title: Coping behaviors and suicide in the middle-aged and older Japanese general population: the Japan Public Health Center-based Prospective Study.
abstract: OBJECTIVE
  Cross-sectional studies have shown an association between different coping styles and suicidal behavior. It is unknown whether there is any prospective association between coping behaviors and suicide in the general population.
  
  
  METHODS
  The study population consisted of participants of the Japanese Public Health Center-based Prospective Study. In the 10-year follow-up questionnaire, subjects aged 50-79 years were asked how they handle daily problems. Coping behaviors were used to determine two coping strategies (approach coping and avoidance coping). Of 99,439 subjects that returned the 10-year follow-up questionnaire, 70,213 subjects provided complete answers on coping and were included in our analyses. Cox regression models, adjusted for confounders, were used to determine the risk of committing suicide according to coping style. Mean follow-up time was 8.8 years.
  
  
  RESULTS
  Two coping behaviors were significantly associated with suicide over time: planning (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.41-0.98) and self-blame (HR, 2.20; 95% CI, 1.29-3.76). Of the coping strategies, only the avoidance coping strategy was significantly associated with suicide (HR, 2.45; 95% CI, 1.24-4.85).
  
  
  CONCLUSIONS
  For the first time, two coping behaviors and one coping strategy have been shown to have a significant prospective association with suicide in a general population.
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Thomas
authors: T
authors: Svensson
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan. Electronic address: mnminoue@m.u-tokyo.ac.jp.
authors: Manami
authors: M
authors: Inoue
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Hadrien
authors: H
authors: Charvat
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Norie
authors: N
authors: Sawada
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Motoki
authors: M
authors: Iwasaki
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Shizuka
authors: S
authors: Sasazuki
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Taichi
authors: T
authors: Shimazu
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Taiki
authors: T
authors: Yamaji
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Ai
authors: A
authors: Ikeda
authors: Gyokikai Medical Corporation, Minato-ku, Tokyo, Japan.
authors: Noriyuki
authors: N
authors: Kawamura
authors: Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Masaru
authors: M
authors: Mimura
authors: Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku Tokyo, Japan. Electronic address: stsugane@ncc.go.jp.
authors: Shoichiro
authors: S
authors: Tsugane
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012649:Self Concept; D012737:Sex Factors; D013405:Suicide / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Approach; Avoidance; Coping; Japan; Planning; Self-blame; Suicide