HIV Insight: Physical Compared to Mental Diseases as Reasons for Committing Suicide: A Retrospective Study

BACKGROUND:

Several studies investigated the relationship between mental disorders and suicidal ideation. However, little is known about physical illnesses being the major trigger for committed suicides. It is necessary to understand these risk factors to be able to meet the needs of patients in a palliative care setting.

METHODS:

Suicide, medical and police notes were retrospectively analysed from all autopsies conducted in 2009-11 at the University of Munich, Germany. Documented reasons for suicide were classified into a "physical disease" (PD) or "mental disease" (MD) group and compared with respect to their sociodemographic characteristics and autopsy outcomes.

RESULTS:

Of all 1069 cases, 18.9 % gave a PD as reason for committing suicide (MD, 32.7 %). Those indicating PD were older than MD (68.8 vs. 48.7 years) with more men being in this group (72.8 % vs. 59.1 %). In PD, 30.7 % suffered from cancer, 28.7 % from chronic pain and 12.4 % from lung disease. 38.8 % of MD and 12.4 % of PD had previous suicide attempts.

CONCLUSIONS:

In palliative care, it is necessary to screen patients on a regular basis for suicidal ideation, especially those with previous suicide attempts.

Circumstances of suicide

	Physical disease as reason for suicide	Mental disorder as reason for suicide	Difference
	n = 202	n = 350	Difference
Soft suicide method	67 (33.3 %)	107 (30.7 %)	χ2 = 0.422, p = 0.516
Hard suicide method	134 (66.7 %)	242 (69.3 %)	χ2 = 0.422, p = 0.516
Suicide method
Strangulation	35 (17.3 %)	88 (25.1 %)	χ2 = 4.518, p = 0.03
Intoxication	59 (29.2 %)	90 (25.7 %)	χ2 = 0.793, p = 0.37
Shooting	41 (20.3 %)	9 (2.6 %)	χ 2 = 48.852, p < 0.001
Breathing back	12 (5.9 %)	10 (2.9 %)	χ2 = 3.182, p = 0.07
Jump from height	34 (16.8 %)	80 (22.9 %)	χ2 = 2.838, p = 0.09
Sharp forces	15 (7.4 %)	21 (6.0 %)	χ2 = 0.427, p = 0.51
Jumping in front of vehicle	4 (2.0 %)	35 (10.0 %)	χ 2 = 12.546, p < 0.001
Vehicle against barrier	2 (1.0 %)	2 (0.6 %)	χ2 = 0.312, p = 0.58
Gas inhalation	3 (1.5 %)	12 (3.4 %)	χ2 = 1.830, p = 0.18
Drowning	16 (7.9 %)	18 (5.1 %)	χ2 = 1.710, p = 0.19
Electricity	1 (0.5 %)	3 (0.9 %)	χ2 = 0.233, p = 0.63
Thermic force	1 (0.5 %)	8 (2.3 %)	χ2 = 2.561, p = 0.11
Previous suicide attempts	25 (12.4 %)	136 (38.8 %)	*χ 2 = 51.369,* p < 0.001

Bold: Significant after Bonferroni correction (suicide method: p < 0.0042)

Full article at: http://goo.gl/mjP1k8

By: Fegg M1, Kraus S2, Graw M3, Bausewein C4.

1Department of Palliative Medicine, University of Munich, Munich, Germany. martin@fegg.de.
2Department of Forensic Medicine, University of Munich, Munich, Germany. sybille.kraus@gmx.de.
3Department of Forensic Medicine, University of Munich, Munich, Germany. matthias.graw@med.uni-muenchen.de.
4Department of Palliative Medicine, University of Munich, Munich, Germany. claudia.bausewein@med.uni-muenchen.de.
BMC Palliat Care. 2016 Feb 9;15(1):14. doi: 10.1186/s12904-016-0088-5.