A Community-based Depression Screening Intervention for Middle-aged Suicide

Suicide Clinical Trial

Official title:

Impact of a Community-based Screening and Educational Intervention for Depression on Suicide Rates Among Japanese Middle-aged Adults

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02468466
• Other study ID #: KAKENHI #70404829
• Status: Completed
• Phase: N/A
• First received: June 3, 2015
• Last updated: June 9, 2015
• Start date: January 2005
• Est. completion date: December 2012

Study information

• Verified date: June 2015
• Source: Aomori University of Health and Welfare
• Contact: n/a
• Is FDA regulated: No
• Health authority: Japan: Ministry of Education, Culture, Sports, Science and Technology
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to examine the effectiveness of a community-based depression-screening program for suicide prevention among middle-aged adults, the investigators conducted a quasi-experimental intervention study, using a parallel cluster design with communities at municipal level as the unit of allocation and individuals as the unit of analysis.

Description:

Suicide is a major cause of premature death, particularly among middle-aged adults, in the majority of Western and Asian countries. A strong association of suicide and depression often indicates the necessity of a high-risk approach for suicide prevention. Improvements in identification and treatment can lead to better depression outcomes and suicide prevention. The investigators hypothesize that a 4-year community-based intervention, consisting of universal depression screening and subsequent care support in the target areas and health education programs, would result in reduced suicide rates among the middle-aged adult population in areas with a high suicide rate.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 89700
• Est. completion date: December 2012
• Est. primary completion date: December 2012
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 36 Years to 64 Years

Eligibility

Inclusion Criteria:

• A municipal area located in the following 4 Aomori Second Medical Zones: Hachinohe, Kamitosan, Aomori, and Tsugaru.

• A municipal area with the higher suicide rate than the prefectural average.

• A municipal area having the sufficient and coverable size to serve the intervention (population 10,000-99,999).

Exclusion Criteria:

• A municipal area receiving further intervention including a depression screening for middle-aged adults.

Study Design

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Related Conditions & MeSH terms

• Suicide

Intervention

Behavioral:
• Multi-level suicide prevention programs
The intervention included both screening and educational components. The screening component invited residents aged 36-64 years to participate in a two-step screening program. In the initial screening, a self-report questionnaire were mailed to all of those residents in the priority districts with a past high suicide rate. The second stage was conducted for the participants who screened positive though a semi-structural interview. Based on the results, participants who were diagnosed with a major depressive episode were provided with a referral to a psychiatry and support for treatment adherence. Written feedback on the screening results was mailed to all respondents. The educational component was implemented through workshops open to the general public (3 times every year) and local public newsletters (twice every year) designed to improve access and adherence to treatment and to reduce stigma associated with suicide and depression.
• Suicide prevention program as usual
Usual mental health program (not including depression screening among middle-aged)

Locations

Country	Name	City	State
Japan	Control group	Fujisaki	Aomori
Japan	Intervention group	Gonohe	Aomori
Japan	Intervention group	Hashikami	Aomori
Japan	Intervention group	Hirakawa	Aomori
Japan	Control group	Hiranai	Aomori
Japan	Intervention group	Nanbu	Aomori
Japan	Intervention group	Oirase	Aomori
Japan	Control group	Owani	Aomori
Japan	Control group	Rokunohe	Aomori
Japan	Control group	Tohoku	Aomori
Japan	Control group	Towada	Aomori

Sponsors (1)

Lead Sponsor	Collaborator
Aomori University of Health and Welfare

Country where clinical trial is conducted

Japan, 

References & Publications (2)

Oyama H, Sakashita T. Differences in specific depressive symptoms among community-dwelling middle-aged Japanese adults before and after a universal screening intervention. Soc Psychiatry Psychiatr Epidemiol. 2014 Feb;49(2):251-8. doi: 10.1007/s00127-013-0735-6. Epub 2013 Jul 4. — View Citation

Oyama H, Sakashita T. Effects of universal screening for depression among middle-aged adults in a community with a high suicide rate. J Nerv Ment Dis. 2014 Apr;202(4):280-6. doi: 10.1097/NMD.0000000000000119. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in suicide rates among adults aged 40-64 years between the 4-year pre- and implementation periods.		4 years pre versus 4 years post	No
Secondary	Invitation rate in the screening component		4 years post	No
Secondary	Participation rate in the screening component		4 years post	No