[Behavior of drinking alcoholic beverages among junior and senior high school students in the area covered with Wakkanai Health Center of Hokkaido, Japan].

We conducted a survey on behavior of drinking alcoholic beverages among students in November, 2000 in the area covered with Wakkanai Health Center of Hokkaido, Japan. A questionnaire was completed by 743 junior high school students (88.9% of the study subjects) and 791 senior high school students (76.3% of the study subjects). As a result, the proportion of the students who drank more than once per month was higher in this area than in other places of Japan. For example, 90.2% and 87.9% in the male and female senior high school students of the third grade drank more than once per month. Their frequent drinking was not related to their early onset of drinking. They often drank alone or only with their friends. Frequent drinkers among the students tended to get alcohol beverages from various roots, including face-to-face salespersons in package stores, convenience stores, or bars. Frequent drinkers among the students tended to have more experienced the problems associated with drinking such as blackout and vomiting. A large proportion of the students in this area had relatively poor knowledge about harmfulness of drinking. It has been suggested that people in this area are permissive to drinking among youngsters, as compared to other places in Japan. We think that it is indispensable to communicate or educate harmfulness of drinking during adolescence for students as well as for their parents, especially, in this area.

Zung's depression scale as a predictor of death in elderly people: a cohort study in Hokkaido, Japan.

The relation between each question in the Self-rating Depression Scale (SDS) of Zung and mortality in elderly people was investigated. Subjects were 2,166 inhabitants aged from 60 to 74 years in the Hidaka district of Hokkaido Prefecture, Japan, who were the same as in our previous prospective study concerning mental depression and mortality (J. Epidemiol. 1997). They were followed until February 1996. Among the original 20 questions of the SDS, 12 ones showed significant risk ratio for mortality (those whose score was 3 or 4 vs 1 or 2; P < 0.01). The mortality of those whose average score of the 12 questions was more than 2.4 (severe depression) was 157.2 per 1,000, which was about 5.8 time as high as that of those who were not depressive (average score < 2.0). The 12 questions showed different risk ratios concerning the mortality of cancer, heart disease and cerebrovascular disease. The questions "Morning is when I feel the best" and "My heart beats faster than usual," e.g., showed a significant risk ratio only for the mortality of heart disease (3.96) and for that of cerebrovascular disease (16.49), respectively (P < 0.01). Similar results were obtained from the subjects without respective diseases at the time of survey. Using these 12 questions, the risk for death and its cause can be estimated to a certain extent, and consequently, social supports can be given more effectively and more carefully.

Mental depression and death in elderly persons.

To investigate the relationship between mental depression and death among elderly persons, a prospective study was conducted. 2,166 inhabitants aged from 60 to 74 years in the Hidaka district of Hokkaido Prefecture, Japan were employed. From December 1990 to January 1991 we estimated the degree of depression of the subjects, using the self-rating depression scale (SDS) developed by Zung. The subjects were classified into 3 groups according to the average SDS score (Group A, < 2.00; Group B, 2.00-2.39 and Group C, > or = 2.40), and were followed up periodically until February 1995 to confirm whether they were still alive. The highest mortality was noted in Group C which consisted of those who had severe depression. Their mortalities for cancer, pneumonia and suicide were significantly high. After the adjustment of age, number of current diseases, smoking state and sex, a similar tendency was noted. Mental depression increased mortality of the aged. Part of this mechanism might be explained by the suppression of immunological resistance.