Self-destruction in Japan: a crosscultural, epidemiological analysis of suicide.

Abstract

SUMMARY A simple comparison of vital statistics of suicide has many biases. For example, 3.1% of the cases submitted for autopsy by the Tokyo Municipal Medical Inspection Office were difficult to attribute to suicide or accident from the legal medical standpoint. Such cases as those of children or severely psychotic patients were sometimes almost impossible to determine. Many suicides were hidden by the victims themselves or by their families, largely because of the shame associated with the act of suicide. Notwithstanding these biases, the writer carried out an epidemiological analysis of the statistical materials of suicide to discern the characteristics of suicide in Japan. By the writer's epidemiological analysis, it is believed possible to discern the characteristics of suicide in Japan and compare them with those of other countries, notwithstanding the abovementioned biases. This is because any errors could be expected to be randomized. There are more difficulties in collecting reliable data on attempted suicide than completed suicide. The writer's survey in a city near Tokyo with 150,000 population in 1959 showed that only 92 cases of attempted suicide against 231 cases of completed suicide over a period of 8 years were obtained, notwithstanding the support of private practitioners, hospitals, health centers, and city police. However, the pattern in the attempted suicide rate of high rate in youth, low rate in the aged and higher rate in female than male, as compared with completed suicide data coincided with that for attempted suicide reported by many reliable statistics in Europe. In this sense, it is notable that the rate of completed suicide in Japan during the last 10 years, particularly that for youth, has declined greatly. One of the characteristics of suicide in Japan, rising in youth, declining in thethe middle aged and rising in the aged, which was the same as that in Taiwan, has begun to change to the Western pattern increasing almost parallel with age. The ratio of female‐male suicide rates in Japan has risen during the past 10 years, in particular the ratio of the aged, as conipared with that among those of youth, which has declined. Consequently, the writer presumed that the fluctuation of completed suicide rates in age and sex are mainly influenced by the change of those rates and ratio in the youth of 15—25 and the aged over 65. It was suggested that in pre‐World War II times, a kind of altruistic suicide still existed in Japan, but after the war the number of anomic suicides increased to a peak in 1955‐58, and both types of suicide have decrcased since 1958. The suicide curve in Japan has been found to fluctuate with the business cycle and war; it rose in prewar time (1913, 1934) and serious depression (1932) and declined in wartime (1906, 1943) and prosperity (1917, 1960). The rise of suicide rates from 1944 to 1958 was probably connected with the financial, moral and political anomie of the postwar times. The decline of suicide rates since 1958 might be closely connected with not only financial, moral and political stability but also with the change of expressing aggression, in particular among the youth, i.e. transfer from intropunitive to extrapunitive responses. The statistics of the Young Adult and Juvenile Section of the Japanese Ministry of Justice showed that the rates of juvenile offenders decreased. It also showed that the proportion of juvenile offenders has overcome that of adult offenders since 1958 and the younger the age, the more marked the rise. As regards the relationship between suicide and homicide, a direct relationship between suicide and homicide in the past 10 years in Japan might confirm the hypothesis that obligatory altruistic or fatalistic suicide is decreasing and anomic suicide is declining after a long rise. Although two surveys on suicide‐rates in Hawaii by Drs. Tyree and Kalish showed different data by ethnity, those rates in Japanese Hawaiian were low in youth and high in old age. The writer interpreted these data as follows: although the Japanese issei showed the same high suicide rate as Japanese Nationals, the low rate of suicide in youth might suggest that not only the suicide rate among Japanese‐Hawaiians but also that of Japanese Nationals will become similar to the Western type in the future.