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Clinical Prediction of Suicide and Undetermined Death: A Pseudo-Prospective Clinical and Medico-Legal Study of Substance Abusers

Author

Listed:
  • Louise Brådvik

    (Department of Clinical Sciences, Division of Psychiatry, Lund University, SE-221 85 Lund, Sweden)

  • Mats Berglund

    (Department of Clinical Sciences, Division of Psychiatry, Lund University, SE-221 85 Lund, Sweden)

  • Arne Frank

    (Department of Clinical Sciences, Division of Psychiatry, Lund University, SE-221 85 Lund, Sweden)

  • Peter Löwenhielm

    (Forensic Medicine, Lund University, SE-221 85 Lund, Sweden)

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 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.

Suggested Citation

  • Louise Brådvik & Mats Berglund & Arne Frank & Peter Löwenhielm, 2017. "Clinical Prediction of Suicide and Undetermined Death: A Pseudo-Prospective Clinical and Medico-Legal Study of Substance Abusers," IJERPH, MDPI, vol. 14(3), pages 1-9, March.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:3:p:310-:d:93363
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    References listed on IDEAS

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    1. Nahid Darvishi & Mehran Farhadi & Tahereh Haghtalab & Jalal Poorolajal, 2015. "Alcohol-Related Risk of Suicidal Ideation, Suicide Attempt, and Completed Suicide: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.
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    Cited by:

    1. Louise Brådvik & Peter Löwenhielm & Arne Frank & Mats Berglund, 2019. "From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study," IJERPH, MDPI, vol. 16(5), pages 1-14, March.

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