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Psychiatric diagnoses are associated with means selection in united states suicide deaths

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to examine whether the choice of means by persons who die by suicide is associated with a prior psychiatric diagnosis.

Methods

In this cross-sectional study, we analyzed suicide surveillance data from 18 states reporting to the National Violent Death Reporting System (NVDRS) between 2003 and 2014. NVDRS compiled data from multiple sources (e.g., coroner’s reports, police reports, death certificates) on every violent death within reporting jurisdictions, including information on indicated psychiatric disorders and suicide means. We assessed whether the selected suicide means were associated with diagnoses using multinomial logistic regression.

Results

Adjusted models suggested that, compared to decedents using firearms, those using poisoning were more likely to have each psychiatric disorder examined, including bipolar disorder (aOR: 2.17 [95% CI 2.03–2.32]), schizophrenia (aOR: 1.81 [1.61–2.04]), depression (aOR: 1.64 [1.58–1.70]), anxiety disorder (aOR: 1.46 [1.35–1.57]), and PTSD (aOR: 1.41 [1.22–1.64]). A far greater proportion of individuals who died from less common means (other than firearms, suffocation, or poisoning) had schizophrenia (aOR: 4.52 [4.00–5.11]).

Conclusions

Many existing and proposed means restriction interventions have focused on firearms. Additional focus on access to potential agents of poisoning (e.g., the type and quantity of medication administered to patients) among individuals with psychiatric diagnoses may be warranted.

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Availability of data and material

This research uses data from NVDRS, a surveillance system designed by the Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control. The findings are based, in part, on the contributions of the 42 funded states and territories that collected violent death data and the contributions of the states’ partners, including personnel from law enforcement, vital records, medical examiners/coroners, and crime laboratories. The analyses, results, and conclusions presented here represent those of the authors and not necessarily reflect those of CDC. Persons interested in obtaining data files from NVDRS should contact CDC’s National Center for Injury Prevention and Control, 4770 Buford Hwy, NE, MS F-64, Atlanta, GA 30341-3717, (800) CDC-INFO (232-4636).

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Acknowledgments

The authors would like to thank Dr. Michael Allen for his helpful comments in reviewing this manuscript. Contributors to this report included participating Violent Death Reporting System states; participating state agencies, including state health departments, vital registrars’ offices, coroners’ and medical examiners’ offices, crime laboratories, and local and state law enforcement agencies; partner organizations, including the Safe States Alliance, National Violence Prevention Network, National Association of Medical Examiners, National Association for Public Health Statistics and Information Systems (NAPHSIS), Council of State and Territorial Epidemiologists (CSTE), and Association of State and Territorial Health Officials; federal agencies, including the Department of Justice (Bureau of Justice Statistics and the Federal Bureau of Investigation), the Department of the Treasury (Bureau of Alcohol, Tobacco, and Firearms); the International Association of Chiefs of Police; other stakeholders, researchers, and foundations, including The Joyce Foundation, the National Institute for Occupational Safety and Health, and the National Center for Health Statistics, CDC. This research uses data from NVDRS, a surveillance system designed by the Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control. The findings are based, in part, on the contributions of the 42 funded states and territories that collected violent death data and the contributions of the states’ partners, including personnel from law enforcement, vital records, medical examiners/coroners, and crime laboratories. The analyses, results, and conclusions presented here represent those of the authors and not necessarily reflect those of CDC. Persons interested in obtaining data files from NVDRS should contact CDC’s National Center for Injury Prevention and Control, 4770 Buford Hwy, NE, MS F-64, Atlanta, GA 30341-3717, (800) CDC-INFO (232-4636).

Author information

Authors and Affiliations

  1. Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Dustin W. Currie & Carol W. Runyan

  2. Department of Public Health, Purdue University, 812 W State St, MTHW 214F, West Lafayette, IN, 47905, USA

    Laura M. Schwab-Reese

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  1. Dustin W. Currie
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Correspondence to Laura M. Schwab-Reese.

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Currie, D.W., Schwab-Reese, L.M. & Runyan, C.W. Psychiatric diagnoses are associated with means selection in united states suicide deaths. Soc Psychiatry Psychiatr Epidemiol 56, 1791–1799 (2021). https://doi.org/10.1007/s00127-020-01999-2

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  • DOI: https://doi.org/10.1007/s00127-020-01999-2

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