[The proportion of suicides committed by patients with a mental health disorder for which treatment costs are now no longer reimbursed by health insurance]. / Het aandeel suïcides door patiënten met een stoornis waarvan de ggz-behandeling thans niet meer vergoed wordt.

BACKGROUND: Suffering from a psychiatric disorder is a well-known risk factor for suicide and suicidal behavior. Treatment of psychiatric disorders can reduce the risk of suicidal behavior and suicide. In the Netherlands, however, since 2012 the treatment costs of some psychiatric disorders have no longer been covered by health insurance.
AIM: To find out what proportion of suicides were committed by patients with a psychiatric disorder for which treatment costs are no longer covered by health insurance since the rules changed in 2012.
METHOD: We studied the files of 314 patients who were known to one of the large mental health hospitals in the Netherlands and who had committed suicide between 1 January 1999 and January 2012. We were able to determine the various psychiatric disorders from which the patients were suffering at the time they died.
RESULTS: About 6% of the patients who committed suicide between 1999 and 2012 suffered from a psychiatric disorder for which treatment costs are now no longer covered by health insurance.
CONCLUSION: Given the results of this study, the increased rates of suicide in the Netherlands and the importance of scientific research into the characteristics of suicide, we recommend that patients with suicidal behavior are not excluded from adequate treatment in the event they may or may not have met the criteria for a DSM-IV classification.

Health-related quality of life in preschool children in five health conditions.

OBJECTIVE: To test the responsiveness of the Infant/Toddler Quality of Life Questionnaire (ITQOL) to five health conditions. In addition, to evaluate the impact of the child's age and gender on the ITQOL domain scores. METHODS: Observational study of 494 Dutch preschool-aged children with five clinical conditions and 410 healthy preschool children randomly sampled from the general population. The clinical conditions included neurofibromatosis type 1, wheezing illness, bronchiolitis, functional abdominal complaints, and burns. Health-related quality of life (HRQoL) was assessed by a mailed parent-completed ITQOL. Mean ITQOL scale scores for all conditions were compared with scores obtained from the reference sample. The effect of patient's age and gender on ITQOL scores was assessed using multi-variable regression analysis. RESULTS: In all health conditions, substantially lower scores were found for several ITQOL scales. The conditions had a variable effect on the type of ITQOL domains and a different magnitude of effect. Scores for 'physical functioning', 'bodily pain', and 'general health perceptions' showed the greatest range. Parental impact scales were equally affected by all conditions. In addition to disease type, the child's age and gender had an impact on HRQoL. CONCLUSIONS: The five health conditions (each with a distinct clinical profile) affected the ITQOL scales differently. These results indicate that the ITQOL is sensitive to specific characteristics and symptom expression of the childhood health conditions investigated. This insight into the sensitivity of the ITQOL to health conditions with different symptom expression may help in the interpretation of HRQoL results in future applications.