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Underdiagnosis, Undertreatment, and Noncompliance With Treatment in People Who Died by Suicide.
Martín-Moreno, Belén S; Guija, Julio; Blanco, Mario; Porras-Segovia, Alejandro; Pereira-Sánchez, Víctor; Baca-García, Enrique; Giner, Lucas.
Afiliación
  • Martín-Moreno BS; Department of Psychiatry, University Hospital of Guadalajara, Guadalajara, Spain.
  • Guija J; Corresponding Author: Belén S. Martín-Moreno, MD, Department of Psychiatry, University Hospital of Guadalajara, C/Donantes de Sangre, S/N, 19002, Guadalajara, Spain (belensanchezmartinmoreno@hotmail.com).
  • Blanco M; Institute of Legal and Forensic Medicine, Seville, Spain.
  • Porras-Segovia A; Department of Psychiatry, Universidad de Sevilla, Seville, Spain.
  • Pereira-Sánchez V; Institute of Legal and Forensic Medicine, Seville, Spain.
  • Baca-García E; Instituto de Investigación Sanitaria Fundación Jiménez Diaz, Madrid, Spain.
  • Giner L; Hospital Universitario Rey Juan Carlos, Madrid, Spain.
J Clin Psychiatry ; 85(3)2024 Jul 10.
Article en En | MEDLINE | ID: mdl-39028543
ABSTRACT

Background:

This study explored the characteristics of people who die by suicide, comparing those who had depression with those who did not.

Methods:

Clinical data were collected through a postmortem proxy-based semistructured interview (psychological autopsy). Postmortem toxicological analysis provides data on the presence of substances or drugs in the blood of suicides. Participants were adults who died by suicide in the province of Seville, Spain, during 2006-2016. The main independent variables were previous diagnosis, postmortem diagnosis, prescribed treatment, and treatment found in blood. The primary outcome was the postmortem diagnosis of depression, after which the sample was divided into 2 groups according to DSM IV criteria to the presence or absence of major depressive episode (MDE).

Results:

Our sample is composed of 313 people, of which 200 (63.9%) had a diagnosis of MDE according to the psychological autopsy. Predeath diagnosis of depression was more frequent in MDE suicides than in non-MDE suicides (18.6% vs 3.5%, respectively; Χ2 = 23.420; df = 9; P = .005) and had more access to mental health treatment previous to death (67.7% vs 35.6%, respectively; Χ2 = 27.572; df = 1; P < .001). Antidepressants were prescribed in 21.5% of the MDE suicides, but only 8.5% of them were taking them at the time of death according to the toxicology exam.

Conclusions:

The underdiagnosis of depression in people who die by suicide is striking, as is the undertreatment. Further efforts must be made to train primary care physicians in the proper identification of persons at risk of suicide, as they are one of the main gatekeepers in the fight for suicide prevention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Depresivo Mayor Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Clin Psychiatry Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Depresivo Mayor Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Clin Psychiatry Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos