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Community-based screening intervention for depression affects suicide rates among middle-aged Japanese adults

Published online by Cambridge University Press:  14 February 2017

H. Oyama
Affiliation:
Department of Social Welfare, Faculty of Heath Sciences, Aomori University of Health and Welfare, Aomori, Japan
T. Sakashita
Affiliation:
Department of Social Welfare, Faculty of Heath Sciences, Aomori University of Health and Welfare, Aomori, Japan
Corresponding
E-mail address:

Abstract

Background

It has been suggested that screening interventions may be effective for suicide prevention. Few studies, however, have reported their effects on outcome measures, including death by suicide among middle-aged adults.

Method

We used a quasi-experimental parallel cluster design with matched community-based intervention and control municipalities (total eligible population: 90 000) in Japan. At-risk residents within the intervention area were invited for universal depression screening and subsequent care/support. We compared changes in suicide incidence of adults aged 40–64 years for the 4-year pre- and post-implementation periods in the intervention group with the control group and the whole country. Incidence rate ratios (IRRs) of the outcomes were adjusted for age group, gender and interaction terms, using mixed-effects negative binomial regression models. Suicide rates among intervention and control subgroups were compared.

Results

The screening procedure was offered to 52% of the intervention group, and 61% of those contacted responded over the implementation period. Suicide rates decreased more in the intervention group [IRR 0.57, 95% (CI) 0.41–0.78; F 1,36 = 12.52, p = 0.001] than the control group (IRR proportion 1.63, 95% CI 1.06–2.48; F 1,82 = 5.20, p = 0.025) or the whole country (IRR proportion 1.64, 95% CI 1.16–2.34; F 1,42 = 8.21, p = 0.006). Sensitivity analyses confirmed the results from the primary analysis. There were lower suicide rates among both respondents and non-respondents to the screening than in the control group during the implementation period.

Conclusions

Prevention efforts involved in the depression screening intervention were probably successful in reducing suicide rates.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

