Masahito Fushimi, M.D., Ph.D.

Escalating sharply in 1998, the suicide rate in Japan increased steadily during the 1990s and has remained high ever since. Presently, Japan has one of the highest suicide rates among developed countries (1). To address this grave situation, the Japanese government announced its resolve to tackle the rise in suicides and launched a nationwide strategy for suicide prevention. Furthermore, the Japanese government enacted a suicide prevention law in 2006. Akita Prefecture is located within Japan’s Tohoku region in the northern part of Honshu Island. Generally, the Tohoku region has a relatively higher suicide rate than other parts of the country.Specifically, Akita Prefecture has the highest suicide rate in Japan (1). We have previously reported the suicide patterns and characteristics of cases in Akita Prefecture investigated by members of the Akita (Prefecture) Medical Association (1). In this article, we report the results of additional analyses, namely, information on the weekly distribution of suicides. In our previous report, the total number of suicide cases was 138 (1). In the present report, this figure was 133 (99 males, 34 females), excluding cases with insufficient data. The weekly distribution of suicide cases was shown in Table 1. Overall, for males, the most suicide cases occurred on Mondays, followed by Tuesdays. There was a decrease in suicide cases from Monday through Friday. In contrast, for females, the most suicide cases occurred on Thursdays, followed by Wednesdays. Moreover, suicide cases on Mondays or Tuesdays were relatively rare among females. The results suggest that for males, the number of suicides tends to be higher on Mondays, indicating the so-called “blue Monday” phenomenon; however, this phenomenon does not seem to apply to females. The results obtained in the present study were similar to those of some previous studies (2-4). With regard to these results, we must consider the regionality of Akita Prefecture, in that it is not an urban region, but a rural region (an agricultural region). The observations of the present study for Akita Prefecture (i.e., a rural region) may be influenced by the fact that the ratio of the people affected by the structure of the workweek (i.e., they commute to their workplace, and Monday is generally their first working day of the week), is relatively less than that for an urban region. As mentioned above, since the number of cases in this study is insufficient for evincing persuasive knowledge, further investigation of similar cases is required to firmly support this finding.

References:

1. Fushimi M, Sugawara J, Shimizu T. Suicide patterns and characteristics in Akita, Japan. Psychiatry Clin. Neurosci. 2005; 59: 296-302.
2. Massing W, Angermeyer MC. The monthly and weekly distribution of suicide. Soc. Sci. Med. 1985; 21: 433-441.
3. Maldonado G, Kraus JF. Variation in suicide occurrence by time of day, day of the week, month, and lunar phase. Suicide Life Threat. Behav. 1991; 21: 174-187.
4. Johnson H, Brock A, Griffiths C, Rooney C. Mortality from suicide and drug-related poisoning by day of the week in England and Wales, 1993-2002. Health Stat. Q. 2005; 27: 13-16.

Table 1.  Weekly distribution of suicide cases in Akita Prefecture, Japan

		Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Male (n=99)		19	18	16	10	9	13	14
Female (n=34)		2	4	7	8	5	3	5
Total (n=133)		21	22	23	18	14	16	19