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Risk factors for suicide independent of DSM–III–R Axis I disorder: Case–control psychological autopsy study in Northern Ireland

  • Tom Foster (a1), Kate Gillespie (a2), Roy McLelland (a1) and Chris Patterson (a1)
Abstract
Background

The vast majority of suicides suffer from at least one mental disorder at the time of death.

Aims

To identify risk factors for suicide, particularly those independent of current DSM–III–R Axis I disorder(s)

Method

A case–control psychological autopsy study comparing suicides with matched community controls.

Results

Independent risk factors for suicide included: Axis II (personality) disorder (particularly antisocial, avoidant and dependent); at least one of 12 life events (from the List of Threatening Experiences) during the previous 52 or 4 weeks (in particular, a ‘serious problem with close friend, neighbour or relative’); current unemployment; previous history of deliberate self-harm; and contact with a GP within 26 weeks. Relative to individuals with no current mental disorder, the estimated risk of suicide in those with Axis I–Axis II comorbidity (OR 346.0) was significantly greater than that in those with Axis I disorder(s) only (OR 52.4)

Conclusions

Suicide risk assessment may be enhanced by enquiry about the aforementioned independent risk factors, and attention to Axis I–Axis II comorbidity.

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Copyright
Corresponding author
Dr Tom Foster. Tyrone and Fermanagh Hospital, 1 Donaghanie Road, Omagh, County Tyrone, Northern Ireland BT79 0NS
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Risk factors for suicide independent of DSM–III–R Axis I disorder: Case–control psychological autopsy study in Northern Ireland

  • Tom Foster (a1), Kate Gillespie (a2), Roy McLelland (a1) and Chris Patterson (a1)
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