Suicide victims' contacts with physicians during the year before death

Area of Science:

• Medical Research
• Public Health
• Epidemiology

Background:

• Suicide victims often interact with physicians in the year preceding death.
• Suicidal ideation is frequently not overtly expressed by patients.

Purpose of the Study:

• To investigate changes in physician contact rates among suicide victims during the year before their death.
• To identify patterns in healthcare seeking behavior preceding suicide.

Main Methods:

• Linked official suicide data with insurance company data for 317 suicide victims (1998-2002).
• Compared quarterly physician contact rates in the final year of life.
• Analyzed contact patterns by age, gender, and physician specialization.

Main Results:

• Overall physician contacts and general practitioner contacts increased throughout the year before suicide, especially in men and individuals over 60.
• Female patients' contacts with psychiatrists rose until one quarter before suicide, then declined sharply.
• Increased 'doctor shopping' (contacting multiple general practitioners per quarter) was observed in the suicide quarter, particularly among older adults.

Conclusions:

• Changes in physician contact patterns, including increased general practitioner use and 'doctor shopping,' may indicate intensified help-seeking behavior.
• Monitoring these contact behavior changes could improve the identification of individuals at risk for suicide.
• This analysis offers insights for suicide prevention strategies by highlighting critical junctures in patient-physician interactions.