Preventing mood disorders associated with suicide-related behaviors among small- and medium-sized enterprise workers in Japan

Although the number of people who commit suicide in Japan has continued to decline since 2009, it is still relatively high from a global perspective. Recently, suicides related to unemployment caused by coronavirus disease 2019 have increased. With increases in karoshi and industrial accidents, ensuring supportive measures for workers’ mental health has become a pressing issue. We previously examined whether screening for mood disorders, which are strongly associated with suicide-related behaviors, helps prevent suicide in small- and medium-sized enterprise employees, where mental health support is insufficient. This study builds on the findings of a previous study that mental illness screening helps identify mood disorders and may be used as a primary prevention method for suicides. A total of 1,411 consenting workers were surveyed using the Mini International Neuropsychiatric Interview. A representative module of each disease item was extracted and analyzed. The Depression, Bipolar Spectrum Diagnostic Scale, Liebowitz Social Anxiety Scale, and Sheehan Disability Scale approved by the Center for Epidemiological Studies were used for secondary assessments. Individuals with depression, bipolar disorder, dysthymia, and mood disorders were compared with a control group, and multivariate analyses were performed to investigate items that identified individuals with depression, mood dysregulation, bipolar disorder, or all-inclusive mood disorders. The adjusted odds ratios in the anxiety disorder groups were 3.2, 2.6, 2.1, and 1.8 for panic disorder, social anxiety disorder, agoraphobia, and generalized anxiety disorder, respectively, and 2.1 and 2.8 for obsessive–compulsive disorders and bulimia nervosa groups, respectively. The adjusted odds ratio in the drug-use disorder groups was 2.0 for bipolar disorder, and in the mood disorder group, it was 3.3 for anorexia nervosa, showing a significant correlation although the results were not reflected in the mood disorder group. However, the bipolar disorder and mood disorder groups may be screened individually. We found that bipolar disorder is a mental illness that cannot be overlooked; the results of the mood disorder group were comparable. These results were significantly correlated with mental illnesses that are referred to as neuroses in a conventional diagnosis. In conclusion, screening for anxiety, obsessive–compulsive, and eating disorders helps prevent mood disorders among workers. We hope that our findings will indirectly contribute to the prevention of suicide among workers.