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Objective: Higher rates of health care service use prior to suicide were previously reported in Western countries; however, these studies have tended to suffer from small sample sizes. This nationwide, population-based study examines the distribution and patterns of health care service use among suicide victims in Taiwan.Method: A retrospective cohort study was conducted using linked population-based data to determine the proportion of health care service use among suicide victims aged 15 years and older within the 1-year and 1-month period prior to their deaths. After adjusting for demographic, socioeconomic and health care indices, the differences in health care service use patterns were assessed for age and sex.Results: Among the 19 426 suicide victims in the sample, 83.1% had used nonmental health care services within the 1-year period prior to their death, while only 22.2% had used mental health care services. Men, and suicide victims aged 55 years and older, were less likely to have had any contact with mental health care professionals prior to their deaths (P < 0.001). Conclusions:In line with prior studies, similarly high rates and distinct patterns of health care service use were found in Taiwan prior to suicide. These findings will be of practical interest and should support designing appropriate methods of suicide intervention and effective preventive strategies. Can J Psychiatry 2008;53(6):377-383Clinical Implications · Suicide prevention should be seen as a responsibility shared by all medical health care professionals. · Collaborative mental health care treatment within ordinary clinical settings could play a crucial role in effectively reducing current suicide rates. · Female suicide victims were more likely to use both mental and nonmental health care services during the 1-year and 1-month periods prior to their deaths. Limitations· Misclassification of the cause of death and any underreporting of suicides within the registry system can also potentially confound the results. · We cannot estimate the use of any health care services that were obtained by out-of-pocket expenditures not covered by the National Health Insurance program.

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Background: There is a medical need for an easy, fast, and non-invasive method for metabolic syndrome (MetS) screening. This study aimed to assess the ability of FibroScan to detect MetS, in participants who underwent a self-paid health examination. Methods: A retrospective cohort study was conducted on all adults who underwent a self-paid health examination comprising of an abdominal transient elastography inspection using FibroScan 502 Touch from March 2015 to February 2019. FibroScan can assess the level of liver fibrosis by using a liver stiffness score, and the level of liver steatosis by using the controlled attenuation parameter (CAP) score. The logistic regression analysis and receiver operating characteristic curve were applied to select significant predictors and assess their predictability. A final model that included all significant predictors that are found by univariate analysis, and a convenient model that excluded all invasive parameters were created. Results: Of 1983 participants, 13.6% had a physical status that fulfilled MetS criteria. The results showed that the CAP score solely could achieve an area under the curve (AUC) of 0.79 (0.76–0.82) in predicting MetS, and the AUC can be improved to 0.88 (0.85–0.90) in the final model. An AUC of 0.85 (0.83–0.88) in predicting MetS was obtained in the convenient model, which includes only 4 parameters (CAP score, gender, age, and BMI). A panel of predictability indices (the ranges of sensitivity, specificity, positive and negative likelihood ratio: 0.78–0.89, 0.66–0.82, 2.64–4.47, and 0.17–0.26) concerning gender- and BMI-specific CAP cut-off values (range: 191.65–564.95) were presented for practical reference. Conclusions: Two prediction systems were proposed for identifying individuals with a physical status that fulfilled the MetS criteria, and a panel of predictability indices was presented for practical reference. Both systems had moderate predictive performance. The findings suggested that FibroScan evaluation is appropriate as a first-line MetS screening; however, the variation in prediction performance of such systems among groups with varying metabolic derangements warrants further studies in the future.