Psychosocial classification of suicide completers by employment situation: A psychological autopsy study

Abstract

Objective This study sought to clarify psychosocial and psychiatric differences of suicide-completers dependent on their employment situation.
Methods Since December 2007, we have been conducting a Japan-wide study on suicide-completers using a psychological autopsy method, a semi-structured interview by a psychiatrist and a mental health professional including a public health nurse with the closest bereaved. Items questioned included family environment, suicide situation, life history f, labor situation, economic problems, and psychiatric diagnosis according to DSM-IV criteria at the time of death. As of July 2009, we had collected psychosocial and psychiatric information for 46 Japanese suicide cases.
Results More than half of 31 suicide-completers with a job at the time of their death were married men aged 40~59 (mean age 48.1±12.6). Many had socialdifficulties such as alcohol-related problems or debt (38.7% and 41.9%, respectively). More than sixty percent of the 15 unemployed suicide-completers were unmarried and aged 20~39 (mean age 43.4±19.9). The percentage of women in the unemployed suicide-completers was significantly higher than that for women with a job. Although social problems were not confirmed in the unemployed, the prevalence of alcohol use disorders was significantly higher in suicide-completers with a job than in those who were unemployed. However, the prevalence of schizophrenia was significantly higher in the unemployed.
Conclusions Our findings suggest that to prevent suicide of those with a job, enhanced mental health support in the workplace and a better understanding of the association between alcohol use disorders and suicide are required. To prevent suicide of those who are unemployed, mental health support for the younger generation, particularly in cases with schizophrenia, is recommended.