We investigated the occurrence and significance of somatic symptoms in
the process leading up to suicide. The material consisted of all indi
viduals who had committed suicide (n = 108) In the province of Kuopio
during the Finnish National Suicide Prevention Project. Methods of stu
dy included semi-structured interviews with workers who had last treat
ed 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 ma
rked loss before suicide. More than half of the losses (69%) had occur
red during the preceding year. Immediately before suicide, some depres
sed individuals found it difficult to talk about their depression and
the losses that have led to it. They often complain about somatic symp
toms instead. Such complaints may be associated with an acute risk of
suicide. Awareness of the fact that psychologic and somatic symptoms a
re connected could facilitate identification of acute risk of suicide
and planning of emergency help for and treatment of a patient.