[Lifetime social, psychological and physical background of suicides --research on the number of suicides during a year in Fukushima prefecture].

We performed a questionnaire survey of the bereaved families of decedents in 523 cases of suicide which occurred during the year beginning July 17, 1997, in Fukushima prefecture in Japan. The questionnaire consisted of 33 items which indicated decedents' behavior changes and stress factors before death. Of the 523 cases, 420 questionnaires were completed by the surviving family members. The risk factors for suicide which are conventionally accepted were found with high frequency in the data. Common stress factors were occupational and financial problems in males and difficulties with human relationships and family problems in females. The sexes were clearly differentiated in this respect. Common changes preceding suicide were expressed as "becoming depressed" or "social isolation". These statements were common and tended to be associated with depression. Hanging was the most frequent method of committing suicide in both sexes and at all ages. Thirty one percent of the victims were diagnosed and treated for mental diseases, and 39% for physical diseases. Many of the 39% who had physical diseases also showed depressive behaviors. The screening and treatment of depression is a matter of highest priority in the strategy of suicide prevention. It is therefore important that general practitioners, occupational physicians and public health nurses improve their skills in managing depressive disorder as a common condition. Psychiatrists should undertake their role of education in the diagnosis and treatment of depressive disorders more seriously.