Risk factors for suicide independent of DSM-III-R axis I disorder - Case-control psychological autopsy study in Northern Ireland

Author(s): Gillespie, K., McClelland, R., Patterson, C.

Journal/Book: Brit J Psychiat. 1999; 175: British Journal of Psychiatry 17 Belgrave Square, London SW1X 8Pg, England. Royal College Of Psychiatrists. 175-179.

Abstract: Background The vast majority of suicides suffer from at least one mental disorder at the time of death. Aims To identify risk factors for suicide, particularly those independent of current DSM-III-R Axis I disorder(s). Method A case-control psychological autopsy study comparing suicides with matched community controls. Results Independent risk factors for suicide included: Axis II (personality) disorder (particularly antisocial, avoidant and dependent); at least one of 12 life events (from the List of Threatening Experiences) during the previous 52 or 4 weeks (in particular, a 'serious problem with close friend, neighbour or relative'); current unemployment; previous history of deliberate self-harm; and contact with a GP within 26 weeks. Relative to individuals with no current mental disorder, the estimated risk of suicide in those with Axis I-Axis II comorbidity (OR 346.0) was significantly greater than that in those with Axis I disorder(s) only (OR 52.4). Conclusions Suicide risk assessment may be enhanced by enquiry about the aforementioned independent risk factors, and attention to Axis I-Axis II comorbidity. Declaration of interest Funded by Department of Health and Social Services (Northern Ireland),Western Health and Social Services Board, Sir Samuel Scott of Yews Trust, Eli Lilly and Co. Ltd and Duphar Laboratories Ltd.

Note: Article Foster T, Tyrone & Fermanagh Hosp, 1 Donaghanie Rd, Omagh BT79 0NS, Tyrone, NORTH IRELAND

Keyword(s): MENTAL-DISORDERS; VALIDITY; DIAGNOSES; VICTIMS

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