Kr. Conner et al., The validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. 1. Psychiatric diagnoses, ACT PSYC SC, 104(3), 2001, pp. 204-209
Objective: To investigate the validity of best-estimate methodology for mak
ing psychiatric diagnoses among individuals who attempted suicide.
Method: Subjects were 80 patients admitted for treatment following a suicid
e attempt. Psychiatric diagnoses based on structured interviews with subjec
ts were compared with diagnoses made based on interviews with proxy respond
ents. In both cases, interview information was supplemented with pre-admiss
ion psychiatric and medical records to inform diagnoses.
Results: Diagnostic agreement, based on kappa coefficients, was substantial
for major depression and bipolar disorders, and moderate for non-affective
psychoses, organic mood and anxiety disorders. Agreement was substantial f
or substance dependence but poor For substance abuse disorders.
Conclusion: Results support best-estimate methodology for making mood and s
ubstance dependence diagnoses in research of suicidal behavior in this age
group, with potential implications for interpreting postmortem research of
completed suicide.