SUICIDE AND MENTAL-DISORDERS - A CASE-CONTROL STUDY OF YOUNG MEN

Objective: By means of the psychological autopsy method and a case-con trol design, the authors examined the association of specific mental d isorders and comorbidity with suicide among young men. Method: Seventy -five men aged 18-35 years whose deaths were adjudicated as completed suicides by coroners of greater Montreal and Quebec City were matched to 75 living young melt for age, neighborhood, marital status, and occ upation. I;or each subject in both groups a key respondent best acquai nted with the subject was interviewed by clinicians using standardized schedules. Information from the coroner and medical records was also collected. Two experienced psychiatrists, blind to outcome, establishe d best-estimate DSM-III-R diagnoses. Results: Six-month prevalence rat es for all axis I diagnoses for the suicide and comparison groups were 88.0% and 37.3%, respectively; major depression was present in 38.7% and 5.3%, alcohol dependence in 24.0% and 5.3%, psychoactive substance dependence in 22.7% and 2.7%. Borderline personality disorder was ide ntified in 28.0% and 4.0%, respectively. Of the suicide subjects, 28.0 % had at least two of the following disorders: major depression, borde rline personality disorder, and alcohol or drug dependence; the rate w as 0.0% among the comparison subjects. Conclusions: In young men, comp leted suicide is linked to specific mental disorders, namely, major de pression, borderline personality disorder, and substance abuse. Comorb idity involving any of these disorders is frequently associated with c ompleted suicide.