Matsumoto Ryusuke, Motomura Eishi, Shiroyama Takashi, Okada Motohiro
Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan.
BJPsych Open. 2023 Dec 19;10(1):e16. doi: 10.1192/bjo.2023.616.
The Japanese Government programme 'General Principles of Suicide Prevention Policy' (GPSPP) contributed to decreasing suicide mortality rates (SMRs) before the COVID-19 pandemic, but they increased after the pandemic.
To identify risk factors for youth suicide and the impact of GPSPP on youth suicide.
Annual suicide numbers during 2007-2022 were obtained from government databases. SMRs of student and non-student youths were analysed with a linear mixed-effects model. Interrupted time-series analysis was conducted to investigate temporal relations between three GPSPP periods and SMRs with 52 suicide motives among high school, special vocational school and university students. Multiple regression analysis was conducted to investigate the influence of grade repetition on university student SMRs.
Non-student youth SMRs were higher than student SMRs. School-related (worrying about the future/underachievement), health-related (mainly mental illness) and family-related (conflict with parent and severe verbal reprimands) motives were major motives for student SMRs. During the first GPSPP period (2007-2012), no student SMRs decreased. During the second period (2012-2017), university and special vocational school student SMRs increased, but high school student SMRs were unchanged. In contrast, during the third period (2017-2022), with the exception of male special vocational school students, all SMRs increased. Unexpectedly, long-term grade repetition was negatively associated with health-related SMRs.
These findings suggest that GPSPP-supported programmes in schools partially contributed to student suicide prevention. To suppress increasing student SMRs, social/life support specialists should participate in in-school support services to bolster the social standing and lives of students who repeat grades or experience setbacks.
日本政府的“自杀预防政策总则”（GPSPP）计划在新冠疫情大流行之前有助于降低自杀死亡率，但在疫情之后自杀死亡率有所上升。
确定青少年自杀的风险因素以及GPSPP对青少年自杀的影响。
从政府数据库中获取2007年至2022年的年度自杀人数。使用线性混合效应模型分析学生和非学生青少年的自杀死亡率。进行中断时间序列分析，以研究GPSPP的三个阶段与高中生、特殊职业学校学生和大学生中52种自杀动机的自杀死亡率之间的时间关系。进行多元回归分析，以研究留级对大学生自杀死亡率的影响。
非学生青少年的自杀死亡率高于学生的自杀死亡率。与学校相关（担心未来/学业成绩不佳）、与健康相关（主要是精神疾病）和与家庭相关（与父母冲突和严厉的言语斥责）的动机是学生自杀死亡率的主要动机。在GPSPP的第一个阶段（2007 - 2012年），学生自杀死亡率没有下降。在第二个阶段（2012 - 2017年），大学生和特殊职业学校学生的自杀死亡率上升，但高中生的自杀死亡率没有变化。相比之下，在第三个阶段（2017 - 2022年），除男性特殊职业学校学生外，所有自杀死亡率都有所上升。出乎意料的是，长期留级与与健康相关的自杀死亡率呈负相关。
这些发现表明，学校中由GPSPP支持的计划在一定程度上有助于预防学生自杀。为了抑制学生自杀死亡率的上升，社会/生活支持专家应参与校内支持服务，以提升留级或经历挫折的学生的社会地位和生活质量。
