Psychische Erkrankungen und Suizid - Überblick zur Epidemiologie

 

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Zusammenfassung

In Studien mit der Methode der psychologischen Autopsie wurde bei 63 - 100 % aller Suizidopfer eine Achse-I-Störung gefunden. Am häufigsten liegen bei Suizidopfern Störungen durch Alkoholkonsum und Depression vor. Außerdem leiden bis zu 62 % aller Suizidopfer unter einer Persönlichkeitsstörung. Bei fast allen Achse-I-Störungen und bei Persönlichkeitsstörungen ist das Suizidrisiko gegenüber der Allgemeinbevölkerung erhöht, besonders stark bei Komorbidität.

Abstract

Psychological autopsy studies revealed that 63 % to 100 % of all suicides were suffering from axis I disorders. In suicides, alcohol use disorders and depression are the most frequent diagnoses. Up to 62 % of all suicides were diagnosed with personality disorders. Almost all axis I disorders are associated with increased suicide risk. Suicide risk is highly elevated for persons suffering from comorbidity of psychiatric disorders.

Literatur

• 1 Pschyrembel Klinisches Wörterbuch .Walter de Gruyter, 260. Auflage. Berlin, New York 2004
  Google Scholar
• 2 Shneidman E S, Farberow N L. Sample investigations of equivocal deaths. In: Farberow NL, Shneidman ES (Hrsg.): The cry for help. New York: McGraw-Hill 1961: 118-129
  Google Scholar
• 3 Kelly T M, Mann J J. Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis.  Acta Psychiatr Scand. 1996;  94 337-343
  Google Scholar
• 4 Conner K R, Duberstein P R, Conwell Y. The validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. I. Psychiatric diagnoses.  Acta Psychiatr Scand. 2001;  104 204-209
  CrossrefGoogle Scholar
• 5 Schneider B, Maurer K, Sargk D, Heiskel H, Weber B, Frölich L, Georgi K, Fritze J, Seidler A. Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.  Psychiatry Res. 2004;  127 121-136
  CrossrefGoogle Scholar
• 6 Schneider B. Risikofaktoren für Suizid. Regensburg: Roderer Verlag 2003
  Google Scholar
• 7 Zhang J, Conwell Y, Zhou L, Jiang C. Culture, risk factors and suicide in rural China: a psychological autopsy case control study.  Acta Psychiatr Scand. 2004;  110 430-437
  CrossrefGoogle Scholar
• 8 Cheng A TA. Mental illness and suicide. A case-control study in East Taiwan.  Arch Gen Psychiatry. 1995;  52 594-603
  Google Scholar
• 9 Vijayakumar L, Rajkumar S. Are risk factors for suicide universal? A case-control study in India.  Acta Psychiatr Scand. 1999;  99 407-411
  CrossrefGoogle Scholar
• 10 Beautrais A L. A case control study of suicide and attempted suicide in older adults.  Suicide Life Threat Behav. 2002;  32 1-9
  CrossrefGoogle Scholar
• 11 Duberstein P R, Conwell Y, Caine E D. Age differences in the personality characteristics of suicide completers: preliminary findings from a psychological autopsy study.  Psychiatry. 1994;  57 213-224
  Google Scholar
• 12 Foster T, Gillespie K, McClelland R. Mental disorders and suicide in Northern Ireland.  Br J Psychiatry. 1997;  170 447-452
  Google Scholar
• 13 Kõlves K, Värnik A, Tooding L M, Wasserman D. The role of alcohol in suicide; a case-control psychological autopsy study (submitted). 
  Google Scholar
• 14 Schneider B, Bartusch B, Schnabel A, Fritze J. Achse-I-Störungen als Risikofaktoren für Suizid in Abhängigkeit von Alter und Geschlecht. Psychiat Prax; in press
