title: Physical compared to mental diseases as reasons for committing suicide: a retrospective study.
abstract: BACKGROUND
  Several studies investigated the relationship between mental disorders and suicidal ideation. However, little is known about physical illnesses being the major trigger for committed suicides. It is necessary to understand these risk factors to be able to meet the needs of patients in a palliative care setting.
  
  
  METHODS
  Suicide, medical and police notes were retrospectively analysed from all autopsies conducted in 2009-11 at the University of Munich, Germany. Documented reasons for suicide were classified into a "physical disease" (PD) or "mental disease" (MD) group and compared with respect to their sociodemographic characteristics and autopsy outcomes.
  
  
  RESULTS
  Of all 1069 cases, 18.9% gave a PD as reason for committing suicide (MD, 32.7%). Those indicating PD were older than MD (68.8 vs. 48.7 years; p < 0.001) with more men being in this group (72.8% vs. 59.1%; p=0.002). In PD, 30.7% suffered from cancer, 28.7% from chronic pain and 12.4% from lung disease. 38.8% of MD and 12.4% of PD had previous suicide attempts.
  
  
  CONCLUSIONS
  In palliative care, it is necessary to screen patients on a regular basis for suicidal ideation, especially those with previous suicide attempts.
authors: Department of Palliative Medicine, University of Munich, Munich, Germany. martin@fegg.de.
authors: Martin
authors: M
authors: Fegg
authors: Department of Forensic Medicine, University of Munich, Munich, Germany. sybille.kraus@gmx.de.
authors: Sybille
authors: S
authors: Kraus
authors: Department of Forensic Medicine, University of Munich, Munich, Germany. matthias.graw@med.uni-muenchen.de.
authors: Matthias
authors: M
authors: Graw
authors: Department of Palliative Medicine, University of Munich, Munich, Germany. claudia.bausewein@med.uni-muenchen.de.
authors: Claudia
authors: C
authors: Bausewein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000523:psychology; D016021:Epidemiologic Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000401:mortality / Q000523:psychology*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data