The validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. I. Psychiatric diagnoses.
OBJECTIVE
To investigate the validity of best-estimate methodology for making psychiatric diagnoses among individuals who attempted suicide.


METHODS
Subjects were 80 patients admitted for treatment following a suicide attempt. Psychiatric diagnoses based on structured interviews with subjects were compared with diagnoses made based on interviews with proxy respondents. In both cases, interview information was supplemented with pre-admission psychiatric and medical records to inform diagnoses.


RESULTS
Diagnostic agreement, based on kappa coefficients, was substantial for major depression and bipolar disorders, and moderate for non-affective psychoses, organic mood and anxiety disorders. Agreement was substantial for substance dependence but poor for substance abuse disorders.


CONCLUSIONS
Results support best-estimate methodology for making mood and substance dependence diagnoses in research of suicidal behavior in this age group, with potential implications for interpreting postmortem research of completed suicide.
Conner
K R
KR
Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, New York 14642, USA.
Duberstein
P R
PR
Conwell
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D015203:Reproducibility of Results; D013405:Suicide / Q000523:psychology*