  Google Scholar
• 15 Phillips M R, Yang G, Zhang Y, Wang L, Ji H, Zhou M. Risk factors for suicide in China: a national case-control psychological autopsy study.  Lancet. 2002;  360 (9347) 1728-1736
  CrossrefGoogle Scholar
• 16 Dorpat T L, Ripley H S. A study of suicide in the Seattle area.  Compr Psychiatry. 1960;  1 349-359
  Google Scholar
• 17 Cheng A TA, Mann A H, Chan K A. Personality disorder and suicide. A case-control study.  Br J Psychiatry. 1997;  170 441-446
  Google Scholar
• 18 Foster T, Gillespie K, McClelland R, Patterson C. Risk factors for suicide independent of DSM-III-R Axis I disorder. Case-control psychological autopsy study in Northern Ireland.  Br J Psychiatry. 1999;  175 175-179
  Google Scholar
• 19 Shafii M, Steltz-Lenarsky J, Derrick A M, Beckner C, Whittinghill J R. Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents.  J Affect Disord. 1988;  15 227-233
  CrossrefGoogle Scholar
• 20 Lesage A D, Boyer R, Grunberg F, Vanier C, Morissette R, Menard-Buteau C, Loyer M. Suicide and mental disorders: a case-control study of young men.  Am J Psychiatry. 1994;  151 1063-1068
  Google Scholar
• 21 Shaffer D, Gould M S, Fisher P, Traufman P, Moreau D, Kleinman M, Flory M. Psychiatric diagnosis in child and adolescent suicide.  Arch Gen Psychiatry. 1996;  53 339-348
  Google Scholar
• 22 Appleby L, Cooper J, Amos T, Faragher B. Psychological autopsy of suicides by people under 35.  Br J Psychiatry. 1999;  175 168-174
  Google Scholar
• 23 Brent D A, Baugher M, Bridge J, Chen T, Chiappetta L. Age- and sex-related risk factors for adolescent suicide.  J Am Acad Child Adolesc Psychiatry. 1999;  38 1497-1505
  Google Scholar
• 24 Waern M, Runeson B S, Allebeck P, Beskow J, Rubenowitz E, Skoog I, Wilhelmson K. Mental disorder in elderly suicides: a case-control study.  Am J Psychiatry. 2002;  159 450-455
  CrossrefGoogle Scholar
• 25 Chiu H F, Yip P S, Chi I, Chan S, Tsoh J, Kwan C W, Li S F, Conwell Y, Caine E. Elderly suicide in Hong Kong - a case-controlled psychological autopsy study.  Acta Psychiatr Scand. 2004;  109 299-305
  CrossrefGoogle Scholar
• 26 Harris E C, Barraclough B. Suicide as an outcome for mental disorders: a meta-analysis.  Br J Psychiatry. 1997;  170 205-228
  Google Scholar
• 27 Harris E C, Barraclough B. Excess mortality of mental disorder.  Br J Psychiatry. 1998;  173 11-53
  CrossrefGoogle Scholar
• 28 Hiroeh U, Appleby L, Mortensen P B, Dunn G. Death by homicide, suicide, and other unnatural causes in people with mental illness: a population-based study.  Lancet. 2001;  358 (9299) 2110-2112
  CrossrefGoogle Scholar
• 29 Baxter D, Appleby L. Case register study of suicide risk in mental disorders.  Br J Psychiatry. 1999;  175 322-326
  Google Scholar
• 30 Waern M. Alcohol dependence and misuse in elderly suicides.  Alcohol alcohol. 2003;  38 249-254
  Google Scholar
• 31 Barraclough B M, Bunch J, Nelson B, Sainsbury P. A hundred cases of suicide: clinical aspects.  Br J Psychiatry. 1974;  125 355-373
  Google Scholar
• 32 Conwell Y, Duberstein P R, Cox C, Herrmann J H, Forbes N T, Caine E D. Relationship of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study.  Am J Psychiatry. 1996;  153 1001-1008
  Google Scholar
