Skip to main content
SpringerLink
Log in

Effect of Community-based Intervention Using Depression Screening on Elderly Suicide Risk: A Meta-analysis of the Evidence from Japan

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

A systematic review was undertaken to quantify the effect of community-based depression screening (CDS) with follow-up on the completed suicide risk for residents aged 65 and over. Five quasi-experimental studies in Japanese regions with high suicide rates were included in the meta-analysis. Combined incidence rate ratios (95% confidence intervals) by the Mantel–Haenszel method and by the DerSimonian–Laird method in two homogenous studies implementing the follow-up conducted by psychiatrists were 0.30 (0.13–0.68) and 0.33 (0.14–0.80) in men, and 0.33 (0.19–0.58) and 0.33 (0.19–0.60) in women, respectively; and those in three homogenous studies implementing the follow-up conducted by general practitioners were 0.73 (0.45–1.18) and 0.74 (0.45–1.23) in men, and 0.36 (0.21–0.60) and 0.39 (0.22–0.66) in women, respectively. There are very few studies included, however, to demonstrate an association between CDS and the reduced risk, suggesting gender difference in the effectiveness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Begg, C. B., & Mazumdar, M. (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50, 1088–1101.

    Article  PubMed  CAS  Google Scholar 

  • Blow, F. C., Bartels, S. J., Brockmann, L. M., & Van Citters, A. D. (2006). Evidence-based practices for preventing substance abuse and mental health problems in older adults. Excerpt: prevention of mental health problems: suicide prevention. SAMHSA Older Americans Substance Abuse and Mental Health Technical Assistance Center, United States Department of Health and Human Services. Retrieved November 1, 2006, from http://www.samhsa.gov/OlderAdultsTAC/EBPSuicidePreventionsectionFINAL.doc.

  • Breslow, N. E., & Day, N. E. (1980). Combination of results from a series of 2 × 2 tables—control of confounding. In Statistical methods in cancer research, Vol. 1: The analysis of case control data (pp. 325–338). Lyon, France: International Agency for Health Research.

  • Cheng, A. T. A., & Lee, C. (2000). Suicide in Asia, the Far East. In K. Hawton & K. van Heeringen (Eds.), The international handbook of suicide and attempted suicide (pp. 29–48). New York: Wiley.

    Chapter  Google Scholar 

  • Conwell, Y., Duberstein, P. R., Cox, C., Herrmann, J. H., Forbens, N. T., & Caine, E. D. (1996). Relationships of age and axis I diagnoses in victims of completed suicide: A psychological autopsy study. American Journal of Psychiatry, 153, 1001–1008.

    PubMed  CAS  Google Scholar 

  • Conwell, Y., & Heisel, M. J. (2006). The elderly. In R. I. Simon & R. E. Hales (Eds.), American psychiatric textbook of suicide assessment and management. Arington (VA): American Psychiatric Publishing.

    Google Scholar 

  • DerSimonian, R., & Laird, N. (1986). Meta-analysis in clinical trials. Controlled Clinical Trials, 7, 177–188.

    Article  PubMed  CAS  Google Scholar 

  • Dombrovski, A. Y., & Szanto, K. (2005). Prevention of suicide in the elderly. Annals of Long-Term Care, 13, 25–32.

    Google Scholar 

  • Duberstein, P. R., Conwell, Y., Conner, K. R., Eberly, S., Evinger, J. S., & Caine, E. D. (2004). Poor social integration and suicide: Facts or artifact? Psychological Medicine, 34, 1331–1337.

    Article  PubMed  CAS  Google Scholar 

  • Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315, 629–634.

    PubMed  CAS  Google Scholar 

  • Greenfield, S. F., Reizes, J. M., Magruder, K. M., Muenz, L. R., Kpans, B., & Jacobs, D. S. (1997). Effectiveness of community-based screening for depression. American Journal of Psychiatry, 154, 1391–1397.

    PubMed  CAS  Google Scholar 

  • Grek, A., Moore, S., & Heisel, M. (2006). National guidelines for seniors’ mental health: The assessment of suicide risk and prevention of suicide (pp. 22–23). Canadian Coalition for Seniors’ Mental Health. Retrieved May 31, 2006, from http://www.cagp.ca/

  • Heisel, M. J. (2006). Suicide and its prevention among older adults. Canadian Journal of psychiatry, 51, 143–154.

    Google Scholar 

  • Heisel, M. J., & Duberstein, P. R. (2005). Suicide prevention in older adults. Clinical Psychology: Science and Practice, 12, 242–259.

    Article  Google Scholar 

  • Jacobs, D. G. (1999). Depression screening as an intervention against suicide. Journal of Clinical Psychiatry, 60(Suppl.), 42–45.

    PubMed  Google Scholar 

  • Jenkins, S., & Singh, B. (2000). General population strategies of suicide prevention. In K. Hawton & K. van Heeringen (Eds.), The international handbook of suicide and attempted suicide (pp. 597–615). New York: Wiley.

    Chapter  Google Scholar 

  • Light, R. J., & Pilemer, D. B. (1984). Summing up. In the scientific of reviewing research. Cambridge, Mass: Harvard University Press.

    Google Scholar 

  • Lönngvist, J. K. (2000). Psychiatric aspects of suicide behavior: Depression. In K. Hawton & K. van Heeringen (Eds.), The international handbook of suicide and attempted suicide (pp. 107–120). New York: Wiley.

