Psychological autopsy studies of suicide: a systematic review

Cavanagh, Jonathan; Carson, Alan; Sharpe, Michael; Lawrie, Stephen M.

doi:10.1017/s0033291702006943

Cited by 1,771 publications

(1,260 citation statements)

References 130 publications

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“…Critical voices have been raised against diagnostic practices and the potential adverse effects of psychiatric medication (Gøtzsche, 2013; Whitaker, 2010), and several authors have questioned the overreliance on biomedical models with regard to how we understand and manage suicidality (Cutcliffe & Santos, 2012; Hjelmeland, Dieserud, Dyregrov, Knizek, & Rasmussen, 2014; Marsh, 2016; Webb, 2010). Even the assumption that 90% of all suicides are associated with mental disorders (Cavanagh, Carson, Sharpe, & Lawrie, 2003) is strongly challenged by researchers who argue that there is no valid evidence for this 90% statistic (Hjelmeland, Dieserud, Dyregrov, Knizek, & Leenaars, 2012). However, psychiatry continues to be heavily influenced by a biomedical ideology that in turn affects how mental health workers understand suicidality and approach suicidal patients (Hagen et al, 2017; Michel et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

Hagen

Knizek

Hjelmeland

2018

International Journal of Qualitative Studies on Health and Well

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Purpose: The purpose of this study is to explore how former suicidal inpatients experienced treatment and care in psychiatric wards in Norway following the implementation of the National guidelines for prevention of suicide in mental health care. The focus of the analysis was on aspects of treatment and care with potential for improvement. Method: We interviewed five former inpatients and analysed the data by means of Interpretative Phenomenological Analysis. Results: Experiencing a sense of companionship with the staff and receiving individualized treatment and care was important for the participants. This involved establishing trusting connections with mental health workers who treated them with respect, made them feel valued, and who recognized their suffering and needs. The formerly suicidal patients experienced being in a recovery process, which was promoted by the support of mental health workers. Although the participants reported mostly positive experiences, there were examples of insufficient care. Sometimes, they felt that their suffering and suicidality were not sufficiently recognized. Conclusion: Our study indicates that although there has been increased focus on suicidality in the mental health services, among other through clinical guidelines, some mental health workers still lack competence and should focus more fully on how to provide individualized care for suicidal inpatients.

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Section: Discussionmentioning

confidence: 99%

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

Hagen

Knizek

Hjelmeland

2018

International Journal of Qualitative Studies on Health and Well

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“…It remains unclear, however, how to isolate this specific association from the association between non-psychotic psychopathology and suicidal ideation and behaviour, since non-psychotic psychopathology is strongly connected to both PE (DeVylder et al, 2014;Guloksuz et al, 2015;Jeppesen et al, 2015;Kelleher et al, 2012b;Van Os et al, 2000), and suicidal behaviour (Cavanagh et al, 2003;ten Have et al, 2009;Ten Have et al, 2013). Suicidality comprises various phenomena on a continuum ranging from suicidal ideation, suicide plans and suicide attempts to completed suicide (Nock, 2010;Sveticic and De Leo, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Even though the mechanisms underlying suicidal behaviour remain poorly understood, research has shown that it is likely determined by a complex interplay of biological, psychological, environmental and cultural factors (O'Connor et al, 2011;World Health Organization, 2014). Mental disorders are an important risk factor for suicidal behaviour (Bostwick and Pankratz, 2000;Nordentoft et al, 2011;Palmer et al, 2005): of the individuals who committed suicide, 91% had a mental disorder, most commonly a depressive disorder, substance abuse or schizophrenia (Cavanagh et al, 2003;ten Have et al, 2009;Ten Have et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology

Honings

Drukker

Nierop

et al. 2016

Psychiatry Research

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Psychotic experiences and incident suicidal ideation and behaviour 2 ABSTRACT This study examines the longitudinal associations between psychotic experiences (PE) and incident suicidal ideation and behaviour in the general population, and to what degree the association may be confounded by nonpsychotic psychopathology. Data from three prospective, general population cohorts were combined into one dataset (n=15837) and analysed using logistic regression, controlling for continuous measures of depression, anxiety and mania symptoms. Analyses were conducted in the entire sample, and in subsamples stratified by presence or absence of mental disorders. The presence of PE at baseline increased the risk of incident suicidal ideation and behaviour. However, adjustment for dimensional measures of psychopathology reduced effect sizes, although PE remained significantly associated with suicide attempts. Further examination of the associations revealed that PE were only associated with suicide attempts in individuals with at least one mental disorder.Similarly, in individuals without mental disorders, the risk of suicidal ideation increased as PE co-occurred with more symptom domains. The results of this study confirm that individuals with PE are at increased risk of suicidal ideation and behaviour. However, these associations are not specific, but reflect the increased risk of suicidal ideation in individuals with subthreshold multidimensional psychopathology and suicide attempts in individuals with co-occurring mental disorders.

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“…In particular, exposure to incidents of community violence can lead directly or indirectly to psychological distress, poor mental health outcomes such anxiety and depression, behavioral problems, and substance misuse (see for example 5 ), each of which are major risk factors for suicide. 6,7 Previous research among adolescents has shown that exposure to violence can increase suicidality. [8][9][10][11] However, these studies were generally limited to small samples, utilized self-reported measures of violence exposure and suicide-related outcomes, and assessed suicidal ideation or attempt rather than completed suicides.…”

Section: Introductionmentioning

confidence: 99%

“…12 For example, those already at high risk due to psychiatric disorder 7 or poor physical health 13 experience dually increased risk when confronted with distressing life events. 14 Identification of the groups most affected by community violenceinduced conditions is important to better inform priority setting and to better understand the relationship between community violence and health.…”

Section: Introductionmentioning

confidence: 99%

Spatial Proximity to Incidents of Community Violence Is Associated with Fewer Suicides in Urban California

2016

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Suicide is a leading cause of premature mortality. Aspects of the social environment such as incidents of violence in the community may induce psychological distress and affect suicidality, but these determinants are not well understood. We conducted an ecological study using California vital statistics records, geocoded to address of the decedent, to examine whether proximity to homicide was associated with the occurrence of suicide in urban census tracts. For each urban tract (N = 7194) and each month in 2012, we assessed homicides in the tract or within buffer zones around the tract with a 1-month lag. We estimated two risk difference parameters that capture how suicide risk is related to differences in homicide exposure. Proximity to homicides was negatively associated with suicide occurrence after controlling for demographic factors, seasonality, and other confounders. Estimates suggest that the absence of homicides would be associated with a 4.2 % higher number of tract-months with one or more suicides (95 % confidence interval 2.2-6.0). This relationship was stronger in tracts that were wealthier, older, and less civically engaged. Results were robust to a wide variety of sensitivity tests. Contrary to expectations, we identified a consistent negative association of proximity to homicide with suicide occurrence. It may be that a homicide deters or distracts from suicidality or that aggression or hopelessness may be expressed as inward or outward directed violence in different settings. Further investigation is needed to identify the drivers of this association.

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Psychological autopsy studies of suicide: a systematic review

Cited by 1,771 publications

References 130 publications

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology

Spatial Proximity to Incidents of Community Violence Is Associated with Fewer Suicides in Urban California

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