Psychiatric assessment of suicide attempters in Japan: a pilot study at a critical emergency unit in an urban area.
BACKGROUND
The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan.


METHODS
Three hundred and twenty consecutive cases of attempted suicide who were admitted to an urban emergency department were interviewed, with the focus on psychosocial background and DSM-IV diagnosis. Moreover, they were divided into two groups according to the method of attempted suicide in terms of lethality, and the two groups were compared.


RESULTS
Ninety-five percent of patients received a psychiatric diagnosis: 81% of subjects met the criteria for an axis I disorder. The most frequent diagnosis was mood disorder. The mean age was higher and living alone more common in the high-lethality group. Middle-aged men tended to have a higher prevalence of mood disorders.


CONCLUSIONS
This is the first large-scale study of cases of attempted suicide since the dramatic increase in suicides began in Japan. The identification and introduction of treatments for psychiatric disorders at emergency departments has been indicated to be important in suicide prevention.
Yamada
Tomoki
T
Department of Psychiatry, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. tomokin@urahp.yokohama-cu.ac.jp
Kawanishi
Chiaki
C
Hasegawa
Hana
H
Sato
Ryoko
R
Konishi
Akiko
A
Kato
Daiji
D
Furuno
Taku
T
Kishida
Ikuko
I
Odawara
Toshinari
T
Sugiyama
Mitsugi
M
Hirayasu
Yoshio
Y
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D013406:Suicide, Attempted / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D014505:Urban Population