Zusammenfassung
In Studien mit der Methode der psychologischen Autopsie wurde bei 63 - 100 % aller
Suizidopfer eine Achse-I-Störung gefunden. Am häufigsten liegen bei Suizidopfern Störungen
durch Alkoholkonsum und Depression vor. Außerdem leiden bis zu 62 % aller Suizidopfer
unter einer Persönlichkeitsstörung. Bei fast allen Achse-I-Störungen und bei Persönlichkeitsstörungen
ist das Suizidrisiko gegenüber der Allgemeinbevölkerung erhöht, besonders stark bei
Komorbidität.
Abstract
Psychological autopsy studies revealed that 63 % to 100 % of all suicides were suffering
from axis I disorders. In suicides, alcohol use disorders and depression are the most
frequent diagnoses. Up to 62 % of all suicides were diagnosed with personality disorders.
Almost all axis I disorders are associated with increased suicide risk. Suicide risk
is highly elevated for persons suffering from comorbidity of psychiatric disorders.
Schlüsselwörter
Psychische Erkrankung - Suizid - Diagnosen - Epidemiologie
Key words
Psychiatric disorders - suizide - diagnoses - epidemiology
Literatur
1 Pschyrembel Klinisches Wörterbuch .Walter de Gruyter, 260. Auflage. Berlin, New
York 2004
2 Shneidman E S, Farberow N L. Sample investigations of equivocal deaths. In: Farberow
NL, Shneidman ES (Hrsg.): The cry for help. New York: McGraw-Hill 1961: 118-129
3
Kelly T M, Mann J J.
Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician
ante-mortem diagnosis.
Acta Psychiatr Scand.
1996;
94
337-343
4
Conner K R, Duberstein P R, Conwell Y.
The validity of proxy-based data in suicide research: a study of patients 50 years
of age and older who attempted suicide. I. Psychiatric diagnoses.
Acta Psychiatr Scand.
2001;
104
204-209
5
Schneider B, Maurer K, Sargk D, Heiskel H, Weber B, Frölich L, Georgi K, Fritze J,
Seidler A.
Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.
Psychiatry Res.
2004;
127
121-136
6 Schneider B. Risikofaktoren für Suizid. Regensburg: Roderer Verlag 2003
7
Zhang J, Conwell Y, Zhou L, Jiang C.
Culture, risk factors and suicide in rural China: a psychological autopsy case control
study.
Acta Psychiatr Scand.
2004;
110
430-437
8
Cheng A TA.
Mental illness and suicide. A case-control study in East Taiwan.
Arch Gen Psychiatry.
1995;
52
594-603
9
Vijayakumar L, Rajkumar S.
Are risk factors for suicide universal? A case-control study in India.
Acta Psychiatr Scand.
1999;
99
407-411
10
Beautrais A L.
A case control study of suicide and attempted suicide in older adults.
Suicide Life Threat Behav.
2002;
32
1-9
11
Duberstein P R, Conwell Y, Caine E D.
Age differences in the personality characteristics of suicide completers: preliminary
findings from a psychological autopsy study.
Psychiatry.
1994;
57
213-224
12
Foster T, Gillespie K, McClelland R.
Mental disorders and suicide in Northern Ireland.
Br J Psychiatry.
1997;
170
447-452
13 Kõlves K, Värnik A, Tooding L M, Wasserman D. The role of alcohol in suicide; a
case-control psychological autopsy study (submitted).
14 Schneider B, Bartusch B, Schnabel A, Fritze J. Achse-I-Störungen als Risikofaktoren
für Suizid in Abhängigkeit von Alter und Geschlecht. Psychiat Prax; in press
15
Phillips M R, Yang G, Zhang Y, Wang L, Ji H, Zhou M.
Risk factors for suicide in China: a national case-control psychological autopsy study.
Lancet.
2002;
360 (9347)
1728-1736
16
Dorpat T L, Ripley H S.
A study of suicide in the Seattle area.
Compr Psychiatry.
1960;
1
349-359
17
Cheng A TA, Mann A H, Chan K A.
Personality disorder and suicide. A case-control study.
Br J Psychiatry.
1997;
170
441-446
18
Foster T, Gillespie K, McClelland R, Patterson C.
Risk factors for suicide independent of DSM-III-R Axis I disorder. Case-control psychological
autopsy study in Northern Ireland.
Br J Psychiatry.
1999;
175
175-179
19
Shafii M, Steltz-Lenarsky J, Derrick A M, Beckner C, Whittinghill J R.
Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide
in children and adolescents.
J Affect Disord.
1988;
15
227-233
20
Lesage A D, Boyer R, Grunberg F, Vanier C, Morissette R, Menard-Buteau C, Loyer M.
Suicide and mental disorders: a case-control study of young men.
Am J Psychiatry.
1994;
151
1063-1068
21
Shaffer D, Gould M S, Fisher P, Traufman P, Moreau D, Kleinman M, Flory M.
