title: Last wills and testaments in a large sample of suicide notes: implications for testamentary capacity.
abstract: BACKGROUND
  The leaving of a will prior to death by suicide is a relatively unexplored area.
  
  
  OBJECTIVE
  To determine the frequency and details of will content in suicide notes.
  
  
  METHODS
  Coroner records for 1565 deaths by suicide in Toronto (2003-2009) were reviewed for (a) will content and (b) the presence of depression, psychotic illness, dementia and intoxication prior to death.
  
  
  RESULTS
  In total, 59 (20.7%) of 285 available suicide notes were found to have will content. Of those who left a will, 43 (72.9%) were reported to have a major mood or psychotic disorder, but none had dementia. Fifteen of 19 toxicology samples showed alcohol, sedative hypnotic/benzodiazepine, opioid and/or recreational drugs were present.
  
  
  CONCLUSIONS
  A substantial minority of suicide notes may also include testamentary intent. The observed high rate of mental illness and substance use around the time of death has important clinical implications for understanding the mindset of people who die by suicide and hence also legal implications regarding testamentary capacity.
authors.affiliation: Mark Sinyor, MSc, MD, FRCPC, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ayal Schaffer, MD, FRCPC, Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ian Hull, BA(Hons), LLB, Partner, Hull & Hull LLP, Toronto, Canada; Carmelle Peisah, MBBS (Hons), MD, FRANZCP, School of Psychiatry, University of NSW and Discipline of Psychiatry, University of Sydney, Sydney, Australia; Kenneth Shulman, MD, FRCPC, Brain Sciences Program, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Sinyor
authors.affiliation: Mark Sinyor, MSc, MD, FRCPC, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ayal Schaffer, MD, FRCPC, Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ian Hull, BA(Hons), LLB, Partner, Hull & Hull LLP, Toronto, Canada; Carmelle Peisah, MBBS (Hons), MD, FRANZCP, School of Psychiatry, University of NSW and Discipline of Psychiatry, University of Sydney, Sydney, Australia; Kenneth Shulman, MD, FRCPC, Brain Sciences Program, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada.
authors.forename: Ayal
authors.initials: A
authors.lastname: Schaffer
authors.affiliation: Mark Sinyor, MSc, MD, FRCPC, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ayal Schaffer, MD, FRCPC, Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ian Hull, BA(Hons), LLB, Partner, Hull & Hull LLP, Toronto, Canada; Carmelle Peisah, MBBS (Hons), MD, FRANZCP, School of Psychiatry, University of NSW and Discipline of Psychiatry, University of Sydney, Sydney, Australia; Kenneth Shulman, MD, FRCPC, Brain Sciences Program, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Hull
authors.affiliation: Mark Sinyor, MSc, MD, FRCPC, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ayal Schaffer, MD, FRCPC, Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ian Hull, BA(Hons), LLB, Partner, Hull & Hull LLP, Toronto, Canada; Carmelle Peisah, MBBS (Hons), MD, FRANZCP, School of Psychiatry, University of NSW and Discipline of Psychiatry, University of Sydney, Sydney, Australia; Kenneth Shulman, MD, FRCPC, Brain Sciences Program, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada.
authors.forename: Carmelle
authors.initials: C
authors.lastname: Peisah
authors.affiliation: Mark Sinyor, MSc, MD, FRCPC, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ayal Schaffer, MD, FRCPC, Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada; Ian Hull, BA(Hons), LLB, Partner, Hull & Hull LLP, Toronto, Canada; Carmelle Peisah, MBBS (Hons), MD, FRANZCP, School of Psychiatry, University of NSW and Discipline of Psychiatry, University of Sydney, Sydney, Australia; Kenneth Shulman, MD, FRCPC, Brain Sciences Program, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Shulman
mesh_terms: D003704:Dementia / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D009864:Ontario / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D014918:Wills / Q000523:psychology* / Q000706:statistics & numerical data*