Elaine M McMahon1,2, Birgit A Greiner2, Paul Corcoran1,2,3, Celine Larkin4, Sara Leitao3, Jacklyn McCarthy1, Eugene Cassidy5, Colin Bradley6, Carmel McAuliffe1, Eve Griffin1,2, Eileen Williamson1, Tom Foster7, John Gallagher2, Ivan J Perry2, Nav Kapur8,9,10, Ella Arensman1,2,11. 1. National Suicide Research Foundation, Cork, Ireland. 2. School of Public Health, University College Cork, Cork, Ireland. 3. National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland. 4. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 5. Department of Psychiatry and Neuro-behavioural Science, University College Cork, Cork, Ireland. 6. Department of General Practice, University College Cork, Cork, Ireland. 7. Southern Health and Social Care Trust, Northern Ireland, UK. 8. Centre for Mental Health and Safety, University of Manchester, Manchester, UK. 9. Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK. 10. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK. 11. Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: A range of factors including mental disorders and adverse life events can increase the risk of suicide. The objectives of this study were to examine psychosocial and psychiatric factors and service engagement among suicide decedents compared with living controls. METHODS: A case-control study using multiple sources was conducted. Information on 132 consecutive cases of suicide was drawn from coronial files, and interviews were carried out with 35 family informants and 53 living controls. GPs completed questionnaires for 60 suicide cases and 27 controls. RESULTS: The majority (83.3%) of suicide decedents had contacted a GP in the year prior to death, while 23.3% had 10 or more consultations during the year prior to death. Half of suicide decedents had a history of self-harm. Suicide cases were significantly more likely than controls to have a psychiatric diagnosis (60% vs. 18.5%) and a depressive illness (36.7% vs. 14.8%). Over one-quarter of suicide decedents had been treated as a psychiatric inpatient. DISCUSSION: Primary care providers should be supported to deliver multidisciplinary interventions to engage, assess, and treat patients at risk of suicide, targeting those who present very frequently, those with a history of self-harm or substance misuse, and those with psychological presentations.
BACKGROUND: A range of factors including mental disorders and adverse life events can increase the risk of suicide. The objectives of this study were to examine psychosocial and psychiatric factors and service engagement among suicide decedents compared with living controls. METHODS: A case-control study using multiple sources was conducted. Information on 132 consecutive cases of suicide was drawn from coronial files, and interviews were carried out with 35 family informants and 53 living controls. GPs completed questionnaires for 60 suicide cases and 27 controls. RESULTS: The majority (83.3%) of suicide decedents had contacted a GP in the year prior to death, while 23.3% had 10 or more consultations during the year prior to death. Half of suicide decedents had a history of self-harm. Suicide cases were significantly more likely than controls to have a psychiatric diagnosis (60% vs. 18.5%) and a depressive illness (36.7% vs. 14.8%). Over one-quarter of suicide decedents had been treated as a psychiatric inpatient. DISCUSSION: Primary care providers should be supported to deliver multidisciplinary interventions to engage, assess, and treat patients at risk of suicide, targeting those who present very frequently, those with a history of self-harm or substance misuse, and those with psychological presentations.