CLINICAL CONTACT PRECEDING SUICIDE

Of the 400 consecutive completed suicides investigated over a 5-year p eriod, 114 (28.5%) who had consulted a doctor in the week preceding de ath were specifically reviewed and compared with those who did not. Th e study comprised an analysis of the medical history, the scene of dea th and a complete autopsy with histological and toxicological examinat ion and the identification of features which occurred more frequently in this group when compared with other suicides not contacting their d octors. Suicide-associated factors include psychiatric illness (58.8%) , deteriorating health (16.7%), and a loss of spouse (7.0%); all these features were manifested by this group of suicides more frequently th an by those who made no clinical contact (P < 0.001). A pre-indication of suicidal intention was made by 45% of these patients. This feature , as with previous attempts, occurred more commonly in patients who co nsulted a doctor (P < 0.001). Drug overdose was the most common suicid al method chosen (50.9%) and anti-depressants predominated (35%); 78% of those who overdosed ingested prescribed drugs. Poisoning was more c ommon in this group (P < 0.001). Half of the victims committed suicide within 24 hours following consultation; of these, 51% overdosed on dr ugs with 61% of them ingesting their prescribed drugs. Of these 114 ca ses, the final consultation in 43% was to collect more drugs. AU suici dal threats should be taken seriously, and particular care should be t aken in prescribing and dispensing medication which may be fatal in ov erdose.