Low Risk of Male Suicide and Lithium in Drinking Water

Ishii, Nobuyoshi; Terao, Takeshi; Araki, Yasuo; Kohno, Kentaro; Mizokami, Yoshinori; Shiotsuki, Ippei; Hatano, Koji; M, Makino; Kodama, Kensuke; Iwata, Noboru

doi:10.4088/jcp.14m09218

Cited by 53 publications

(64 citation statements)

References 31 publications

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“…The lithium levels of water were measured by using mass spectroscopy analyzed by a third party [2,4,5]. This method can measure very small amounts of lithium; the limit of quantification of lithium is 0.1 ppb (0.1 μg/L).…”

Section: Methodsmentioning

confidence: 99%

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Comparison of lithium levels between Japanese and foreign mineral waters

Ishii¹,

Terao²,

Shiotsuki³

et al. 2017

CNPT

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Purpose: To measure the lithium levels of mineral waters and compare those of Japanese mineral waters to foreign ones. Methods: The lithium levels of Japanese mineral waters, foreign mineral waters, and Japanese tap waters were compared using the Kruskal-Wallis test due to a skewed distribution. Results: As a whole, there was a significant difference between the 3 groups. Post hoc comparison by Bonferroni correction revealed that the lithium levels of foreign mineral waters were significantly higher than Japanese mineral waters and tap waters, though there was no significant difference between Japanese mineral waters and tap waters. Discussion: The present findings indicate that foreign mineral waters may have higher lithium levels than Japanese mineral waters and tap waters. In future studies, it is desirable to consider which type of mineral waters (Japanese or foreign) the residents drink, for adjustment of the analytic data of any potential lithium effect on suicide rates and other mental states.

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Section: Methodsmentioning

confidence: 99%

“…Several epidemiological studies have shown the inverse association of lithium levels in tap water and suicide rates [1][2][3][4][5][6], although a few studies failed to find such association [7] or have reported an ambiguous association [8]. However, many people drink both mineral water and tap water.…”

Section: Introductionmentioning

confidence: 99%

Comparison of lithium levels between Japanese and foreign mineral waters

Ishii¹,

Terao²,

Shiotsuki³

et al. 2017

CNPT

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“…As noted above, an article in this issue of The Journal of Clinical Psychiatry suggests that lithium may decrease suicide rates among men but not among women. 1 This finding may indicate that lithium affects men differently than women.…”

Section: Neurobiologymentioning

confidence: 99%

Suicide in Men

Sher¹

2015

J. Clin. Psychiatry

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The authors found that lithium levels in drinking water were significantly and inversely associated with male suicide standard mortality ratios (SMRs) but not total or female SMRs. This observation reminds us about the complex issue of gender differences in suicidal behavior. PREVALENCEWhile women show higher rates of reported nonfatal suicidal behavior, men have a much greater rate of completed suicide.2-4 Worldwide, men commit suicide 3-10 times more frequently than women. 2,3 Male suicide rates are higher than female rates at all ages. In the United States and Canada, men die from suicide attempts 3 times more often than do women.3,4 The gender-suicide gap is especially large in some European countries such as Hungary, Lithuania, Latvia, Belarus, and Ukraine. 5 PSYCHOSOCIAL FACTORSMultiple psychosocial factors may contribute to the observed gender differences in suicidal behavior. The traditional male gender role is described by characteristics such as independence, aggressiveness, risk-taking behavior, pursuit of power and dominance, competitiveness, success, and control. 2,[6][7][8][9] The male gender role in Western cultures implies not acknowledging anxiety or depression, which might arise under difficult or threatening conditions.The susceptibility of many men to suicide is probably related to their relative unwillingness to get help when they are distressed.2,6-10 A review of help seeking by persons who committed suicide revealed that men had lower overall rates of contact with health care providers compared with women. 10 This study showed that in the year before suicide, 58% of women versus 35% of men sought care from a mental health professional. Men's lack of help seeking may be partially related to a lack of training and responsiveness from some psychiatrists and other clinicians who may not treat depressed, anxious, or suicidal men empathically.2 Suicidality in men is considerably affected by socioeconomic aspects such as income, wealth, employment status, and social position.2,6-9,11 Men's susceptibility to suicide may be increased in periods of unemployment because of gender anticipations that men should support themselves and their families. Also, unemployment is frequently associated with poverty, domestic difficulties, depression, and hopelessness, which all may contribute to suicidality.Studies have shown that the association between alcohol/drug abuse and suicide is more significant for men, and many more men than women use alcohol/drugs immediately prior to their suicide. 7,9,12 In many societies, alcohol use is associated with masculinity, and this may explain a connection between alcohol use and suicide in men.7 Alcohol may be consumed by some men to lessen depression or anxiety and as an unhealthy alternative to getting professional help for psychiatric issues.Marital breakdown leads to many difficulties for men, including the possibility of parental alienation from children. 13,14 Fathers who have lost some or all contact with their children for months or even years following separatio...

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“…In this issue, Ishii and colleagues 8 present further argument for the hypothesis that even low lithium doses-or rather, doses of lithium at a supplemental level-might have their place in suicide prevention.…”

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confidence: 99%

“…9,10 However, the estimates of risk reduction by lithium have been criticized as too optimistic, and the first prospective RCTs of lithium versus valproate in bipolar disorder showed no difference in suicide events or attempts between both compounds, 12 which share a common mode of action on glycogen synthase kinase-3β (GSK-3β), brain-derived neurotrophic factor (BDNF), and other neurobiological markers. 13 Besides the general question about lithium's antisuicidal properties, the important point with ecological studies like the one presented by Ishii and colleagues 8 is that natural lithium contents of tap water range up to 1 mg or more of dissolved lithium per liter per day (1 L of water with 1 mg/L lithium per day corresponds to 6.9 mg lithium carbonate per day), depending on the geographic origin of the drinking water. 2,14 Under the assumption that individuals drink not more than 2 L water per day (corresponding to a daily dose of 13.8 mg lithium carbonate by mouth), such an intake would result in a daily dose of approximately 1% of a therapeutic lithium dose.…”

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confidence: 99%