Characteristics of general practitioner consultations prior to suicide: a nested case-control study in New Zealand.
OBJECTIVE
To examine characteristics of general practice consultations in a New Zealand primary care population of patients who died by suicide.


METHODS
Case control study design, with data linkage between the RNZCGP Research Unit Database, the National Mortality Database and the Hospital Separation Diagnosis Database (hospital discharges) from 1996 to 2001. The cases were suicides who had attended a general practice contributing data to the Research Unit database. Each case was matched by gender and age to three randomly selected patients from the Research Unit database.


RESULTS
There were 221 cases of suicide identified, of which 60% had a general practice consultation in the 6 months prior to death. The significant exposure variables, corrected OR (95% CI) in the multivariate analysis were: any previous hospital admission (between January 1996 and date of death) for a psychiatric condition, 23.75 (9.01 to 62.63); any notation in the general practice record of depression, suicidal ideation or self-harm, 14.97 (4.61 to 48.65); previous hospital admission with self-harm, 8.39 (1.73 to 40.65); and general practice prescription of sedatives, 4.34 (1.69 to 11.10).


CONCLUSIONS
In general, general practice patients who commit suicide have higher rates of depression, suicidal ideation, previous self harm, and sedative prescription than average.
Didham
Rebecca
R
Dunedin School of Medicine, University of Otago, Dunedin.
Dovey
Susan
S
Reith
David
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003863:Depression / Q000453:epidemiology; D004332:Drowning / Q000401:mortality; D005194:Family Practice; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009520:New Zealand / Q000453:epidemiology; D011041:Poisoning / Q000401:mortality; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D013405:Suicide / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot / Q000401:mortality