Psychiatric diagnosis in child and adolescent suicide.
Arch Gen Psychiatry.
1996;
53
339-348
22
Appleby L, Cooper J, Amos T, Faragher B.
Psychological autopsy of suicides by people under 35.
Br J Psychiatry.
1999;
175
168-174
23
Brent D A, Baugher M, Bridge J, Chen T, Chiappetta L.
Age- and sex-related risk factors for adolescent suicide.
J Am Acad Child Adolesc Psychiatry.
1999;
38
1497-1505
24
Waern M, Runeson B S, Allebeck P, Beskow J, Rubenowitz E, Skoog I, Wilhelmson K.
Mental disorder in elderly suicides: a case-control study.
Am J Psychiatry.
2002;
159
450-455
25
Chiu H F, Yip P S, Chi I, Chan S, Tsoh J, Kwan C W, Li S F, Conwell Y, Caine E.
Elderly suicide in Hong Kong - a case-controlled psychological autopsy study.
Acta Psychiatr Scand.
2004;
109
299-305
26
Harris E C, Barraclough B.
Suicide as an outcome for mental disorders: a meta-analysis.
Br J Psychiatry.
1997;
170
205-228
27
Harris E C, Barraclough B.
Excess mortality of mental disorder.
Br J Psychiatry.
1998;
173
11-53
28
Hiroeh U, Appleby L, Mortensen P B, Dunn G.
Death by homicide, suicide, and other unnatural causes in people with mental illness:
a population-based study.
Lancet.
2001;
358 (9299)
2110-2112
29
Baxter D, Appleby L.
Case register study of suicide risk in mental disorders.
Br J Psychiatry.
1999;
175
322-326
30
Waern M.
Alcohol dependence and misuse in elderly suicides.
Alcohol alcohol.
2003;
38
249-254
31
Barraclough B M, Bunch J, Nelson B, Sainsbury P.
A hundred cases of suicide: clinical aspects.
Br J Psychiatry.
1974;
125
355-373
32
Conwell Y, Duberstein P R, Cox C, Herrmann J H, Forbes N T, Caine E D.
Relationship of age and axis I diagnoses in victims of completed suicide: a psychological
autopsy study.
Am J Psychiatry.
1996;
153
1001-1008
33
Marttunen M J, Aro H M, Henriksson M M, Lönnqvist J K.
Mental disorders in adolescent suicide: DSM-III-R Axes I and II diagnoses in suicides
among 13- to 19-year-olds in Finland.
Arch Gen Psychiatry.
1991;
48
834-839
34
Harwood D, Hawton K, Hope T, Jacoby R.
Psychiatric disorder and personality factors associated with suicide in older people:
a descriptive and case-control study.
Int J Geriatr Psychiatry.
2001;
16
155-165
35
Conner K R, Beautrais A L, Conwell Y.
Risk factors for suicide and medically serious suicide attempts among alcoholics:
analyses of Canterbury Suicide Project Data.
J Stud Alcohol.
2003;
64
551-554
36
Schneider B, Schnabel A, Sargk D, Maurer K, Weber B, Wetterling T.
Detection of alcohol consumption in suicides.
Eur Arch Psychiatry Clin Neurosci.
2005;
255
1-5
37
Murphy G E, Wetzel R D, Robins E, McEvoy L.
Multiple risk factors predict suicide in alcoholism.
Arch Gen Psychiatry.
1992;
49
459-463
38
Conner K R, Beautrais A L, Conwell Y.
Moderators of the relationship between alcohol dependence and suicide and medically
serious suicide attempts: analyses of Canterbury Suicide Project data.
Alcohol Clin Exp Res.
2003;
27
1156-1161
39
Andreasson S, Allebeck P.
Cannabis and mortality among young men: A longitudinal study of Swedish conscripts.
Scand J Soc Med.
1990;
18
9-15
40
Schneider B, Schnabel A, Weber B, Frölich L, Maurer K, Wetterling T.
Nicotine use in suicides: a case-control study.
Eur Psychiatry.
2005;
20
129-136
41
de Hert M, Peuskens J.
First-episode schizophrenia, a naturalistic 10 year follow-up study.
Schizophr Res.
1998;
29
7-8
42
Drake R E, Gates C, Cotton P G, Whitaker A.
Suicide among schizophrenics: who is at risk?.
J Nerv Ment Dis.
1984;
172
613-617
43
Drake R, Gates C, Cotton P.
Suicide among schizophrenics: a comparison of attempters and completed suicides.
Br J Psychiatry.
1986;
149
784-787
44
Westermeyer J F, Harrow M, Marengo J T.
Risk of suicide in schizophrenia and other psychotic and non-psychotic disorders.
J Nerv Ment Dis.
1991;
179
259-266
45
Stephens J, Richard P, McHigh P.
