title: Suicide Among Inuit: Results From a Large, Epidemiologically Representative Follow-Back Study in Nunavut.
abstract: OBJECTIVE
  The Inuit population in Canada's North has suffered from high rates of death by suicide. We report on the first large-scale, controlled, epidemiologically representative study of deaths by suicide in an Indigenous population, which investigates risk factors for suicide among all Inuit across Nunavut who died by suicide during a 4-year period.
  
  
  METHODS
  We identified all suicides by Inuit (n = 120) that occurred between January 1, 2003, and December 31, 2006, in Nunavut. For each subject, we selected a community-matched control subject. We used proxy-based procedures and conducted structured interviews with informants to obtain life histories, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I and II diagnoses, and measures of impulsive and (or) aggressive traits.
  
  
  RESULTS
  Compared with control subjects, subjects who died by suicide were more likely to have experienced childhood abuse (OR 2.38; 95% CI 1.39 to 4.08), have family histories of major depressive disorder (P = 0.002) and suicide completion (P = 0.02), and have been affected by major depressive disorder (OR 13.00; 95% CI 6.20 to 27.25), alcohol dependence (OR 2.90; 95% CI 1.59 to 5.24), or cannabis dependence (OR 3.96; 95% CI 2.29 to 6.8) in the last 6 months. In addition, subjects who died by suicide were more likely to have been affected with cluster B personality disorders (OR 10.18; 95% CI 3.34 to 30.80) and had higher scores of impulsive and aggressive traits (P < 0.001).
  
  
  CONCLUSIONS
  At the individual level, clinical risk factors for suicide among Inuit are similar to those observed in studies with the general population, and indicate a need for improved access to mental health services. The high rate of mental health problems among control subjects suggests the need for population-level mental health promotion.
authors.affiliation: Psychiatrist, McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Quebec; Assistant Professor, Department of Psychiatry, McGill University, Montreal, Quebec.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Chachamovich
authors.affiliation: Psychiatrist, James McGill Professor, and Director, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Quebec; Senior Investigator, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec.
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Kirmayer
authors.affiliation: Psychiatrist and Professor, Northern Ontario School of Medicine, Division of Clinical Sciences, Thunder Bay, Ontario.
authors.forename: John M
authors.initials: JM
authors.lastname: Haggarty
authors.affiliation: Future Fellow, School of Population Health, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Cargo
authors.affiliation: Counselling Psychologist, Thompson Rivers University, Aboriginal Education, Kamloops, British Columbia.
authors.forename: Rod
authors.initials: R
authors.lastname: Mccormick
authors.affiliation: Psychiatrist, Professor of Psychiatry, and Director, McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Quebec; Director, Quebec Network for Suicide, Mood Disorders and Comorbidities, Montreal, Quebec.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Turecki
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D003865:Major Depressive Disorder / Q000208:ethnology*; D005260:Female; D006801:Humans; D004930:Inuit / Q000208:ethnology*; D008297:Male; D015873:Northwest Territories / Q000208:ethnology; D010554:Personality Disorders / Q000208:ethnology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000208:ethnology*; D013405:Suicide / Q000208:ethnology*; D055815:Young Adult