Suicide victims' contacts with physicians during the year before death.

Suicide victims frequently have had contact with physicians during the last year before death. However, oftentimes suicidal ideation is not reported overtly. This study investigates the course of contact rates of suicide victims with physicians during the year before death. Official suicide data and insurance company data were linked for 317 subjects who had committed suicide between 1998 and 2002. Quarterly contact rates with physicians during the respective last year of life were compared. Contact rates of suicide victims with physicians varied considerably concerning age, gender and physicians' specialization. Contacts with 'any physician' and general practitioners generally increased over the year, most pronounced in men and in those older than 60 years. In contrast to males, female contacts to psychiatrists increased until one quarter before suicide and then dropped significantly shortly before suicide. A pattern of contacting more than one general practitioner per quarter occurred significantly more often in the suicide quarter than during the year before, predominantly in those older than 60 years. Such a 'doctor shopping' behavior may reflect an intensified patients' searching for adequate help. Taking contact behavior changes into account may increase the chance to identify individuals at risk and thus may contribute to suicide prevention.