Analysis of pre-suicide signs: implications for suicide prevention

The EditorSir,The number of suicides in Japan has increased from about 22000 per year between 1988 to 1997 to over 30 000 per yearsince then. Mie Prefecture, in central Japan, has also seen anincrease in suicide. We believe suicide victims express sui-cidal signs before they act. According to a report by Yoshio-ka for the Ministry of Education, Culture, Sports, Scienceand Technology of Japan, which presented a statistical analy-sis of suicides in Mie Prefecture between 1989 to 1995, theprefecture showed intermediate levels of suicide and patternsof suicide similar to those of Japan as a whole (1). Therefore,the Mie Prefecture suicide data were analyzed as a reflectionof the national problem. In the present report, the authorsinvestigated the incidence and the circumstances surroundingall suicide cases from 1996 to 2002 in cooperation with thefirst department of criminal investigation of the MiePrefectura police headquarters. Pre-suicide signs were alsoexamined in detail. All data in the records were completelyanonymous after encoding.Pre-suicide signs were determined by psychiatric spe-cialists and divided into four stages: direct linguistic signs,indirect linguistic signs, direct action signs and indirect ac-tion signs. Direct linguistic signs are direct expressions ofsuicidal thoughts, such as