[Psychosocial classification of suicide completers by employment situation: a psychological autopsy study].
OBJECTIVE
This study sought to clarify psychosocial and psychiatric differences of suicide-completers dependent on their employment situation.


METHODS
Since December 2007, we have been conducting a Japan-wide study on suicide-completers using a psychological autopsy method, a semi-structured interview by a psychiatrist and a mental health professional including a public health nurse with the closest bereaved. Items questioned included family environment, suicide situation, life history f, labor situation, economic problems, and psychiatric diagnosis according to DSM-IV criteria at the time of death. As of July 2009, we had collected psychosocial and psychiatric information for 46 Japanese suicide cases.


RESULTS
More than half of 31 suicide-completers with a job at the time of their death were married men aged 40-59 (mean age 48.1 +/- 12.6). Many had social difficulties such as alcohol-related problems or debt (38.7% and 41.9%, respectively). More than sixty percent of the 15 unemployed suicide-completers were unmarried and aged 20-39 (mean age 43.4 +/- 19.9). The percentage of women in the unemployed suicide-completers was significantly higher than that for women with a job. Although social problems were not confirmed in the unemployed, the prevalence of alcohol use disorders was significantly higher in suicide-completers with ajob than in those who were unemployed. However, the prevalence of schizophrenia was significantly higher in the unemployed.


CONCLUSIONS
Our findings suggest that to prevent suicide of those with ajob, enhanced mental health support in the workplace and a better understanding of the association between alcohol use disorders and suicide are required. To prevent suicide of those who are unemployed, mental health support for the younger generation, particularly in cases with schizophrenia, is recommended.
Akazawa
Masato
M
Department of Mental Health Administration, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
Matsumoto
Toshihiko
T
Katsumata
Yotaro
Y
Kitani
Masahiko
M
Hirokawa
Seiko
S
Takahashi
Yoshitomo
Y
Kawakami
Norito
N
Watanabe
Naoki
N
Hirayama
Masami
M
Kameyama
Akiko
A
Yokoyama
Yukari
Y
Takeshima
Tadashi
T
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D004651:Employment; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D013405:Suicide / Q000523:psychology*; D055815:Young Adult