Clinical and social variables which differentiate suicide, open and accident verdicts

Abstract

SynopsisA study has been made of cases coming before the Brighton coroner in the period 1970–2. Fifty cases in which a suicide verdict was recorded were specially studied, and relatives and acquaintances of the deceased were interviewed. The information thus obtained was compared with information available to the coroner in considering his verdict in 83 further cases in which he made a verdict of ‘suicide’. The reliability of thewhich the coroner's decision is based was largely validated. A study was made of variables which differentiated ‘suicide’ from 25 ‘open’ and 33 ‘accident’ cases considered by the same coroner. The prevalence of depression did not differentiate ‘suicide’ and ‘open’ cases, and this finding contradicts suggestions that the association of depression and suicide might be an artefact of the method of arriving at a suicide verdict. A number of other demographic and clinical factors did however significantly vary between ‘suicide’, ‘open’ and ‘accident’ cases.

Social construction or causal ascription: Distinguishing suicide from undetermined deaths

“…Another difference concerned the presence of a suicide note (38% of suicides vs 2% of undetermined deaths). In respect of previous parasuicide and current depressive symptomatology, these findings differ from those reported by Jacobson et al (1976) and in our study. However, inter-study differences could be due to the fact that Holding and Barraclough's samples were matched on variables (age, gender, method) which have been shown to be associated in a complex manner with classification of death.…”

“…We conclude that, with respect to the psychiatric findings, there is no support for the social construction hypothesis, and that evidence concerning the role of psychiatric illness and prior parasuicide remains valid. Jacobson et al (1976) interpreted their results in a similar manner. For the most part, the distinction between the two groups of deaths hinges upon legal criteria of inference concerning intent.…”

A Comparison of Suicide and Undetermined Deaths in Psychiatric Patients

“…Alcoholism itself is a self destructive behavior but when alcohol is involved in a death, it may obscure clear intent to die and thus be less likely to be called a suicide. Jacobsen et al (1976) in a study of suicide, “open” and accident verdicts in one coroner's district in England, found that the “open” cases were significantly more likely to have had a drinking problem and to have consumed alcohol at the time of death. Conversely, schizophrenia was much more closely associated with a suicide verdict.…”

Taxonomies of Death by Suicide: A Review, with Proposals for Research and Policy, and a Challenge for Suicidology

“…So far as this review can discover, the first published work using methods of numerical taxonomy on data collected after death by suicide was a study conducted in Brighton, UK [10,11] using coroner's data files. In this study, suicidal deaths fell into three groups: (a) younger males with disrupted childhoods, leading sociopathic, criminal, drug-addicted, and marginalized lives, with several prior suicide attempts; (b) middle-aged males, many of whom expressed suicidal ideation, and only atypically had made an attempt-but who could not abide further episodes of acute depression and schizophrenia; and (c) elderly people of both sexes, with no history of previous attempts, currently plagued by infirmity, depression, pain, and poor sleep.…”