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Clinical prediction of suicide and undetermined death : A pseudo-prospective clinical and medico-legal study of substance abusers

Brådvik, Louise LU ; Berglund, Mats LU ; Frank, Arne LU and Löwenhielm, Peter LU (2017) In International Journal of Environmental Research and Public Health 14(3).
Abstract

This study examines aspects of prediction of suicide and death of undetermined intent. We investigated all consecutive, autopsied patients between 1993 and 1997 who had been in contact with the Addiction Centre in Malmö from 1968 onwards. The staff was asked, shortly after autopsy but before they knew of the manner of death, if they thought the patient had committed suicide. The case records were blindly evaluated, and toxicological autopsy findings for alcohol in blood samples investigated. The specificity of prediction was 83% and significantly more often correct than the sensitivity, which was only 45% for suicide and for suicide/death of undetermined intent (93% versus 39%). Suicidal communication was more often considered... (More)

This study examines aspects of prediction of suicide and death of undetermined intent. We investigated all consecutive, autopsied patients between 1993 and 1997 who had been in contact with the Addiction Centre in Malmö from 1968 onwards. The staff was asked, shortly after autopsy but before they knew of the manner of death, if they thought the patient had committed suicide. The case records were blindly evaluated, and toxicological autopsy findings for alcohol in blood samples investigated. The specificity of prediction was 83% and significantly more often correct than the sensitivity, which was only 45% for suicide and for suicide/death of undetermined intent (93% versus 39%). Suicidal communication was more often considered non-serious before death of undetermined intent than before suicide. The former could be predicted by ideation but not by suicide attempt reported in case records, unlike suicide, which was predicted by both. The undetermined group also showed higher levels of alcohol in the blood at autopsy. We concluded that more serious clinical investigation of suicidal feelings, which may be hidden and not taken seriously, and treatment of alcohol use disorders with active follow-up appear urgent in the efforts to prevent suicide.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Autopsy findings, Death of undetermined intent, Prediction, Substance use disorders, Suicidal ideation, Suicide, Suicide attempt
in
International Journal of Environmental Research and Public Health
volume
14
issue
3
publisher
Multidisciplinary Digital Publishing Institute (MDPI)
external identifiers
  • scopus:85015965969
  • pmid:28304357
  • wos:000398524100093
ISSN
1661-7827
DOI
10.3390/ijerph14030310
language
English
LU publication?
yes
id
b910bd72-1d42-4a44-8ae7-c4bbf863c331
date added to LUP
2017-04-23 14:12:12
date last changed
2017-09-18 13:32:56
@article{b910bd72-1d42-4a44-8ae7-c4bbf863c331,
  abstract     = {<p>This study examines aspects of prediction of suicide and death of undetermined intent. We investigated all consecutive, autopsied patients between 1993 and 1997 who had been in contact with the Addiction Centre in Malmö from 1968 onwards. The staff was asked, shortly after autopsy but before they knew of the manner of death, if they thought the patient had committed suicide. The case records were blindly evaluated, and toxicological autopsy findings for alcohol in blood samples investigated. The specificity of prediction was 83% and significantly more often correct than the sensitivity, which was only 45% for suicide and for suicide/death of undetermined intent (93% versus 39%). Suicidal communication was more often considered non-serious before death of undetermined intent than before suicide. The former could be predicted by ideation but not by suicide attempt reported in case records, unlike suicide, which was predicted by both. The undetermined group also showed higher levels of alcohol in the blood at autopsy. We concluded that more serious clinical investigation of suicidal feelings, which may be hidden and not taken seriously, and treatment of alcohol use disorders with active follow-up appear urgent in the efforts to prevent suicide.</p>},
  articleno    = {310},
  author       = {Brådvik, Louise and Berglund, Mats and Frank, Arne and Löwenhielm, Peter},
  issn         = {1661-7827},
  keyword      = {Autopsy findings,Death of undetermined intent,Prediction,Substance use disorders,Suicidal ideation,Suicide,Suicide attempt},
  language     = {eng},
  month        = {03},
  number       = {3},
  publisher    = {Multidisciplinary Digital Publishing Institute (MDPI)},
  series       = {International Journal of Environmental Research and Public Health},
  title        = {Clinical prediction of suicide and undetermined death : A pseudo-prospective clinical and medico-legal study of substance abusers},
  url          = {http://dx.doi.org/10.3390/ijerph14030310},
  volume       = {14},
  year         = {2017},
}