Suicide among Inuit: Results from a Large, Epidemiologically Representative Follow-Back Study in Nunavut

• Published in: Canadian journal of psychiatry Vol. 60; no. 6; pp. 268 - 275
• Main Authors: Chachamovich, Eduardo, Kirmayer, Laurence J, Haggarty, John M, Cargo, Margaret, McCormick, Rod, Turecki, Gustavo
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2015; SAGE PUBLICATIONS, INC; The Canadian Psychiatric Association
• Subjects: Adult; Adult Survivors of Child Adverse Events - statistics & numerical data; Depressive Disorder, Major - ethnology; Female; Humans; Inuit; Inuits - ethnology; Male; Native peoples; Northwest Territories - ethnology; Original Research; Personality Disorders - ethnology; Psychiatry; Risk Factors; Studies; Substance-Related Disorders - ethnology; Suicide - ethnology; Suicides & suicide attempts; Young Adult; Northwest Territories; Canada; social determinants of health; Inuit; psychiatry; psychopathology; suicide
• ISSN: 0706-7437; 1497-0015; 1497-0015
• DOI: 10.1177/070674371506000605

Objective: The Inuit population in Canada's North has suffered from high rates of death by suicide. We report on the first large-scale, controlled, epidemiologically representative study of deaths by suicide in an Indigenous population, which investigates risk factors for suicide among all Inuit across Nunavut who died by suicide during a 4-year period. Methods: We identified all suicides by Inuit (n = 120) that occurred between January 1, 2003, and December 31, 2006, in Nunavut. For each subject, we selected a community-matched control subject. We used proxy-based procedures and conducted structured interviews with informants to obtain life histories, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I and II diagnoses, and measures of impulsive and (or) aggressive traits. Results: Compared with control subjects, subjects who died by suicide were more likely to have experienced childhood abuse (OR 2.38; 95% CI 1.39 to 4.08), have family histories of major depressive disorder (P = 0.002) and suicide completion (P = 0.02), and have been affected by major depressive disorder (OR 13.00; 95% CI 6.20 to 27.25), alcohol dependence (OR 2.90; 95% CI 1.59 to 5.24), or cannabis dependence (OR 3.96; 95% CI 2.29 to 6.8) in the last 6 months. In addition, subjects who died by suicide were more likely to have been affected with cluster B personality disorders (OR 10.18; 95% CI 3.34 to 30.80) and had higher scores of impulsive and aggressive traits (P < 0.001). Conclusions: At the individual level, clinical risk factors for suicide among Inuit are similar to those observed in studies with the general population, and indicate a need for improved access to mental health services. The high rate of mental health problems among control subjects suggests the need for population-level mental health promotion.