Oyama Hirofumi, Koida Junichi, Sakashita Tomoe, Kudo Keiko
Department of Human Welfare, Ritsumeikan University, Kyoto, Japan.
Community Ment Health J. 2004 Jun;40(3):249-63. doi: 10.1023/b:comh.0000026998.29212.17.
The aim of the study was to evaluate the outcome of a community-based prevention program against suicides among the elderly aged 65 and over in the Japanese rural town of Joboji (population 7,010), using a quasi-experimental design with two neighboring control areas. During the 10-year implementation of the program based on strategies including screening for depression, follow up with mental health care or psychiatric treatment and health education on depression, the relative risks estimated by the age-adjusted odds ratios for both males and females were reduced to almost one quarter more than a regional historical trend, with a better response to education for females than for males. A community-based management for later-life depression with mental health care supported by the psychiatric treatment can be effective against suicide among the elderly for both males and females.
本研究的目的是在日本农村小镇城地寺(人口7,010),针对65岁及以上老年人开展一项基于社区的自杀预防项目,并采用准实验设计,设置两个相邻的对照区域。在该项目为期10年的实施过程中,采取了包括抑郁症筛查、心理健康护理或精神科治疗随访以及抑郁症健康教育等策略,经年龄调整的优势比估计,男性和女性的相对风险均降至几乎为区域历史趋势的四分之一,且女性对教育的反应比男性更好。由精神科治疗提供支持的基于社区的晚年抑郁症管理,对男性和女性老年人的自杀预防均有效。