title: The recognition of diagnosable psychiatric disorders in suicide cases' last medical contacts.
abstract: OBJECTIVE
  The objective of this study is to examine physicians' awareness of diagnosable psychiatric disorders in suicide cases' last medical contacts (MCs).
  
  
  METHODS
  The contact rates and proportions of both psychiatric and somatic diagnoses in a national cohort of suicide subjects (N=3468) in Taiwan seeking psychiatric or nonpsychiatric medical services within 1 month and 1 year preceding death were examined.
  
  
  RESULTS
  The overall rates of MCs were 72.6% within 1 month and 89.2% within 1 year preceding suicide. While around 99.9% of the suicide subjects who contacted psychiatrists within 1 month preceding death were diagnosed as having psychiatric disorders, only 19.7% of those visiting nonpsychiatric physicians had psychiatric diagnoses. Suicide subjects, however, frequently complained of somatic symptoms, for example, gastrointestinal discomfort, headache/dizziness and back problem during their contacts with nonpsychiatric physicians within 1 month preceding death.
  
  
  CONCLUSIONS
  Despite the high rates of MCs preceding suicide, the majority of suicide subjects were not diagnosed. Emphasizing psychosomatic manifestations of psychiatric disorders in physician education programs may help enhance the awareness of psychiatric disorders/suicide risk in clinical settings.
authors.affiliation: Department of Health, Taiwan Suicide Prevention Center, Taiwan, ROC.
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Pan
authors.forename: Ming-Been
authors.initials: MB
authors.lastname: Lee
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chiang
authors.forename: Shih-Cheng
authors.initials: SC
authors.lastname: Liao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012720:Severity of Illness Index; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult