title: Outcomes of community-based screening for depression and suicide prevention among Japanese elders.
abstract: OBJECTIVE
  In this study we evaluate outcomes of a community-based program to prevent suicide among elderly individuals aged 65 and older.
  
  
  METHODS
  We used a quasi-experimental design with intervention and referent municipalities. The program included a 7-year implementation of depression screening with follow-up by general practitioners and a 10-year implementation of public education conducted in Yasuzuka (population 4,940; elderly suicide rate for women, 275/100,000; for men, 323/100,000). We estimated changes in the risk of completing suicide before and after the 10-year implementation by the incidence-rate ratio (IRR).
  
  
  RESULTS
  The risk for women in the intervention area was reduced by 64% (age-adjusted IRR=0.36; 95% confidence interval=0.14-0.93), whereas there was no significant change in the risk for men in the intervention area and either men or women in the referent municipalities. A ratio of the IRR for women aged 65 to 74 in the intervention area to that in its prefecture was estimated at 0.23 (90% confidence interval=0.05-0.99), showing that the risk reduction was greater than the secular trend.
  
  
  CONCLUSIONS
  The management of depression by use of community resources involving public health and primary care physicians is effective in the prevention of suicide for elderly women but uncertain for men.
authors.affiliation: Faculty of Health Sciences, Aomori University of Health and Welfare, 58-1, Mase Hamadate, Aomori 030-8505, and National Nishigunma Hospital, Shibukawa, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Oyama
authors.forename: Motoi
authors.initials: M
authors.lastname: Fujita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Goto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shibuya
authors.forename: Tomoe
authors.initials: T
authors.lastname: Sakashita
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention