title: Relationships between suicidal ideation and psychosocial factors among residents living in Nagano Prefecture of Japan.
abstract: OBJECTIVE
  Feeling ashamed for seeking help when distressed is known to be a critical factor promoting suicidal behaviors. The objective of this study was to examine the relationship between suicidal ideation and psychosocial factors, including worries or anxieties, having a person to confide in, feeling ashamed for seeking help when distressed, and K6 score.
  
  
  METHODS
  Fourteen out of 77 municipalities from Nagano Prefecture participated in this questionnaire survey. Participants of both sexes over 20 years of age were randomly selected according to age distribution in each municipality. Association between suicidal ideation and sociodemographic and psychosocial factors, including "feeling ashamed for seeking help", were determined by multiple logistic regression analysis.
  
  
  RESULTS
  Among a total of 11,100 participants, 7394 (66.6%) returned the questionnaire. 2147 participants responded properly to essential study parameters and were submitted to the final analyses. The adjusted odds ratio of suicidal ideation was 2.09 (95% CI 1.49-2.94) among participants feeling ashamed for seeking help, compared to those not feeling ashamed. Although the rate of "no person to confide in" was 4.4%, participants who responded with "no person to confide in" had significantly increased odds ratio of suicidal ideation compared with those who responded with "having a person to confide in" (OR 1.97, 95% CI 1.12-3.47).
  
  
  CONCLUSIONS
  Our findings suggest a need for tailored intervention targeting individuals at risk by gatekeepers to encourage individuals at risk to overcome feeling ashamed for seeking help and to cultivate an appropriate person to confide in.
authors.affiliation: Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan. tsukat@shinshu-u.ac.jp.|Department of Occupational Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan. tsukat@shinshu-u.ac.jp.
authors.forename: Teruomi
authors.initials: T
authors.lastname: Tsukahara
authors.affiliation: Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Arai
authors.affiliation: Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kamijo
authors.affiliation: Nagano Prefecture Saku Health and Welfare Office, 65-1 Atobe, Saku, Nagano, 385-8533, Japan.
authors.forename: Yoshikiyo
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Department of Psychiatry, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Washizuka
authors.affiliation: Department of Occupational Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Heihachiro
authors.initials: H
authors.lastname: Arito
authors.affiliation: Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.|Department of Occupational Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nomiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011584:Psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Feeling ashamed; Gatekeeper; K6 score; Suicidal ideation; Suicide