• 33 Marttunen M J, Aro H M, Henriksson M M, Lönnqvist J K. Mental disorders in adolescent suicide: DSM-III-R Axes I and II diagnoses in suicides among 13- to 19-year-olds in Finland.  Arch Gen Psychiatry. 1991;  48 834-839
  Google Scholar
• 34 Harwood D, Hawton K, Hope T, Jacoby R. Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study.  Int J Geriatr Psychiatry. 2001;  16 155-165
  Google Scholar
• 35 Conner K R, Beautrais A L, Conwell Y. Risk factors for suicide and medically serious suicide attempts among alcoholics: analyses of Canterbury Suicide Project Data.  J Stud Alcohol. 2003;  64 551-554
  Google Scholar
• 36 Schneider B, Schnabel A, Sargk D, Maurer K, Weber B, Wetterling T. Detection of alcohol consumption in suicides.  Eur Arch Psychiatry Clin Neurosci. 2005;  255 1-5
  CrossrefGoogle Scholar
• 37 Murphy G E, Wetzel R D, Robins E, McEvoy L. Multiple risk factors predict suicide in alcoholism.  Arch Gen Psychiatry. 1992;  49 459-463
  Google Scholar
• 38 Conner K R, Beautrais A L, Conwell Y. Moderators of the relationship between alcohol dependence and suicide and medically serious suicide attempts: analyses of Canterbury Suicide Project data.  Alcohol Clin Exp Res. 2003;  27 1156-1161
  Google Scholar
• 39 Andreasson S, Allebeck P. Cannabis and mortality among young men: A longitudinal study of Swedish conscripts.  Scand J Soc Med. 1990;  18 9-15
  Google Scholar
• 40 Schneider B, Schnabel A, Weber B, Frölich L, Maurer K, Wetterling T. Nicotine use in suicides: a case-control study.  Eur Psychiatry. 2005;  20 129-136
  CrossrefGoogle Scholar
• 41 de Hert M, Peuskens J. First-episode schizophrenia, a naturalistic 10 year follow-up study.  Schizophr Res. 1998;  29 7-8
  Google Scholar
• 42 Drake R E, Gates C, Cotton P G, Whitaker A. Suicide among schizophrenics: who is at risk?.  J Nerv Ment Dis. 1984;  172 613-617
  Google Scholar
• 43 Drake R, Gates C, Cotton P. Suicide among schizophrenics: a comparison of attempters and completed suicides.  Br J Psychiatry. 1986;  149 784-787
  Google Scholar
• 44 Westermeyer J F, Harrow M, Marengo J T. Risk of suicide in schizophrenia and other psychotic and non-psychotic disorders.  J Nerv Ment Dis. 1991;  179 259-266
  Google Scholar
• 45 Stephens J, Richard P, McHigh P. Suicide in patients hospitalized for schizophrenia: 1913 - 1940.  J Nerv Ment Dis. 1999;  187 10-14
  CrossrefGoogle Scholar
• 46 De Hert M, McKenzie K, Peuskens J. Risk factors for suicide in young patients suffering from schizophrenia.  Schizophr Res. 2001;  47 127-134
  CrossrefGoogle Scholar
• 47 Inskip H M, Harris C, Barraclough B. Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia.  Br J Psychiatry. 1998;  172 35-37
  Google Scholar
• 48 Boardman A P, Healy D. Modelling suicide risk in affective disorders.  Eur Psychiatry. 2001;  16 400-405
  CrossrefGoogle Scholar
• 49 Cavanagh J TO, Owens D GC, Johnstone E C. Life events in suicide and undetermined death in south-east Scotland: a case-control study using the method of psychological autopsy.  Soc Psychiatry Psychiatr Epidemiol. 1999;  34 645-650
  CrossrefGoogle Scholar
• 50 Arato M, Demeter E, Rihmer Z, Somogyi E. Retrospective psychiatric assessment of 200 suicides in Budapest.  Acta Psychiatr Scand. 1988;  77 454-456
  Google Scholar
• 51 Wulsin L R, Vaillant G E, Wells V E. A systematic review of the mortality of depression.  Psychosom Med. 1999;  61 6-17
  Google Scholar