    Chapter  Google Scholar 

  • Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. (2005). Suicide prevention strategies. A systematic review. Jounal of the American Medical Association, 294, 2064–2074.

    Article  CAS  Google Scholar 

  • Motohashi, Y., Kaneko, Y., & Sakai, H. (2005). Lowering suicide rates in rural Japan. Akita Journal of Public Health, 2, 105–106.

    Google Scholar 

  • Motohashi, Y., Kaneko, Y., Sakai, H., & Yamaji, M. (2007). Prevalence of depression symptoms and related risk factors for depressive symptoms among elderly persons living in a rural Japanese community: A cross-sectional study. Community Mental Health Journal, 43, 583–590.

    Article  PubMed  Google Scholar 

  • O’Connell, H., Chin, A., Cunningham, C., & Lawlor, B. A. (2004). Recent developments: Suicide in older people. British Medical Journal, 329, 895–899.

    Article  PubMed  Google Scholar 

  • Ono, Y., Tanaka, E., Oyama, H., Toyokawa, K., Koizumi, T., Shinohe, K., et al. (2001). Epidemiology of suicidal ideation and help-seeking behaviors among the elderly in Japan. Psychiatry and Clinical Neurosciences, 55, 605–610.

    Article  PubMed  CAS  Google Scholar 

  • Oxman, A. D., Cook, D. J., & Guyatt, G. H. (1994). Users’ guides to the medical literature. VI. How to use an overview. Evidence-based medical working group. Jounal of the American Medical Association, 272, 1367–1371.

    Article  CAS  Google Scholar 

  • Oyama, H., Fujita, M., Goto, M., Shibuya, H., & Sakashita, T. (2006b). Outcomes of community-based screening for depression and suicide prevention among Japanese elders. The Gerontologist, 46, 821–826.

    PubMed  Google Scholar 

  • Oyama, H., Goto, M., Fujita, M., Shibuya, H., & Sakashita, T. (2006a). Preventing elderly suicide through primary care by community-based screening for depression in rural Japan. Crisis, 27, 58–65.

    PubMed  Google Scholar 

  • Oyama, H., Koida, J., Sakashita, T., & Kudo, K. (2004). Community-based prevention for suicide in elderly by screening and follow-up. Community Mental Health Journal, 40, 249–263.

    Article  PubMed  Google Scholar 

  • Oyama, H., Ono, Y., Watanabe, N., Tanaka, E., Kudo, S., Sakashita, T., et al. (2006c). Local community intervention through depression screening and group activity for elderly suicide prevention. Psychiatry and Clinical Neurosciences, 60, 110–114.

    Article  PubMed  Google Scholar 

  • Oyama, H., Watanabe, N., Ono, Y., Sakashita, T., Takenoshita, Y., Taguchi, M., et al. (2005). Community-based suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females. Psychiatry and Clinical Neurosciences, 59, 337–344.

    Article  PubMed  Google Scholar 

  • Robins, J., Breslow, N., & Greenland, S. (1986). Estimators of the Mantel-Haenszel variance consist in both sparse data and large strata limiting models. Biometrics, 42, 311–323.

    Article  PubMed  CAS  Google Scholar 

  • Rutz, W. (2001). Preventing suicide and premature death by education and treatment. Journal of Affective Disorders, 62, 123–129.

    Article  PubMed  CAS  Google Scholar 

  • Rutz, W., von Knorring, L., Pihlgren, H., Rihmer, Z., & Walinder, J. (1995). Prevention of male suicides: Lessons from Gotland study. Lancet, 524, 345.

    Google Scholar 

  • Takahashi, Y. (1997). Culture and suicide: From a Japanese psychiatrist’s perspective. Suicide and Life-Threatening Behavior, 27, 137–147.

    PubMed  CAS  Google Scholar 

  • Takahashi, K., Naito, H., Morita, M., Suga, R., Ogura, T., & Koizumi, T. (1998). Suicide prevention for the elderly in Matsunoyama Town, Higashikubiki County, Niigata Prefecture: Psychiatric care for elderly depression in the community. Psychiatria et Neurologia Japonica, 100, 469–485.

    PubMed  CAS  Google Scholar 

  • Zung, W. W. K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 63–70.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan

    Hirofumi Oyama & Tomoe Sakashita

  2. Health Center, Keio University, Yokohama, Japan

    Yutaka Ono

  3. School of Health Sciences, Niigata University, Niigata, Japan

    Masahiro Goto

  4. Department of Pediatrics, National Niigata Hospital, Kashiwazaki, Japan

    Motoi Fujita

  5. Department of Psychiatry, Iwate Prefectural Ichinohe Hospital, Ninohe, Japan

    Junichi Koida

Authors
  1. Hirofumi Oyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomoe Sakashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yutaka Ono
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masahiro Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Motoi Fujita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Junichi Koida
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hirofumi Oyama.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oyama, H., Sakashita, T., Ono, Y. et al. Effect of Community-based Intervention Using Depression Screening on Elderly Suicide Risk: A Meta-analysis of the Evidence from Japan. Community Ment Health J 44, 311–320 (2008). https://doi.org/10.1007/s10597-008-9132-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-008-9132-0

Keywords

Search

Navigation