Somatic symptoms and risk of suicide

Abstract

We investigated the occurrence and significance of somatic symptoms in the process leading up to suicide. The material consisted of all individuals who had committed suicide (n=108) in the province of Kuopio during the Finnish National Suicide Prevention Project. Methods of study included semi-structured interviews with workers who had last treated the suicide victim, and consensus case reports based on psychologic autopsy. Nearly half (44%) of the suicide victims, particularly men, had complained of somatic symptoms during their last treatment contact. Seventy-four per cent had contacted health or social services during the month immediately before suicide. Suicide was usually a surprise to workers. Most (79%) of the individuals studied had experienced a marked loss before suicide. More than half of the losses (69%) had occurred during the preceding year. Immediately before suicide, some depressed individuals found it difficult to talk about their depression and the losses that have led to it. They often complain about somatic symptoms instead. Such complaints may be associated with an acute risk of suicide. Awareness of the fact that psychologic and somatic symptoms are connected could facilitate identification of acute risk of suicide and planning of emergency help for and treatment of a patient.