Palacio, Carlos; Garcia, Jenny; Mejia, Carlos University of Antioquia/ University of Antioquia, Colombia
Substance abuse and depression are associated with 17.6 percent and 30.2 percent of suicide cases, respectively. Little is known about the psychiatric comorbidity of people who die in accidents. The purpose of this study was to compare the psychiatric comorbidity of victims of suicide and accidents. A case-control study was conducted in 108 victims of suicide and 108 victims of accidents. The cases were matched with controls by age and gender. A psychological autopsy was conducted among close friends and relatives of the victims to assess history of psychiatric disorders, including substance abuse. The median age was 29 years, 87 (80.6 percent) of the suicides and of the accident victims were male. The unemployment rate was 27.8 percent for the suicides and 10.2 percent for accident victims. The methods to commit suicide consisted of: 51 (47.2 percent) hanging, 24 (22.2 percent) fired gunshot, 17 (15.7 percent) poisoning, 7 (6.5 percent) jumping from a height, three (2.8 percent) sharp weapon wound and 6 (5.6 percent) others. The accidents consisted of transit. There were no significant group differences in sociodemographic characteristics. It was found that 90 percent of the individuals who committed suicide had a psychiatric disorder in contrast with only 37 percent of those who died as a result of an accident (OR = 22.79, CI: 9.09 - 57,11). History of substance abuse was present in 54.6 percent of the suicides and 34.3 percent of the accident victims (OR=2.72, C.I.:1.50-4,92). History of depression was present in 62 percent and 11.1 percent of suicides and accident victims, respectively (OR=23.14, C.I.: 9,24-57,91). Multivariate logistic regression showed that there was not interaction between the depressive disorder and substance abuse to trigger a suicidal event. The results show that psychiatric comorbidities and substance abuse are an important risk factor for suicide and to a lower extent to accidents and that substance abuse and depression may be independent risk factors for suicide. Emphasis should be placed on the early identification and treatment of substance abuse and depression to prevent deaths associated with suicide and accidents.