Suicide in patients hospitalized for schizophrenia: 1913 - 1940.
J Nerv Ment Dis.
1999;
187
10-14
46
De Hert M, McKenzie K, Peuskens J.
Risk factors for suicide in young patients suffering from schizophrenia.
Schizophr Res.
2001;
47
127-134
47
Inskip H M, Harris C, Barraclough B.
Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia.
Br J Psychiatry.
1998;
172
35-37
48
Boardman A P, Healy D.
Modelling suicide risk in affective disorders.
Eur Psychiatry.
2001;
16
400-405
49
Cavanagh J TO, Owens D GC, Johnstone E C.
Life events in suicide and undetermined death in south-east Scotland: a case-control
study using the method of psychological autopsy.
Soc Psychiatry Psychiatr Epidemiol.
1999;
34
645-650
50
Arato M, Demeter E, Rihmer Z, Somogyi E.
Retrospective psychiatric assessment of 200 suicides in Budapest.
Acta Psychiatr Scand.
1988;
77
454-456
51
Wulsin L R, Vaillant G E, Wells V E.
A systematic review of the mortality of depression.
Psychosom Med.
1999;
61
6-17
52
Fawcett J, Scheftner W, Clark D, Hedeker D, Gibbons R, Coryell W.
Clinical predictors of suicide in patients with major affective disorders: a controlled
prospective study.
Am J Psychiatry.
1987;
144
35-40
53
Fawcett J, Scheftner W A, Fogg L, Clark D C, Young M A, Hedeker D, Gibbons R.
Time-related predictors of suicide in major affective disorder.
Am J Psychiatry.
1990;
147
1189-1194
54
Beck A T, Brown G, Berchick R J, Stewart B L, Steer R A.
Relationship between hopelessness and ultimate suicide: a replication with psychiatric
outpatients.
Am J Psychiatry.
1990;
147
190-195
55
Keller F, Wolfersdorf M.
Hopelessness and the tendency to commit suicide in the course of depressive disorders.
Crisis.
1993;
14
173-177
56
Nordström P, Asberg M, Aberg-Wistedt A, Nordin C.
Attempted suicide predicts suicide risk in mood disorders.
Acta Psychiatr Scand.
1995;
92
345-350
57
Schneider B, Philipp M, Müller M J.
Psychopathological predictors of suicide in patients with major depression during
a 5-year follow-up.
Eur Psychiatry.
2001;
16
283-288
58
Angst F, Stassen H H, Clayton P J, Angst J.
Mortality of patients with mood disorders: follow-up over 34 - 38 years.
J Affect Disord.
2002;
68
167-181
59
Brent D A, Bridge J, Johnson B A, Connolly J.
Suicidal behaviour runs in families. A controlled family study of adolescent suicide
victims.
Arch Gen Psych.
1996;
53
1145-1152
60
Asgard U.
A psychiatric study of suicide among urban Swedish females.
Acta Psychiatr Scand.
1990;
82
115-124
61
Henriksson M M, Aro H M, Marttunen M J, Heikkinen M E, Isometsä E T, Kuoppasalmi K I,
Lönnqvist J K.
Mental disorders and comorbidity in suicide.
Am J Psychiatry.
1993;
150
935-940
62
Conwell Y, Olsen K, Caine E D, Flannery C.
Suicide in later life: psychological autopsy findings.
Int Psychogeriatr.
1991;
3
59-66
63
Emborg C.
Mortality and causes of death in eating disorders in Denmark 1970 - 1993: a case register
study.
Int J Eating Disord.
1999;
25
243-251
64
Keel P K, Dorer D J, Eddy K T, Franko D, Charatan D L, Herzog D B.
Predictors of mortality in eating disorders.
Arch Gen Psychiatry.
2003;
60
179-183
65
Herzog D B, Greenwood D N, Dorer D J, Flores A T, Ekeblad E R, Richards A, Blais M A,
Keller M B.
Mortality in eating disorders: a descriptive study.
Int J Eat Disord.
2000;
28
20-26
66
Runeson B.
Mental disorder in youth suicide. DSM-III-R Axes I and II.
Acta Psychiatr Scand.
1989;
79
490-497
67
Houston K, Hawton K, Sheppard R.
Suicide in young people aged 15 - 24: a psychological autopsy study.
J Affect Disord.
2001;
63
159-170
68
Isometsä E T, Henriksson M M, Heikkinen M E, Aro H M, Marttunen M J, Kuoppasalmi K I,
Lönnqvist J K.
Suicide among subjects with personality disorders.
Am J Psychiatry.
1996;
153
667-673
Dr. Barbara Schneider
Zentrum der Psychiatrie, Klinik für Psychiatrie und Psychotherapie · Johann Wolfgang
Goethe-Universität
Heinrich-Hoffmann-Str. 10
60528 Frankfurt/Main ·
Email: B.Schneider@em.uni-frankfurt.de