Citation

Hirokawa S, Kawakami N, Matsumoto T, Inagaki A, Eguchi N, Tsuchiya M, Katsumata Y, Akazawa M, Kameyama A, Tachimori H, Takeshima T. J. Affect. Disord. 2012; 140(2): 168-175.

Affiliation

National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.jad.2012.02.001

PMID

22391515

Abstract

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.

Language: en