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Original article
DOI: 10.1016/j.rpsmen.2016.01.004
Psychiatric disorders in cases of completed suicide in a hospital area in Spain between 2007 and 2010
Trastornos psiquiátricos en los casos de suicidio consumado en un área hospitalaria entre 2007–2010
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Esperanza L. Gómez-Durána,b,c,d,
Corresponding author
elgomezduran@gmail.com

Corresponding author.
, M. Azul Forti-Burattia,e, Beatriz Gutiérrez-Lópeza,f, Anna Belmonte-Ibáñeza,g, Carles Martin-Fumadóh
a Centres Assistencials Emili Mira i López, Santa Coloma de Gramanet, Spain
b Fundació Sociosanitària de Barcelona, Barcelona, Spain
c Universitat Internacional de Catalunya, Barcelona, Spain
d Colegio de Médicos de Barcelona, Barcelona, Spain
e Saint Mary's Hospital, Imperial College, London, United Kingdom
f Fundación ARGIBIDE, Pamplona, Spain
g Centro de Salud Mental Maresme Nord, Calella, Spain
h Institut de Medicina Legal de Catalunya, Barcelona, Spain
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Tables (4)
Table 1. Characteristics of the entire sample of subjects deceased through consummated suicide.
Table 2. Characteristics of the sub-sample of deceased subjects with psychiatric antecedents.
Table 3. Diagnoses of the subsample of subjects with psychiatric antecedents.
Table 4. Specific methodology in subjects with affective and psychotic disorders.
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Abstract
Introduction

Suicide is an important Public Health problem. One of the most relevant known risk factors for suicide is suffering from a mental health disorder, identified in up to 90–95% of completed suicides, with this risk being increased if comorbidity is present. Findings from international research on the most common psychiatric disorders are dichotomous, divided into mood disorders and psychotic disorders. In Spain, data of this kind are scarce.

Methods

This study describes the psychiatric and forensic characteristics of completed suicide cases (n=79) occurred in a psychiatric hospital healthcare area (in Spain), between 2007 and 2010. The forensic data were obtained from the Institute of Legal Medicine of Catalonia and the clinical data by reviewing the clinical records.

Results

Most of the subjects in this sample were males (78.5%, 95% CI; 68.4–87.3%). Almost half of the sample (45.4%, 95% CI; 33.8–57.1%, 35/77) had records in the Mental Health Services Network (including substance misuse services). Two of the 79 were under 18, so we were not able to access the records. More than half (54.3%, 95% CI; 37.1–71.4%) of those with psychiatric history suffered from a mood disorder; 37.1% (95% CI; 22.9–51.4% from a depressive disorder; 14.3% (95% CI; 2.9–25.7%) from a bipolar disorder, and 17.1% (95% CI; 5.7–31.4%) suffered from a psychotic disorder. With regard to substance misuse, 42.9% (95% CI; 25.7–60.0%) presented substance misuse, and 48.6% did not.

Conclusions

Psychiatric and forensic characteristics of completed suicide in this Spanish sample confirm previous findings from international studies: there is a high rate of psychiatric disorders in those who complete suicide, and there is a specific pattern as regards the method used to complete it.

Keywords:
Completed suicide
Mental health disorder
Psychiatric diagnosis
Suicide method
Resumen
Introducción

El suicidio es un importante problema de salud pública. Uno de los principales factores de riesgo conocidos para el suicidio es el padecimiento de patología psiquiátrica que se identifica en un 90–95% de suicidios consumados, incrementándose el riesgo si existe comorbilidad. Los resultados internacionales sobre la patología psiquiátrica más frecuente son dicotómicos, divididos entre los trastornos del humour y los trastornos psicóticos, si bien los datos en nuestro entorno sobre casos de suicidio consumado son muy escasos.

Metodología

El presente estudio describe las características psiquiátricas y forenses de los casos de suicidio consumado (n=79) acontecidos en la región asistencial de un hospital psiquiátrico entre 2007 y 2010. Los datos forenses fueron obtenidos en el Instituto de Medicina Legal de Catalunya y los datos clínicos a partir de la revisión de las historias clínicas.

Resultados

La mayoría de los sujetos fallecidos por suicidio consumado en la muestra de referencia fueron varones (78,5%) (IC 68,4%-87,3%). El 45,5% (IC 33,8%-57,1%) (35 de 77) de los fallecidos disponía de historia en el circuito de salud mental y/o toxicomanías de la zona, desconociéndose los antecedentes de dos de los fallecidos por tratarse de menores de edad. De los 35 individuos con historia en el circuito de salud mental, el 54,3% (IC 37,1%-71,4%) presentaba un trastorno afectivo; (37,1%, IC 22,9%-51,4%) trastorno depresivo; 14,3% (IC 2,9%-25,7%) trastorno bipolar y el 17,1% (IC 5,7%-31,4%) un trastorno del espectro psicótico. Además, el 48,6% presentaba comorbilidad psiquiátrica no relacionada con tóxicos y el 42,9% (IC 25,7%-60,0%) comorbilidad con trastornos relacionados con sustancias.

Conclusiones

Las características psiquiátricas y forenses del fenómeno del suicidio consumado en nuestro entorno confirman los datos internacionales sobre una tasa elevada de patología psiquiátrica y un patrón característico en cuanto a metodología suicida.

Palabras clave:
Suicidio consumado
Trastorno mental
Diagnóstico psiquiátrico
Metodología suicida

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