Suicide among Inuit: Results from a large, epidemiologically representative follow-back study in Nunavut.

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.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, DSM IV Axis I and II diagnoses, and measures of impulsive and (or) aggressive traits. Compared with control subjects, subjects who died by suicide were more likely to have experienced childhood abuse, have family histories of major depressive disorder and suicide completion and have been affected by major depressive disorder, alcohol dependence, or cannabis dependence in the last 6 months. In addition, subjects who died by suicide were more likely to have been affected with cluster B personality disorders and had higher scores of impulsive and aggressive traits. 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.

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