title: History of diabetes and risk of suicide and accidental death in Japan: The Japan Public Health Centre-based Prospective Study, 1990-2012.
abstract: OBJECTIVE
  This study looked at whether a history of diabetes mellitus (DM) is associated with a higher risk of externally caused death (by suicide and accident), using data for a large population-based prospective cohort from an Asian population.
  
  
  METHODS
  Data collected between 1990 and 2012 from the Japan Public Health Centre-based Prospective Study were analyzed, and Poisson regression models were used to calculate adjusted risk ratios (RR) for external causes of death.
  
  
  RESULTS
  The population-based cohort comprised 105,408 Japanese residents (49,484 men and 55,924 women; mean age: 51.2 [SD 7.9] years). At baseline, 3250 (6.6%) men and 1648 (3.0%) women had a history of DM. During the follow-up period, 113 external deaths (41 suicides and 72 accidents) were noted among those with a history of DM, with 1304 external deaths (577 suicides and 727 accidents) among those without such a history. A higher risk of external death (men, RR: 1.4, 95% CI: 1.2-1.8; women, RR: 1.6, 95% CI: 1.01-2.4) was observed in those with a history of DM. Also, among those aged 40-49 years (RR: 1.9, 95% CI: 1.3-2.7) and 50-59 years (RR: 1.4, 95% CI: 1.05-1.9) at baseline, the risk of external death was significantly higher in those with a history of DM.
  
  
  CONCLUSIONS
  Compared with people with no history of DM, those with such a history had a significantly greater risk of externally caused death (particularly accidental deaths) in both genders and in those aged≤59 years at baseline.
authors.affiliation: Centre for Suicide Prevention, National Institute of Mental Health, National Centre of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamauchi
authors.affiliation: Department of Neuropsychiatry, Okayama University Hospital, Shikata-cho, Kita-ku, Okayama 700-8558, Japan. Electronic address: masatoshiinagaki@okayama-u.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Inagaki
authors.affiliation: Department of Neuropsychopharmacology, National Institute of Mental Health, National Centre of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yonemoto
authors.affiliation: Epidemiology and Prevention Group, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Iwasaki
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Akechi
authors.affiliation: Epidemiology and Prevention Group, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Public Health Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iso
authors.affiliation: Department of Diabetes Research, National Centre for Global Health and Medicine, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Noda
authors.affiliation: Epidemiology and Prevention Group, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan. Electronic address: stsugane@ncc.go.jp.
authors.forename: S
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000059:Accidents / Q000401:mortality*; D000328:Adult; D002423:Cause of Death; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*
keywords: Accidents; Asian population; Cohort studies; Diabetes mellitus; Prospective studies; Suicide