Abstract
BackgroundIt is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion.MethodsWe carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables.ResultsTwenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0%) had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78–4.61), personality disorders (OR = 2.01; 95% CI: 1.38–2.95) and childhood disorders (OR = 4.95; 95% CI: 2.69–9.31) were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53–0.83), including depressive disorders (OR = 0.53; 95% CI: 0.42–0.68) were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides.ConclusionsAlthough psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers.
Highlights
It is well known that most suicide cases meet criteria for a psychiatric disorder
The aim of this study was to carry out quantitative syntheses of overall and specific psychiatric diagnoses found in suicide studies and to explore possible gender and geographical differences in the distribution of psychiatric disorders among suicide completers
Studies had to: 1) be original, 2) be published in English, 3) contain information on diagnostic distribution, 4) include suicide completers unselected according to specific mental disorders, 5) use of a psychological autopsy method, which for the purpose of this review was considered as the process of reconstructing psychiatric diagnoses based either on interviews with informants or on review of multiple official records that contained interviews with informants such as general practitioners, other professionals and relatives or friends, 6) use of standard diagnostic criteria
Summary
It is well known that most suicide cases meet criteria for a psychiatric disorder. rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion. The relationship between suicide and mental disorders has been the focus of several studies and has generated important debate [2] This relationship has been investigated by different strategies, but by the psychological autopsy method [3], which is generally considered the method of choice to retrieve postmortem information on psychopathology. The psychological autopsy procedure entails the retrospective psychiatric assessment of the deceased by variable methodologies, but generally by means of proxy-based interviews. This procedure is frequently completed by (page number not for citation purposes). The aim of this study was to carry out quantitative syntheses of overall and specific psychiatric diagnoses found in suicide studies and to explore possible gender and geographical differences in the distribution of psychiatric disorders among suicide completers
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