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Research Trends

A Pilot Study of the Suicide Victim’s Last Contact with a Health Professional

Published Online:June 16, 2008https://doi.org/10.1027/0227-5910.29.2.96

Abstract

Suicide victims frequently have contact with health care professionals in the months before death. The primary aims of this pilot psychological autopsy study were to determine the feasibility of undertaking a full study and to describe the characteristics of the last health care professional contacts with suicide victims aged > 34 years. We interviewed the informants of 52 suicides. Interviews were obtained from 37 health care professionals who had contact with 28 of the suicides during the 3 months before death. The primary reasons for the last contact with the health care professional were mental health (62%), physical health (22%), and social (14%). 87% of health care professional contacts occurred within 1 month of death. Symptoms of depression were noted in 49% of health care professional contacts. Consensus psychological autopsy diagnoses of depression were made in 64% of suicide victims. Overall suicide risk was assessed by 38% of health care professionals during their last contact. This was more likely to occur when the deceased presented as depressed, was aged < 60 years or seen by a psychiatrist. None was assessed to be suicidal. The family informants regarded nine of the suicide victims to have been suicidal before death but informed a health care professional in only one third of the cases. Critical information that might have altered the management is not often accessed from family members.

References

  • Alexopoulos, G.S. , Katz, I.R. , Bruce, M.L. , Heo, M. , Ten Have T., Raue P. ,et al. (2005). Remission in depressed geriatric primary care patients: A report from the PROSPECT study. American Journal of Psychiatry, 162, 718–724. First citation in articleCrossref Medline, Google Scholar

  • Bruce, M.L. , Ten Have, T.R. , Reynolds, C.F. III , Katz, I.I. , Schulberg, H.C. , Mulsant, B.H. et al. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized controlled trial. JAMA, 291, 1081–1091. First citation in articleCrossref Medline, Google Scholar

  • Conwell, Y. , Duberstein, P.R. , Cox , C. , Herrmann, J.H. , Forbes, , N.T. , Caine, E.D. (1996). Relationships of age and Axis 1 diagnoses in victims of completed suicide: A psychological autopsy study. American Journal of Psychiatry, 153, 1001–1008. First citation in articleCrossref Medline, Google Scholar

  • Conwell, Y. , Duberstein, P.R. , Cox, , C. , Herrmann, J. , Forbes, N. , & Caine, E.D. (1998). Age differences in behaviors leading to completed suicide. American Journal of Geriatric Psychiatry, 6, 122–126. First citation in articleCrossref Medline, Google Scholar

  • Draper, B. (1995). Prevention of suicide in old age. The Medical Journal of Australia, 162, 533–534. First citation in articleMedline, Google Scholar

  • Hall, W.D. , Mant, A. , Mitchell, P.B. , Rendle, V.A. , Hickie, I.B. , & McManus, P. (2003). Association between antidepressant prescribing and suicide in Australia, 1991–2000: Trend analysis. British Medical Journal, 326, 1008. First citation in articleCrossref Medline, Google Scholar

  • Isacsson, G. (2000). Suicide prevention – A medical breakthrough?. Acta Psychiatrica Scandinavica, 102, 113–117. First citation in articleCrossref Medline, Google Scholar

  • Isometsa, E.T. , Heikkinen, M.E. , Marttunen, M.J. , Henriksson, M.M. , Aro, H.M. , Lonnqvist, J.K. (1995). The last appointment before suicide: Is suicide intent communicated?. American Journal of Psychiatry, 152, 919–922. First citation in articleCrossref Medline, Google Scholar

  • Juurlink, D.N. , Herrmann, N. , Szalai, J.P. , Kopp, A. , Redelmeier, D.A. (2004). Medical illness and the risk of suicide in the elderly. Archives of Internal Medicine, 164, 1179–1184. First citation in articleCrossref Medline, Google Scholar

  • Lodhi, L.M. , Shah, A. (2005). Factors associated with the recent decline in suicide rates in the elderly in England and Wales, 1985–1998. Medicine, Science & the Law, 45, 31–8. First citation in articleGoogle Scholar

  • Luoma, J.B. , Martin, C.E. , Pearson, J.L. (2002). Contact with mental health and primary care providers before suicide: A review of the evidence. American Journal of Psychiatry, 159, 909–916. First citation in articleCrossref Medline, Google Scholar

  • Milne, S. , Matthews, K. , Ashcroft, G.W. (1994). Suicide in Scotland 1988–1989. Psychiatric and physical morbidity according to primary care case notes. British Journal of Psychiatry, 165, 541–544. First citation in articleGoogle Scholar

  • Obafunwa, J.O. , Busuttil, A. (1994). Clinical contact preceding suicide. Postgraduate Medical Journal, 70, 428–432. First citation in articleCrossref Medline, Google Scholar

  • Pearson, J.L. , Conwell, Y. , Lyness, J.M. (1997). Late-life suicide and depression in the primary care setting. In L.S. Schneider, Ed.), Developments in Geriatric Psychiatry, New Directions for Mental Health Services 75, 13–38. First citation in articleCrossref, Google Scholar

  • Pfaff, J. , & Almeida, O. (2003). Identifying and managing suicidal risk in older adults: A desktop reference guide for general practice. Commonwealth Department of Health and Ageing. Perth, Western Australia: Advance Press. First citation in articleGoogle Scholar

  • Pirkis, J. , & Burgess, P. (1998). Suicide and recency of health care contacts: A systematic review. British Journal of Psychiatry, 173, 462–475. First citation in articleCrossref Medline, Google Scholar

  • Spitzer, R.L. , Gibbon, M. , Williams, J. (1994). Structured clinical interview for Axis I DSM-IV disorders. New York: New York State Psychiatric Institute, Biometrics Research Department. First citation in articleGoogle Scholar

  • Statistical Package for the Social Sciences. (2004). (Version 13) [Computer software]. Chicago: SPSS Inc. First citation in articleGoogle Scholar

  • Suominen, K. , Isometsa, E. , Lonnqvist, J. (2004). Elderly suicide attempters with depression are often diagnosed only after the attempt. International Journal of Geriatric Psychiatry, 19, 35–40. First citation in articleCrossref Medline, Google Scholar

  • Unûtzer, J. , Katon, W. , Callahan, C.M. , Williams, J.W. Jr. , Hunkeler, E. , Harpole, L. et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. JAMA, 288, 2836–2845. First citation in articleCrossref Medline, Google Scholar

  • Van Casteren, V. , Van der Veken, J. , Tafforeau, J. , & Van Oyen, H. (1993). Suicide and attempted suicide reported by general practitioners in Belgium, 1990–1991. Acta Psychiatrica Scandinavica, 87, 451–455. First citation in articleCrossref Medline, Google Scholar

  • Vassilas, C.A. , Morgan, H.G. (1994). Elderly suicides’ contact with their general practitioner before death. International Journal of Geriatric Psychiatry, 9, 1008–1009. First citation in articleGoogle Scholar