A Descriptive Cohort of Suicidal Cancer Patients: Analysis of the Autopsy Case Series from 1993 to 2019 in Milan (Italy)

Abstract

Suicide in cancer patients has always been a subject of clinical studies, but the contribution of forensic pathology to this phenomenon is poorly reported. With the aim of at least partially filling this gap in information, at the Institute of Forensic Medicine of Milan, Italy, we assessed all suicides that occurred in cancer patients. A descriptive and retrospective analysis was carried out by examining the database of the Institute and autopsy reports. We included 288 suicide cases with proven cancer diseases. For each suicide, sex, age, country of origin, body area affected by cancer, further pathological history, medications, previous suicide attempts and suicidal communications, as well as the place where the suicide occurred, were assessed. Furthermore, from a forensic point of view, we considered the chosen suicide method and any involved means. The majority of cases were male older adults affected by lung, colon and prostate cancer. Violent suicide methods were prevalent, and the most represented suicide method was falling from height regardless of the body area affected by cancer. Such data may be of clinical use for clinicians engaged in the front lines in order to address suicide risk prevention strategies among cancer patients.

Hospital inpatient suicides: A retrospective comparison between psychiatric and non‐psychiatric inpatients in Milan healthcare facilities

“…Interestingly, some studies have shown that the presence of multiple mental disorders should be deepen as a risk factor both in the general population (Rockett et al, 2007) and in psychiatric patients (Nock et al, 2010). However, among organic diseases cancer is prevalent in suicide (Gentile et al, 2022). Considering the administered pharmacological treatments, as expected, psychiatric inpatients were mainly treated with psychotropic medications whereas non‐psychiatric inpatients with non‐psychotropic medications.…”

“…Considering non‐psychiatric inpatients, cancer patients are among the most affected by suicide. The current sub‐sample of oncological inpatients ( N = 24) has already been included in a recent study (Calati et al, 2021; Gentile et al, 2022). Drug therapies have been grouped in psychotropic drugs, such as antidepressants, anxiolytics, benzodiazepines, and sedatives, and non‐psychotropic drugs, such as chemotherapeutics, cardiotonics, antiretrovirals, and antihypertensives.…”