Lack of joy in life ups early death risk

People who don't think life is worth living are more likely to die within the next few years, research from Japan shows.

The increased death risk was mainly due to cardiovascular disease and external causes --most commonly, suicide.

The research is the largest to date to investigate how "ikigai," or "joy and a sense of well-being from being alive," affects mortality risk, and only the second to examine death from specific causes, according to Dr. Toshimasa Sone and colleagues from the Tohoku University Graduate School of Medicine in Sendai.

The investigators looked at 43,391 men and women 40 to 79 years old living in the Ohsaki region who were followed for seven years, during which time 3,048 died. All were asked, "Do you have ikigai in your life?" Fifty-nine percent said yes, 36.4 percent said they weren't sure, and 4.6 percent said no.

Those who didn't have a sense of ikigai were less likely to be married or employed, and were also less educated, in worse health, more mentally stressed, and in more bodily pain. They were also more likely to have limited physical function.

But even after the researchers used statistical techniques to adjust for these factors, people with no sense of ikigai were still at increased risk of dying over the follow-up period compared to people who did have ikigai. The relationship also was independent of history of illness and alcohol use.

Overall, people with no sense of ikigai were 50 percent more likely to die from any cause during follow-up compared to those who did have a sense that life was worth living. They had a 60 percent greater risk of death from cardiovascular disease, most commonly stroke, and were 90 percent more likely to die of "external" causes.

Of the 186 deaths due to external causes among study participants, 90 were suicides.

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Mental illness may up risk of postpartum suicide

New mothers with a history of depression or other psychiatric disorders appear more likely than other women to attempt suicide soon after giving birth, a new study suggests.

Researchers found that among nearly 1,800 women who recently gave birth, those with a history of a psychiatric disorder were 27 times more likely to attempt suicide in the year after having their baby.

Similarly, women with a history of substance abuse had a six-fold increase in their risk of attempted suicide.

Postpartum suicide is rare, but the new findings point to a group of women who may be at greatest risk, the researchers note in the American Journal of Obstetrics & Gynecology.

Women, their families and their doctors should be aware that past psychiatric disorders and substance abuse are risk factors for postpartum suicide, lead researcher Dr. Katherine A. Comtois, of the University of Washington School of Medicine in Seattle, told Reuters Health.

The findings are based on hospital records from women who gave birth in Washington State between 1992 and 2001. The researchers identified 355 women who were hospitalized for a suicide attempt in the year after giving birth; they matched each of these women with another four who had given birth in the same year but did not attempt suicide.

Overall, Comtois and her colleagues found, the risk of postpartum suicide was markedly higher among women who'd been hospitalized with a psychiatric disorder, substance abuse problem or both 5 years before giving birth.

Such diagnoses are "clearly important risk factors" of which families and medical providers should be aware, Comtois said.

The American College of Obstetricians and Gynecologists recently recommended that women be screened for depression and other "psychosocial risk factors" during prenatal care, Comtois and her colleagues note in the report.

"Future studies," they write, "should evaluate the effectiveness of screening for psychiatric and substance use disorders on decreasing adverse outcomes such as suicide attempts during the postpartum period."

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