Michael Hawkins1, Ayal Schaffer2, Mark Sinyor3, Yasunori Nishikawa4, Nathan Herrmann5, Krista L Lanctôt6, Rima Styra7, Maurizio Pompili8, Jeffrey Huffman9. 1. Department of Psychiatry, University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada. Electronic address: michael.hawkins@mail.utoronto.ca. 2. Mood & Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada. Electronic address: ayal.schaffer@sunnybrook.ca. 3. Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada. Electronic address: mark.sinyor@sunnybrook.ca. 4. Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Mood & Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada. 5. Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada. Electronic address: nathan.herrmann@sunnybrook.ca. 6. Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada. Electronic address: krista.lanctot@sunnybrook.ca. 7. Department of Psychiatry, Division of Consultation/Liaison Psychiatry, University Health Network, 200 Elizabeth Street, Toronto M5G 2C4, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada. Electronic address: rima.styra@uhn.ca. 8. Psychiatry Residency Training Program, Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Italy; Sant'Andrea Hospital, Sapienza University of Rome, Italy; Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy. Electronic address: maurizio.pompili@uniroma1.it. 9. Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: JHUFFMAN@mgh.harvard.edu.
Abstract
OBJECTIVE: We aimed to characterize self-poisoning deaths in people with cardiovascular disease (CVD) and compare to other suicide decedent groups. METHODS: Suicide deaths by self-poisoning in people with CVD (n = 151) were compared to suicide deaths by other methods in people with CVD (n = 260) and suicide deaths by self-poisoning in people without CVD (n = 509). Sub-analysis of the CVD self-poisoning group compared people with depression and without depression. Toxicology reports were compared between intentional self-poisoning groups. RESULTS: A higher proportion of suicide deaths were due to self-poisoning in the CVD group compared to the non-CVD group. People with CVD were less likely to have any identified stressor (excluding medical stressor) prior to dying from self-poisoning compared to those without CVD. Female sex, past suicide attempts, living circumstances, and comorbid substance abuse were each significantly associated with self-poisoning as the method of suicide in people with CVD. Opioid, any antidepressants, benzodiazepines, and tricyclic antidepressants (TCAs) were commonly identified as lethal in people with CVD. Compared to people in the CVD self-poisoning without depression group, people in the CVD self-poisoning with depression group were more likely to have lethal levels of TCAs. CONCLUSIONS: Our findings characterize suicide deaths in people with CVD, and identified notable differences based on method of death and presence of depression.
OBJECTIVE: We aimed to characterize self-poisoning deaths in people with cardiovascular disease (CVD) and compare to other suicide decedent groups. METHODS: Suicide deaths by self-poisoning in people with CVD (n = 151) were compared to suicide deaths by other methods in people with CVD (n = 260) and suicide deaths by self-poisoning in people without CVD (n = 509). Sub-analysis of the CVD self-poisoning group compared people with depression and without depression. Toxicology reports were compared between intentional self-poisoning groups. RESULTS: A higher proportion of suicide deaths were due to self-poisoning in the CVD group compared to the non-CVD group. People with CVD were less likely to have any identified stressor (excluding medical stressor) prior to dying from self-poisoning compared to those without CVD. Female sex, past suicide attempts, living circumstances, and comorbid substance abuse were each significantly associated with self-poisoning as the method of suicide in people with CVD. Opioid, any antidepressants, benzodiazepines, and tricyclic antidepressants (TCAs) were commonly identified as lethal in people with CVD. Compared to people in the CVD self-poisoning without depression group, people in the CVD self-poisoning with depression group were more likely to have lethal levels of TCAs. CONCLUSIONS: Our findings characterize suicide deaths in people with CVD, and identified notable differences based on method of death and presence of depression.