Suicide cases in New Brunswick from April 2002 to May 2003: the importance of better recognizing substance and mood disorder comorbidity.
OBJECTIVE
To investigate all suicide cases that occurred in New Brunswick in the 14 months spanning April 1, 2002, to May 31, 2003, to determine 6-month and lifetime prevalence rates of psychopathology in the deceased.


METHODS
We used 2 psychological autopsy methods: direct proxy-based interviews and medical chart reviews, together with telephone contacts with informants. Consensus DSM-IV diagnoses were formulated by clinical panels on the basis of the Structured Clinical Interviews I and II for DSM-IV complemented by medical charts.


RESULTS
Of the 109 suicide deaths identified by the coroner at the time of the study, we were able to investigate 102. At time of death, 65% of the suicide victims had a mood disorder, 59% had a substance-related disorder, and 42% had concurrent mood and substance-related disorders. The lifetime prevalence of substance-related disorders among these suicide victims was 66%. Finally, 52% of the suicide victims presented with a personality disorder; one-half of these were of the cluster B type.


CONCLUSIONS
Although treatment of depression has frequently been recognized as the focal point of clinically based suicide-prevention efforts, our results underscore substance-related disorders as a key dimension of completed suicide. Suicide-prevention programs should be designed to address this problem more directly.
Séguin
Monique
M
Department of Psychology, Université du Québec en Outaouais, Gatineau. monique.seguin@uqo.ca
Lesage
Alain
A
Chawky
Nadia
N
Guy
Andrée
A
Daigle
France
F
Girard
Gina
G
Turecki
Gustavo
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D015897:Comorbidity; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009509:New Brunswick / Q000453:epidemiology; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D013405:Suicide / Q000706:statistics & numerical data*