Michael Hawkins1, Ayal Schaffer2, Catherine Reis3, Mark Sinyor4, Nathan Herrmann5, Krista L Lanctôt6. 1. Department of Psychiatry, University of Toronto, Toronto, Canada. 2. Department of Psychiatry, University of Toronto, Toronto, Canada; Mood & Anxiety Disorders Program, Toronto, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada. Electronic address: ayal.schaffer@sunnybrook.ca. 3. Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Mood & Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada. 4. Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada. 5. Department of Psychiatry, University of Toronto, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada. 6. Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Departments of Psychiatry, and Pharmacology and Toxicology, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Myocardial infarction (MI) has been associated with an increased risk of suicide, further increased among individuals with a comorbid psychiatric illness. A paucity of studies have examined details of suicide among individuals with cardiovascular disease (CVD) and comorbid depression. We aimed to compare demographic, clinical and suicide-specific characteristics between suicide victims with CVD with depression (CVD+D) and without comorbid depression (CVD-D). METHODS: Coroner data on suicide decedents with CVD (n=413) occurring in Toronto, Canada from 1998 to 2012 were collected. Characteristics were compared between the CVD+D and CVD-D groups. Regression analysis examined for gender differences in these groups. RESULTS: CVD+D subjects compared to CVD-D were more likely to have had a past suicide attempt (p=0.008), and to have experienced a bereavement (p=0.008) or financial stressor (p=0.005) in the past year. Each of these variables remained significantly associated with the presence of depression after the regression analysis. Within the CVD+D group, females were more likely to die from suicide by self-poisoning (p<0.0001) and males by shooting (p=0.001). LIMITATIONS: Psychological autopsies were not available. The definition of CVD was broad and the accuracy of its diagnosis could not be confirmed. CONCLUSION: Individuals with CVD+D who died from suicide had significant differences in clinical characteristics and specific stressors compared to those without depression. These data may help to better characterize suicide risk and prevention in this vulnerable population.
BACKGROUND:Myocardial infarction (MI) has been associated with an increased risk of suicide, further increased among individuals with a comorbid psychiatric illness. A paucity of studies have examined details of suicide among individuals with cardiovascular disease (CVD) and comorbid depression. We aimed to compare demographic, clinical and suicide-specific characteristics between suicide victims with CVD with depression (CVD+D) and without comorbid depression (CVD-D). METHODS: Coroner data on suicide decedents with CVD (n=413) occurring in Toronto, Canada from 1998 to 2012 were collected. Characteristics were compared between the CVD+D and CVD-D groups. Regression analysis examined for gender differences in these groups. RESULTS: CVD+D subjects compared to CVD-D were more likely to have had a past suicide attempt (p=0.008), and to have experienced a bereavement (p=0.008) or financial stressor (p=0.005) in the past year. Each of these variables remained significantly associated with the presence of depression after the regression analysis. Within the CVD+D group, females were more likely to die from suicide by self-poisoning (p<0.0001) and males by shooting (p=0.001). LIMITATIONS: Psychological autopsies were not available. The definition of CVD was broad and the accuracy of its diagnosis could not be confirmed. CONCLUSION: Individuals with CVD+D who died from suicide had significant differences in clinical characteristics and specific stressors compared to those without depression. These data may help to better characterize suicide risk and prevention in this vulnerable population.