title: Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study.
abstract: OBJECTIVE
  To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research.
  
  
  METHODS
  Retrospective analysis of data obtained through medical file review.
  
  
  METHODS
  Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012.
  
  
  METHODS
  100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21-80 years).
  
  
  METHODS
  Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up.
  
  
  RESULTS
  Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1).
  
  
  CONCLUSIONS
  Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request euthanasia due to unbearable psychological suffering.
authors.affiliation: University Hospital Brussels, Brussels, Belgium.
authors.forename: Lieve
authors.initials: L
authors.lastname: Thienpont
authors.affiliation: MSc student at the Open University of the Netherlands, Heerlen, The Netherlands.
authors.forename: Monica
authors.initials: M
authors.lastname: Verhofstadt
authors.affiliation: Free University of Brussels, Brussels, Belgium.
authors.forename: Tony
authors.initials: T
authors.lastname: Van Loon
authors.affiliation: Free University of Brussels, Brussels, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Distelmans
authors.affiliation: Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.
authors.forename: Kurt
authors.initials: K
authors.lastname: Audenaert
authors.affiliation: University of Antwerp, Institute Born-Bunge, Wilrijk, Belgium University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Middelheim General Hospital, ZNA, Antwerp, Belgium.
authors.forename: Peter P
authors.initials: PP
authors.lastname: De Deyn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders; D001530:Belgium; D001714:Bipolar Disorder; D003865:Major Depressive Disorder; D061218:Depressive Disorder, Treatment-Resistant; D033101:Euthanasia, Active, Voluntary / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D010554:Personality Disorders; D011618:Psychotic Disorders; D012189:Retrospective Studies; D012559:Schizophrenia; D013313:Stress Disorders, Post-Traumatic; D055815:Young Adult
keywords: MENTAL HEALTH