Affective disorders and completed suicide by self-poisoning, trend of using antidepressants as a method of self-poisoning.

The aim of this research was to study the role and trend of antidepressant use as a method of suicide in completed self-poisoning suicides in patients with affective disorders during a 23-year follow up period. The data consisted of 483 completed self-poisoning suicides from 1988 to 2011 in the province of Oulu in Northern Finland (286 men and 197 women). Of the self-poisoning victims, 26.9% (n=130) had hospital-treated unipolar depression and 3.1% (n=15) hospital-treated bipolar disorder. Further, 53.8% (n=70) of those with unipolar depression and 53.3% (n=8) of those with bipolar depression died by suicide using antidepressants. During the 23-year follow-up period, the proportion of those using antidepressants doubled among all self-poisoning victims of suicide. A significant decline was observed in the use of tricyclic antidepressants in self- poisoning suicides while a linear increase was found in the use of SSRIs (selective serotonin reuptake inhibitors) and other antidepressants. During recent years one in five self-poisoning suicides involved the use of antiepileptics. A limitation of our study was that the psychiatric diagnoses only include hospital inpatient episodes. In conclusion, the use of new antidepressants has increased rapidly, but the risk of their use in self-poisoning suicide has perhaps been underestimated.

Characteristics of suicide among diabetes patients: a population based study of suicide victims in Northern Finland.

OBJECTIVE: Recent case reports of insulin suicides have raised the need to study in detail the suicides among diabetes patients. METHODS: The data consisted of 2489 suicides (2030 men, 459 women) in Northern Finland during 1988 to 2010. The suicide victims with hospital-treated type 1 (n=27) or type 2 diabetes (n=51) were compared with those without diabetes (n=2411). RESULTS: Of all suicide victims, 3.1% had diabetes (34.6% type 1 and 65.4% type 2 diabetes). 24.0% of victims with type 2 diabetes were under the influence of alcohol when they died from suicide, while the proportion was 44.4% in type 1 diabetes and 46.6% in victims without diabetes (P=0.007). Compared to those with type 2 diabetes or without diabetes, victims with type 1 diabetes had suffered more commonly from depression (44.4%, 23.5%, 19.9%, respectively) (P=0.006) and chosen self-poisoning as suicide method (48.1%, 31.4%, and 18.0%) (P<0.001). In victims with type 1 diabetes insulin as a suicide method covered half of the self-poisoning cases, while the proportion in type 2 diabetes was 13%. CONCLUSION: We suggest that physicians who treat diabetes patients should evaluate co-occurring depression and substance abuse, both of which are major risk factors of suicide.

Suicide among persons with back pain: a population-based study of 2310 suicide victims in Northern Finland.

STUDY DESIGN: A population-based study of suicides and linkage with national hospital discharge registers. OBJECTIVE: To investigate the prevalence of hospital-treated musculoskeletal diseases, particularly back pain (BP), among suicide victims to compare suicide characteristics between victims with and without musculoskeletal diseases, to analyze comorbidity between musculoskeletal diseases and psychiatric disorders, and to evaluate whether specific drugs have a role in suicides by poisoning. SUMMARY OF BACKGROUND DATA: Depression, other psychiatric disorders, and suicidal behavior are common comorbid conditions in patients with diseases of the musculoskeletal system. METHODS: The data consisted of 2310 suicides (1885 men and 425 women) committed in the province of Oulu in Northern Finland during 1988 to 2007. The information on hospital-treated musculoskeletal diseases (MSD) was extracted from the Finnish Hospital Discharge Registers. The suicide victims with a diagnosis of BP, including sciatica (BP, n = 133), and victims with MSD other than BP/MSD, n = 357) were compared with those of having no history of MSD (reference group, n = 1820). The data on suicides were based on death certificates that were taken from official medicolegal investigations. RESULTS: A total of 490 (21.3%) of suicide victims had a history of hospital-treated MSD. The age of death of the victims with BP was about 11 years higher compared with the reference group. After adjusting for age, nonviolent suicide methods and use of analgesics in poisoning suicides in both genders and hospital-treated depression/substance-related disorders in men were also more common in the BP and MSD groups. Women with BP had been more often under the influence of alcohol when committing suicide compared with the other groups. CONCLUSION: Victims with a history of hospital-treated MSD committed suicide at older age. However, the older the person is, the more is the chance that he or she needs to have a treatment for some MSD at some point of life. Use of analgesics as a potential suicide method should be kept in mind when treating patients with musculoskeletal system diseases.