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References

Ajdacic-Gross, V, Weiss, MG, Ring, M, Hepp, U, Bopp, M, Gutzwiller, F, Rössler, W (2008). Methods of suicide: international suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization 86, 726732.CrossRefGoogle ScholarPubMed
Bostwick, JM, Pankratz, VS (2000). Affective disorders and suicide risk: a reexamination. American Journal of Psychiatry 157, 19251932.CrossRefGoogle ScholarPubMed
Brown, C, Battista, DR, Bruehlman, R, Sereika, SS, Thase, ME, Dunbar-Jacob, J (2005). Beliefs about antidepressant medications in primary care patients: relationship to self-reported adherence. Medical Care 43, 12031207.CrossRefGoogle ScholarPubMed
Chen, YY, Wu, KCC, Yousuf, S, Yip, PSF (2012). Suicide in Asia: opportunities and challenges. Epidemiologic Reviews 34, 129144.CrossRefGoogle ScholarPubMed
Dumesnil, H, Verger, P (2009). Public awareness campaigns about depression and suicide: a review. Psychiatric Services 60, 12031213.CrossRefGoogle ScholarPubMed
Fountoulakis, KN, Gonda, X, Rihmer, Z (2011). Suicide prevention programs through community intervention. Journal of Affective Disorders 130, 1016.CrossRefGoogle ScholarPubMed
Fukuda, K, Kobayashi, S (1973). A study on a self-rating depression scale [in Japanese]. Seishin Shinkeigaku Zasshi 75, 673679.Google Scholar
Gunnell, D, Bennewith, O, Hawton, K, Simkin, S, Kapur, N (2005). The epidemiology and prevention of suicide by hanging: a systematic review. International Journal of Epidemiology 34, 433442.CrossRefGoogle ScholarPubMed
Health and Welfare Statistics Association (2013). Annual Statistical Report of National Health Conditions, Vol. 60. Health and Welfare Statistics Association: Tokyo.Google Scholar
Hegerl, U, Althaus, D, Schmidtke, A, Niklewski, G (2006). The alliance against depression: 2-year evaluation of a community-based intervention to reduce suicidality. Psychological Medicine 36, 12251233.CrossRefGoogle Scholar
Hirokawa, S, Kawakami, N, Matsumoto, T, Inagaki, A, Eguchi, N, Tsuchiya, M, Katsumata, Y, Akazawa, M, Kameyama, A, Tachimori, H, Takeshima, T (2012). Mental disorders and suicide in Japan: a nation-wide psychological autopsy case–control study. Journal of Affective Disorders 140, 168175.CrossRefGoogle ScholarPubMed
Kawakami, N, Shimizu, H, Haratani, T, Iwata, N, Kitamura, T (2004). Lifetime and 6-month prevalence of DSM-III-R psychiatric disorders in an urban community in Japan. Psychiatry Research 121, 293301.CrossRefGoogle Scholar
Knox, KL, Litts, DA, Talcott, GW, Catalano Feig, J, Caine, ED (2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study. British Medical Journal 327, 1376.CrossRefGoogle ScholarPubMed
Luxton, DD, June, JD, Comtois, KA (2013). Can postdischarge follow-up contacts prevent suicide and suicidal behavior? A review of the evidence. Crisis 34, 3241.CrossRefGoogle Scholar
Mann, JJ, Apter, A, Bertolote, J, Beautrais, A, Currier, D, Haas, A, Hegerl, U, Lonnqvist, J, Malone, K, Marusic, A, Mehlum, L, Patton, G, Phillips, M, Rutz, W, Rihmer, Z, Schmidtke, A, Shaffer, D, Silverman, M, Takahashi, Y, Varnik, A, Wasserman, D, Yip, P, Hendin, H (2005). Suicide prevention strategies: a systematic review. Journal of the American Medical Association 294, 20642074.CrossRefGoogle ScholarPubMed
Mayo, E (1993). The Human Problems of an Industrial Civilization, vol. 3, 2nd edn, Macmillan: New York.Google Scholar
Milner, AJ, Carter, G, Pirkis, J, Robinson, J, Spittal, MJ (2015). Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide. British Journal of Psychiatry 206, 184190.CrossRefGoogle ScholarPubMed
Ministry of Health, Labour and Welfare of Japan (2014). Vital Statistics of Japan 2014. Health and Welfare Statistics Association, Tokyo.Google ScholarPubMed
Nakanishi, M, Yamauchi, T, Takeshima, T (2015). National strategy for suicide prevention in Japan: impact of a national fund on progress of developing systems for suicide prevention and implementing initiatives among local authorities. Psychiatry and Clinical Neurosciences 69, 5564.CrossRefGoogle ScholarPubMed
Nakao, M, Takeuchi, T, Yoshimasu, K (2008). A proposed approach to suicide prevention in Japan: the use of self-perceived symptoms as indicators of depression and suicidal ideation. Environmental Health and Preventive Medicine 13, 313321.CrossRefGoogle Scholar
Ono, Y, Sakai, A, Otsuka, K, Uda, H, Oyama, H, Ishizuka, N, Awata, S, Ishida, Y, Iwasa, H, Kamei, Y, Motohashi, Y, Nakamura, J, Nishi, N, Watanabe, N, Yotsumoto, T, Nakagawa, A, Suzuki, Y, Tajima, M, Tanaka, E, Sakai, H, Yonemoto, N (2013). Effectiveness of a multimodal community intervention program to prevent suicide and suicide attempts: a quasi-experimental study. PLoS ONE 8, e74902.CrossRefGoogle ScholarPubMed
Otsubo, T, Tanaka, K, Koda, R, Shinoda, J, Sano, N, Tanaka, S, Aoyama, H, Mimura, M, Kamijima, K (2005). Reliability and validity of Japanese version of the Mini-International Neuropsychiatric Interview. Psychiatry and Clinical Neurosciences 59, 517526.CrossRefGoogle ScholarPubMed
Rutz, W, von Knorring, L, Wålinder, J (1992). Long-term effects of an educational program for general practitioners given by the Swedish Committee for the Prevention and Treatment of Depression. Acta Psychiatrica Scandinavica 85, 8388.CrossRefGoogle ScholarPubMed
Sakashita, T, Oyama, H (2011). Impact of the invitation process for depression screening using a self-report questionnaire on its performance and accessibility [in Japanese]. Seishin Igaku (Clinical Psychiatry) 53, 225233.Google Scholar
Sakashita, T, Oyama, H (2015). Overview of community-based studies of depression screening interventions among the elderly population in Japan. Aging & Mental Health 20, 231239.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 2233.Google ScholarPubMed
Szanto, K, Kalmar, S, Hendin, H, Rihmer, Z, Mann, JJ (2007). A suicide prevention program in a region with a very high suicide rate. Archives of General Psychiatry 64, 914920.CrossRefGoogle Scholar
Székely, A, Konkolÿ Thege, B, Mergl, R, Birkás, E, Rózsa, S, Purebl, G, Hegerl, U (2013). How to decrease suicide rates in both genders? An effectiveness study of a community-based intervention (EAAD). PLoS ONE 8, e75081.CrossRefGoogle Scholar
WHO (1993). The ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. World Health Organization: Geneva.Google ScholarPubMed
WHO (2014). Preventing Suicide: A Global Imperative. World Health Organization: Geneva.Google Scholar
Yamasaki, A, Sakai, R, Shirakawa, T (2005). Low income, unemployment, and suicide mortality rates for middle-age persons in Japan. Psychological Reports 96, 337348.CrossRefGoogle ScholarPubMed
Zalsman, G, Hawton, K, Wasserman, D, van Heeringen, K, Arensman, E, Sarchiapone, M, Carli, V, Höschl, C, Barzilay, R, Balazs, J, Purebl, G, Kahn, JP, Sáiz, PA, Lipsicas, CB, Bobes, J, Cozman, D, Hegerl, U, Zohar, J (2016). Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry. doi:10.1016/S2215-0366(16)30030-X.CrossRefGoogle ScholarPubMed
Zung, WWK (1965). A self-rating depression scale. Archives of General Psychiatry 12, 6370.CrossRefGoogle ScholarPubMed
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