title: A community-based survey and screening for depression in the elderly: the short-term effect on suicide risk in Japan.
abstract: BACKGROUND
  In addition to implementing a depression screening program, conducting a survey beforehand might contribute to suicide risk reduction for the elderly.
  
  
  OBJECTIVE
  This study evaluates outcomes of a community-based program to prevent suicide among individuals aged 60 and over, using a quasiexperimental design with an intervention region (41,337 residents, 35.1% aged 60 and over) and a neighboring reference region.
  
  
  METHODS
  Our 2-year intervention program included an anonymous survey by random sample in the entire intervention region and, in the second year, a depression screening with follow-up by a psychiatrist in the higher-risk districts. Changes in the risk of completed suicide were estimated by the incidence-rate ratio (IRR).
  
  
  RESULTS
  The risk for men in the intervention region was reduced by 61% (age-adjusted IRR = 0.39; 90% CI = 0.18-0.87), whereas there was a (statistically insignificant) 51% risk reduction for women in the intervention region, and no risk reduction for either men or women in the reference region. The ratio of the crude IRR for elderly men in the intervention region to that for all elderly men in Japan was estimated at 0.42 (90% CI = 0.18-0.92), showing that the risk reduction was greater than the national change.
  
  
  CONCLUSIONS
  The management of depression through a combination of an initial survey and subsequent screening holds clear promise for prompt effectiveness in the prevention of suicide for elderly men, and potentially for women.
authors.affiliation: Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan. h_oyama@auhw.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Oyama
authors.forename: Tomoe
authors.initials: T
authors.lastname: Sakashita
authors.forename: Kei
authors.initials: K
authors.lastname: Hojo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ono
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Tohru
authors.initials: T
authors.lastname: Takizawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Shiho
authors.initials: S
authors.lastname: Takizawa
authors.forename: Hiroichi
authors.initials: H
authors.lastname: Tasaki
authors.forename: Eriko
authors.initials: E
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D003156:Community Mental Health Services; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D018570:Risk Assessment; D012424:Rural Population; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D000092864:Suicide Prevention