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Psychiatric Diagnoses Are Associated With Selection of Lethal Means in Suicide Deaths

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Suicides are the second leading cause of death among 15-44-year-olds and the tenth overall leading cause of death in the United States. Suicide prevention efforts include consideration of whether an at-risk individual has access to lethal means and whether an individual has any psychiatric disorder such as mood disorders, personality disorders, anxiety disorders, schizophrenia, or substance abuse disorders. A psychiatric disorder diagnosis is a known risk for factor for suicide. Previous studies that examined specific means of suicide focused on demographic factors such as gender, race, urban/rural designation, age, or health status, and whether those factors are associated with specific lethal means. A recent study from the Colorado School of Public Health examined whether the choice of means by which a person dies by suicide is associated with specific psychiatric diagnoses.

This analysis was conducted using 2003-2014 data from the National Violent Death Reporting System, a surveillance system from the CDC that tracks violent deaths across the United States by compiling data from police reports, coroners’ reports, death certificates, and other sources. Data from 18 states was included in this study. Dustin Currie and Carol Runyan from the Colorado School of Public Health, along with a colleague from Purdue University, found that individuals who died by poisoning were more likely to have a psychiatric diagnosis than those who died by firearms or other means. Among those who died by poisoning, 48% had a depressive disorder diagnosis, compared to 34% of overall decedents and 29% of those who died by firearms. Bipolar disorder diagnoses were also found in 12% of those dying by poisoning, compared to 7% of decedents overall and 4% of those dying by firearms. Schizophrenia diagnosis was associated with suicide by other means such as fire or burns, falls from heights, vehicles, sharp instruments, and drowning.

Public Health Impact

Firearms continue to be the major means by which individuals in the United States die by suicide; 40% of individuals with psychiatric diagnoses and 50% of those without psychiatric diagnoses use firearms as a means of suicide. For this reason, suicide prevention efforts often focus primarily on access to firearms. This study showed an association between poisoning as a means of suicide and the presence of psychiatric diagnosis, particularly depressive disorder and bipolar disorder. This could indicate the usefulness of including access to poisoning agents as another important suicide prevention measure to be adapted in the future.