• 52 Fawcett J, Scheftner W, Clark D, Hedeker D, Gibbons R, Coryell W. Clinical predictors of suicide in patients with major affective disorders: a controlled prospective study.  Am J Psychiatry. 1987;  144 35-40
  Google Scholar
• 53 Fawcett J, Scheftner W A, Fogg L, Clark D C, Young M A, Hedeker D, Gibbons R. Time-related predictors of suicide in major affective disorder.  Am J Psychiatry. 1990;  147 1189-1194
  Google Scholar
• 54 Beck A T, Brown G, Berchick R J, Stewart B L, Steer R A. Relationship between hopelessness and ultimate suicide: a replication with psychiatric outpatients.  Am J Psychiatry. 1990;  147 190-195
  Google Scholar
• 55 Keller F, Wolfersdorf M. Hopelessness and the tendency to commit suicide in the course of depressive disorders.  Crisis. 1993;  14 173-177
  Google Scholar
• 56 Nordström P, Asberg M, Aberg-Wistedt A, Nordin C. Attempted suicide predicts suicide risk in mood disorders.  Acta Psychiatr Scand. 1995;  92 345-350
  Google Scholar
• 57 Schneider B, Philipp M, Müller M J. Psychopathological predictors of suicide in patients with major depression during a 5-year follow-up.  Eur Psychiatry. 2001;  16 283-288
  CrossrefGoogle Scholar
• 58 Angst F, Stassen H H, Clayton P J, Angst J. Mortality of patients with mood disorders: follow-up over 34 - 38 years.  J Affect Disord. 2002;  68 167-181
  CrossrefGoogle Scholar
• 59 Brent D A, Bridge J, Johnson B A, Connolly J. Suicidal behaviour runs in families. A controlled family study of adolescent suicide victims.  Arch Gen Psych. 1996;  53 1145-1152
  Google Scholar
• 60 Asgard U. A psychiatric study of suicide among urban Swedish females.  Acta Psychiatr Scand. 1990;  82 115-124
  Google Scholar
• 61 Henriksson M M, Aro H M, Marttunen M J, Heikkinen M E, Isometsä E T, Kuoppasalmi K I, Lönnqvist J K. Mental disorders and comorbidity in suicide.  Am J Psychiatry. 1993;  150 935-940
  Google Scholar
• 62 Conwell Y, Olsen K, Caine E D, Flannery C. Suicide in later life: psychological autopsy findings.  Int Psychogeriatr. 1991;  3 59-66
  CrossrefGoogle Scholar
• 63 Emborg C. Mortality and causes of death in eating disorders in Denmark 1970 - 1993: a case register study.  Int J Eating Disord. 1999;  25 243-251
  Google Scholar
• 64 Keel P K, Dorer D J, Eddy K T, Franko D, Charatan D L, Herzog D B. Predictors of mortality in eating disorders.  Arch Gen Psychiatry. 2003;  60 179-183
  CrossrefGoogle Scholar
• 65 Herzog D B, Greenwood D N, Dorer D J, Flores A T, Ekeblad E R, Richards A, Blais M A, Keller M B. Mortality in eating disorders: a descriptive study.  Int J Eat Disord. 2000;  28 20-26
  CrossrefGoogle Scholar
• 66 Runeson B. Mental disorder in youth suicide. DSM-III-R Axes I and II.  Acta Psychiatr Scand. 1989;  79 490-497
  Google Scholar
• 67 Houston K, Hawton K, Sheppard R. Suicide in young people aged 15 - 24: a psychological autopsy study.  J Affect Disord. 2001;  63 159-170
  CrossrefGoogle Scholar
• 68 Isometsä E T, Henriksson M M, Heikkinen M E, Aro H M, Marttunen M J, Kuoppasalmi K I, Lönnqvist J K. Suicide among subjects with personality disorders.  Am J Psychiatry. 1996;  153 667-673
  Google Scholar

Dr. Barbara Schneider

Zentrum der Psychiatrie, Klinik für Psychiatrie und Psychotherapie · Johann Wolfgang Goethe-Universität

Heinrich-Hoffmann-Str. 10

60528 Frankfurt/Main ·

Email: B.Schneider@em.uni-frankfurt.de