Akazawa Masato, Matsumoto Toshihiko, Tachimori Hisateru, Takeshima Tadashi
Department of Mental Health Administration, National Institute of Mental Health, National Center of Neurology and Psychiatry.
Seishin Shinkeigaku Zasshi. 2010;112(8):720-33.
Alcohol abuse is a well-known risk factor for suicide, as alcohol-related problems can deteriorate the medical and psychosocial conditions of individuals. Furthermore, the pharmacological effect of alcohol can cause impulsive behavior. However, few studies have investigated the association of alcohol-related problems with suicide or suicide-related mental health problems in a Japanese population. This study aimed to investigate suicidal behavior and factors influencing the mental health of people with alcohol-related problems. We conducted a self-reporting survey of members of alcohol abstinence self-help groups in Japan, "Danshu-kai". Of those members who attended meetings held during April and June 2009, 4,616 (rate of consent, 85.1%; 4064 males, 518 females, and 34 undetermined; mean age +/- SD, 60.2 +/- 10.9 years) participated in our study. The questionnaire sought the following information: gender, age, living with someone, marriage, jobs, present family relationships, health condition, history of attending the Danshu-kai meeting, family histories of alcohol-related problems, duration of abstinence, and history of suicide-related phenomena. A total of 44.2% of the subjects reported they had experienced suicidal thoughts, 24.6% had planned suicide, with 21.6% having attempted suicide. Seventy parcent of these phenomena occurred before participation in Danshu-kai. We also collected Kessler 10 (K10) scores, the self reporting scale for screening depressive and anxiety disorders. We classified subjects into two groups, those with a poor or favorable mental health according to the total K10 score cutoff, and analyzed factors predicting the present mental health condition. Multivariate logistic regression analyses demonstrated that age, physical health, and parental histories of alcohol-related problems were significantly associated with the present mental health condition in both genders. However, jobs, present family relationships, history of attending the Danshu-kai meeting, and duration of abstinence were also significantly associated, but only in males. In conclusion, it is important to cooperate with self help groups such as Danshu-kai to highlight the association between alcohol-related problems and suicide. Furthermore, early intervention for individuals with alcohol-related problems before there is progression of any medical and/or psychosocial damage may prevent future suicides among alcoholics.
酗酒是一个众所周知的自杀风险因素，因为与酒精相关的问题会使个体的身体状况和心理社会状况恶化。此外，酒精的药理作用会导致冲动行为。然而，很少有研究调查在日本人群中与酒精相关的问题与自杀或自杀相关心理健康问题之间的关联。本研究旨在调查有与酒精相关问题的人群的自杀行为及影响其心理健康的因素。我们对日本戒酒自助组织“Danshu-kai”的成员进行了一项自我报告调查。在2009年4月至6月期间参加会议的成员中，有4616人（同意率为85.1%；男性4064人，女性518人，34人未确定；平均年龄±标准差，60.2±10.9岁）参与了我们的研究。问卷寻求了以下信息：性别、年龄、是否与他人同住、婚姻状况、工作、当前家庭关系、健康状况、参加Danshu-kai会议的历史、酒精相关问题的家族史、戒酒持续时间以及自杀相关现象的历史。共有44.2%的受试者报告他们曾有过自杀念头，24.6%曾计划自杀，21.6%曾尝试自杀。这些现象中有70%发生在参加Danshu-kai之前。我们还收集了凯斯勒10项量表（K10）得分，这是一种用于筛查抑郁和焦虑障碍的自我报告量表。我们根据K10总分临界值将受试者分为心理健康状况差或良好的两组，并分析了预测当前心理健康状况的因素。多因素逻辑回归分析表明，年龄、身体健康状况以及父母的酒精相关问题家族史在男女两性中均与当前心理健康状况显著相关。然而，工作、当前家庭关系、参加Danshu-kai会议的历史以及戒酒持续时间也显著相关，但仅在男性中如此。总之，与Danshu-kai这样的自助组织合作以突出与酒精相关的问题和自杀之间的关联很重要。此外，在任何身体和/或心理社会损害进展之前对有酒精相关问题的个体进行早期干预，可能会预防未来酗酒者中的自杀行为。
