Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2025-01-05T15:03:19.022Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk factors for suicide independent of DSM–III–R Axis I disorder

Case–control psychological autopsy study in Northern Ireland

Published online by Cambridge University Press:  03 January 2018

Tom Foster ,
Kate Gillespie ,
Roy McLelland  and
Chris Patterson
Tom Foster*
Affiliation:
School of Clinical Medicine, The Queen's University of Belfast
Kate Gillespie
Affiliation:
Tyrone and Fermanagh Hospital, Omagh, Northern Ireland
Roy McLelland
Affiliation:
School of Clinical Medicine, The Queen's University of Belfast
Chris Patterson
Affiliation:
School of Clinical Medicine, The Queen's University of Belfast
*
Dr Tom Foster. Tyrone and Fermanagh Hospital, 1 Donaghanie Road, Omagh, County Tyrone, Northern Ireland BT79 0NS
Get access Rights & Permissions [Opens in a new window]

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.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 2 , August 1999 , pp. 175 - 179
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III-R). Washington, DC: APA.Google Scholar
Barraclough, B., Bunch, J., Nelson, B., et al (1974) A hundred cases of suicide: clinical aspects. British Journal of Psychiatry, 125, 355–373.Google Scholar
Brent, D. A., Perper, J. A., Moritz, G., et al (1993) The validity of diagnoses obtained through the psychological autopsy procedure in adolescent suicide victims: use of a family history. Acta Psychiatrica Scandinavica, 87, 118–122.CrossRefGoogle Scholar
Brugha, T. & Cragg, D. (1990) The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatrica Scandinavica, 82, 77–81.Google Scholar
Cheng, A. T. A. (1995) Mental illness and suicide: a case–control study in East Taiwan. Archives of General Psychiatry, 52, 594–603.Google Scholar
Conwell, Y., Duberstein, P. R., Cax, C., et al (1996) Relationships of age and Axis I diagnoses in victims of completed suicide: a psychological autopsy study. American Journal of Psychiatry, 153, 1001–1008.Google Scholar
Davidson, J. D. & Knudsen, D. D. (1977) A new approach to religious commitment. Sociological Focus, 10, 151–173.Google Scholar
Dorpet, T. L. & Ripley, H. S. (1960) A study of suicide in the Seattle area. Comprehensive Psychiatry, 1, 349–359.CrossRefGoogle Scholar
Foster, T., Gillesple, K. & McClelland, R. (1997) Mental disorders and suicide in Northern Ireland. British Journal of Psychiatry, 170, 447–452.Google Scholar
Hawton, K., Appleby, L., Platt, S., et al (1998) The psychological autopsy approach to studying suicide: a review of methodological issues. Journal of Affective Disorders, 50, 269–276.Google ScholarPubMed
Kelly, T. M. & Mann, J. J. (1996) Validity of DSM–III–R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis. Acta Psychiatrica Scandinavica, 94, 337–343.CrossRefGoogle ScholarPubMed
Koenig, H. G., Cohen, H. J., Blazer, D. J., et al (1992) Religious coping and depression among elderly, hospitalised medically ill men. American Journal of Psychiatry, 149, 1693–1700.Google Scholar
Lesage, A. D., Boyer, R., Grunberg, F., et al (1994) Suicide and mental disorders: a case–control study of young men. American Journal of Psychiatry, 151, 1063–1068.Google ScholarPubMed
Lonnqvist, J. K., Henriksson, M. M., Isometss, E. T., et al (1995) Mental disorders and suicide prevention. Psychiatry and Clinical Neuroscience, 49 (suppl 1), S111–S116.CrossRefGoogle ScholarPubMed
Mann, A. J., Jenldns, R., Cutting, J. C., et al (1981) The development and use of a standardised assessment of abnormal personality Psychological Medicine, II, 839–847.Google Scholar
Spitzer, R. L., Williams, J. B. W. Gilbbon, M., et al (1989) Instruction Manual for the Structured Clinical Interview. New York: New York State Psychiatric Institute.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.