On mental disorder and somatic disease in suicide: A psychological autopsy study of 100 suicides in northern Sweden

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Abstract
Suicide is strongly correlated to mental disorders. In several studies up to more than 90% of the deceased could be given psychiatric diagnoses. The aim of this study is to account for psychiatric and somatic disorders in suicide and to discuss their relation to the suicide and the implications for preventive work. One hundred consecutive cases of suicide in Va¨sterbotten County, 25 women and 75 men, were investigated by means of telephone interviews with close relatives, police reports, psychiatric and other medical records, and data from the forensic investigation. In 96% at least one axis-I diagnosis according to DSM-III-R was found. The most common psychiatric disorders were mood disorders (63%), psychoactive substance use disorders (37%), and personality disorders (22%). Two-thirds of the subjects had one or more somatic disorder of significance for the case. In 50% of the cases two or more psychiatric diagnoses could be given. Schizophrenic subjects died on average 14 years after their first psychiatric contact, at a mean age of 36 years, whereas subjects with major depression died on average 4 years after their first contact, at 55 years. The finding that 96% of the deceased had at least one mental disorder and a high occurrence of somatic disorders is interpreted as a severe increase in the burden of the person, which restricts his/her ability to satisfy vital dependency needs. The issue of specific personality characteristics in suicide should be further investigated.