The profile of suicide: changing or changeable?
OBJECTIVE
The aims of this study were to: (1) examine the role of psychosocial factors, physical and mental health in suicide; (2) to examine gender differences on those variables; and (3) determine whether there was a group who died by suicide who did not have a history of mental illness.


METHODS
Data were obtained from The Australian National Coroners Information System (NCIS) for all deaths classified as suicides from 2000 to 2004 in all Australian states. The NCIS is an internet-based system for storing and retrieving data on coronial cases.


RESULTS
The overall results from the total sample reinforces many previous findings but also found some differences; importantly, psychiatric morbidity was less than generally reported, and comparable proportions of males and females used violent means to suicide. Using latent class analysis the study identified four clusters of people who had suicided. In two of those clusters mental illness appeared to be a significant factor; in one of those two clusters the mental illness was compounded by additional drug and alcohol and relationship problems whilst the other was without such levels of comorbidity. The third group was predominantly male, older and physical illness seemed to be a significant factor. The final group was characterised by low rates of mental illness and treatment for the same, but marked by relationship and financial difficulties.


CONCLUSIONS
These data may suggest that the profile of suicide is changing or changeable. Certainly there has been a shift in the gender profile with comparable proportions of women and men. Whilst mental illness remains a major risk factor, perhaps greater emphasis needs to be placed on the broader psychosocial issues which may initiate or hasten the pathway to suicide. In addition, it may be that the relative contribution of mental illness and other factors is fluid in relation to both life stage and life circumstances. Suicide prevention programmes might usefully define a range of discrete areas of work.
Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia.
Fiona
F
Judd
Henry
H
Jackson
Angela
A
Komiti
Richard
R
Bell
Caitlin
C
Fraser
D000328:Adult; D001315:Australia / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011584:Psychology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data / Q000639:trends*; D055815:Young Adult