Risk factors for suicide in melancholia A case‐record evaluation of 89 suicides and their controls

Abstract

Eighty-nine inpatients with a primary severe depression and melancholia who had committed suicide were investigated. They were admitted to the Department of Psychiatry, Lund, Sweden between 1956-1969 and died before 1984. Matched controls were selected. Case records were evaluated at index admission to find suicidal risk factors in melancholia. Prospective ratings were compared. Women committing suicide had higher scores than their controls on the items unmarried, non-compliance and suicide attempt but lower ratings on disharmonic childhood and non-severe physical disease. Men committing suicide had higher scores on the items heredity for psychosis and a brittle or sensitive personality. For the latter item suicide was related to life-weariness. Suicide attempt was related to acute onset and lack of psychomotor retardation. Two suicidal processes were proposed for men: one related to aggression and one not. Social factors seem less important in the prediction of suicide in melancholia than in depression in general.

Suicidality in Huntington's disease

“…The suicide risk can be calculated using the following formulas: suicide risk (during first year of follow-up)=1 -e (-rate per person-year at year 1) . A and B: Psychiatric subgroup included: Bradvik and Berglund 1993;11 Coryell and Young 2005;30 Dutta et al 2007;31 Goldstein et al 1991;33 Bioulac et al 2000;39 Dingman and McGlashan 1986;40 Lin et al 2014; 49 Park et al 2013;50 Sani et al 2011;52 Spiessl et al 2002;54 Allebeck et al 1987;56 de Hert et al 2001;58 Drake and Cotton 1986;59 Dutta et al 2011;60 Stephens et al 1999;69 Kuo et al 2011;76 Simon et al 2013;78 C and D: Non-psychiatric subgroup included: Khang et al 2010;83 Kleiman and Liu 2014;84 Brinkman et al 2014;89 Crandall et al 2006;90 Hyman 2012;92 McEwan et al 2010. 94 …”

Sex Differences in Clinical Predictors of Suicidal Acts After Major Depression: A Prospective Study

“…suicide in men was related to heredity for psychosis and brittle or sensitive personality (7,9). Another multisite prospective study of 3,130 teenagers assessed anger at oneself, anger at society, and suicidal ideation (8).…”

Last Suicide Attempt before Completed Suicide in Severe Depression: An Extended Suicidal Process May Be Found in Men Rather Than Women

“…The case records of the suicides and matched controls were prepared for a thorough blind evaluation by omitting the last sheet with information on the suicide, as has previously been described (Brådvik & Berglund 1993), and a similar procedure was used at second and third follow-up. Only suicide victims were included in the present study for a comparison of the relation of the last suicide attempt to completed suicide.…”

“…Other variables, which might be possible confounders in the analysis, were bipolar disorder, repeated or severe suicide attempts, marital/cohabitation status (living alone) and treatment at last contact (adequate ECT and/or antidepressant pharmacotherapy and/or Lithium). These have been described in previous studies (Brådvik & Berglund 1993, Brådvik & Berglund 2000 and have been included in the analysis. The case records were rated by one person and all suicidal behaviour was repeatedly rated in two sessions.…”

“…Suicide attempt was first scored by severity on the basis of the schedules introduced by Motto (1965) and Weisman & Worden (1972), as described in two previous papers (Brådvik & Berglund 1993, Brådvik & Berglund 2002. The first follow-up was performed in 1984 and the same definitions were used in the two follow-ups in 1998 and 2010.…”