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From the Aboriginal Mental Health Research Team, Culture and Mental Health Research Unit, Institute of Community and Family Psychiatry, Sir Mortimer B. Davis–Jewish General Hospital, Montreal, Que. Dr. Kirmayer is Professor and Director of the Division of Social and Transcultural Psychiatry, McGill University, Montreal, Que.; Dr. Malus is Associate Professor with the Department of Family Medicine, McGill University, and Director of the Herzl Family Practice Centre, Sir Mortimer B. Davis–Jewish General Hospital, Montreal, Que.; and Dr. Hodgins is Former Director of the Department of Public Health, Nunavik Regional Board of Health and Social Services, Kuujjuaq, Que.
Correspondence to: Dr. Laurence J. Kirmayer, Institute of Community and Family Psychiatry, 4333 Côte Ste. Catherine Rd., Montreal QC H3T 1E4; fax 514 340-7503; laurence.kirmayer{at}mcgill.ca
Background: The rate of completed suicide among Inuit in Canada has been alarmingly high in recent years, and the suicide rate among Inuit in northern Quebec has increased since 1982. Our objectives were to describe the characteristics of Inuit people who died by suicide in Nunavik between 1982 and 1996, and to identify the antecedents and correlates of completed suicide.
Methods: We carried out a case–control study of 71 people who died by suicide between 1982 and 1996 and 71 population-based living control subjects matched for sex, community of residence and age within 1 year. Comprehensive medical charts were reviewed for data on sociodemographic characteristics, medical and psychiatric history, childhood separations and family history, and use of health care services.
Results: Most of the case subjects were single males aged 15 to 24 years. The two principal means of suicide were hanging (in 39 cases [54.9%]) and gunshot (in 21 cases [29.6%]). About 33% had been in contact with medical personnel in the month before their death. The case subjects were significantly more likely than the control subjects to have received a lifetime psychiatric diagnosis (one or more of depression, personality disorder or conduct disorder) (odds ratio [OR] 4.3 [95% confidence interval (CI) 1.2–15.2]) and to have had a history of psychiatric symptoms, disorder (including solvent sniffing) or treatment (OR 3.5 [95% CI 1.4–8.7]). The case subjects had experienced more severe types of nonpsychiatric illnesses and injuries than the control subjects (p = 0.04). The case subjects had more lifetime contacts with health care services than the control subjects (p = 0.01) and were more likely than the control subjects to have had contact with health care services in the year before death of the case subject (p = 0.03), even when psychiatric diagnoses were controlled for in conditional regression analysis (OR 1.02 [95% CI 1.01–1.04] and 5.0 [95% CI 1.07–23.7] respectively).
Interpretation: Since case subjects had frequent contact with health care services, frontline medical personnel may be in a position to identify people at risk for suicide.
This article has been cited by other articles:
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  P. Bjerregaard, T. Kue Young, E. Dewailly, and S. O.E. Ebbesson Review Article: Indigenous health in the Arctic: an overview of the circumpolar Inuit population Scand J Public Health, October 1, 2004; 32(5): 390 - 395. [Abstract] [PDF]
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 M. Chui, L. N. de Tilly, R. Moulton, and D. Chui Suicidal stab wound with a butter knife Can. Med. Assoc. J., October 15, 2002; 167(8): 899 - 899. [Full Text] [PDF]
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Copyright 1995-2001, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
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