek help if they become depressed or have suicidal ideation. Therefore, in the present study, help-seeking behavior using case vignettes was investigated. Data from 230 residents (82 men, 148 women) in the model area of Town A, aged 65 or over, were analyzed in the present study. If participants were unable to answer by themselves due to physical condition, public health nurses read out each item and wrote in their answers. The relationship between help-seeking behavior and demographic variables, psychosocial variables, depressive symptoms and so forth, were examined. The results show that participation in mental health workshops facilitated consultation with specialists (e.g. primary care doctors and nurses). The expected effects of psychoeducation on the general public and specialists were considered.


Subject(s)
Depressive Disorder/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Rural Population/statistics & numerical data , Social Support , Suicide Prevention , Aged , Aged, 80 and over , Depressive Disorder/diagnosis , Female , Geriatric Assessment/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Humans , Japan , Male , Mass Screening , Models, Psychological , Risk Factors , Socioeconomic Factors , Suicide/psychology
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