title: Social support and suicidal ideation in Japan: are home visits by commissioned welfare volunteers associated with a lower risk of suicidal ideation among elderly people in the community?
abstract: OBJECTIVE
  Social support has consistently been reported to be effective in reducing suicidal ideation. This cross-sectional study was performed to determine whether home visits by commissioned welfare volunteers (i.e., organizations of community residents appointed by national or prefectural governments) are associated with a lower risk of suicidal ideation among the elderly.
  
  
  METHODS
  In August 2010, questionnaires were sent to all residents aged ≥65 years in three municipalities (n = 21,232) in Okayama prefecture, Japan, and 13,929 returned the questionnaire (response rate: 65.6%). We finally analyzed 11,218 subjects. Both home visits by commissioned welfare volunteers and suicidal ideation within the last 30 days were assessed in the questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) for suicidal ideation were calculated adjusting for age, sex, educational attainment, and marital status. We then additionally adjusted for instrumental and emotional support, separately.
  
  
  RESULTS
  The prevalence of suicidal ideation was 10.0% and higher in women than in men (11.4% vs. 8.0%). Home visits were significantly associated with a lower risk of suicidal ideation after adjusting for instrumental and emotional support, respectively (OR: 0.60, 95% CI: 0.53-0.69; OR: 0.67, 95% CI: 0.59-0.78). In sex-stratified analysis, the association was clearer for women than for men: the corresponding ORs among women were 0.55 (95% CI: 0.46-0.65) and 0.61 (95% CI: 0.52-0.73), whereas they were 0.71 (95% CI: 0.56-0.90) and 0.78 (95% CI: 0.61-0.99) among men.
  
  
  CONCLUSIONS
  Our findings suggest that home visits by commissioned welfare volunteers are significantly associated with lower suicidal ideation among the elderly, particularly in women.
authors: Okayama Prefectural Mental Health and Welfare Center, 1-1-10-101 Furugyo-cho, Naka-ku, Okayama, 703-8278, Japan, nogumasa917@gmail.com.
authors: Masayuki
authors: M
authors: Noguchi
authors: Toshihide
authors: T
authors: Iwase
authors: Etsuji
authors: E
authors: Suzuki
authors: Yoko
authors: Y
authors: Kishimoto
authors: Soshi
authors: S
authors: Takao
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012306:Risk; D012931:Social Environment; D012944:Social Support; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014838:Volunteers
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