Abstract
BACKGROUND: Knowledge of and attitudes toward suicide and depression have not been fully investigated in Japan. METHODS: Study areas comprised municipalities in northern Japan where standardized mortality ratios (SMRs) from suicide compared with a Japanese standard ranged from 1.62 to 3.72 in men and from 1.43 to 3.49 in women. We conducted a questionnaire survey on a random sample of 7,136 participants aged 20 to 79 years, and analyzed data of 5,547 (77.7%) subjects. We categorized seven municipalities, from which the subjects were drawn, into three groups according to the SMR from suicide. Self-Rating Depression Scale (SDS) score was used for evaluation of depressive states. RESULTS: The SDS score was significantly higher in the high SMR group in women, but no significant difference among the three SMR groups was observed in men. The percentage of subjects with nine years or less of education was significantly higher in the high SMR group both in men and in women. The percentage of men who drank alcohol once a week or more was significantly higher in the high SMR group. The percentages of subjects unaware that depressive states are treatable by medication were not significantly different among the three SMR groups both in men and in women, while the percentage of men unwilling to see a psychiatrist when depressed was the lowest in the high SMR group. CONCLUSION: Although a significant difference in SDS score was observed in women, most of the psychosocial factors or knowledge of and attitudes toward suicide and depression were not adversely associated with SMR group.