The British Journal of Psychiatry (2009) 194: 175-180. doi: 10.1192/bjp.bp.108.050500
© 2009 The Royal College of Psychiatrists
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Suicide in dementia: 9-year national clinical survey in England and Wales

Nitin Purandare, PhD, FRCPsych

University of Manchester, Psychiatry Research Group, School of Community Based Medicine, Manchester, UK

Richard C. Oude Voshaar, MD, MSc, PhD

University of Manchester, Psychiatry Research Group, School of Community Based Medicine, Manchester, UK, and Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands

Cathryn Rodway, MSc and Harriet Bickley, MSc

University of Manchester, Centre for Suicide Prevention, Manchester, UK

Alistair Burns, FRCPsych

University of Manchester, Psychiatry Research Group, School of Community Based Medicine, Manchester, UK

Nav Kapur, MD, FRCPsych

University of Manchester, Centre for Suicide Prevention, Manchester, UK.

Correspondence: Dr N. Purandare, Room 3.316, Psychiatry Research Group, School of Community Based Medicine, University of Manchester, University Place (3rd Floor East), Oxford Road, Manchester M13 9PL, UK. Email: nitin.purandare{at}manchester.ac.uk

Declaration on interest

None. Funding detailed in Acknowledgements.

Background

Knowledge of suicide in people with dementia is limited to small case series.

Aims

To describe behavioural, clinical and care characteristics of people with dementia who died by suicide.

Method

All dementia cases (n=118) from a 9-year national clinical survey of suicides in England and Wales (n=11 512) were compared with age- and gender-matched non-dementia cases (control group) (n=492) by conditional logistic regression.

Results

The most common method of suicide in patients with dementia was self-poisoning, followed by drowning and hanging, the latter being less frequent than in controls. In contrast to controls, significantly fewer suicides occurred within 1 year of diagnosis in patients with dementia. Patients with dementia were also less likely to have a history of self-harm, psychiatric symptoms and previous psychiatric admissions.

Conclusions

Known indicators of suicide risk are found less frequently in dementia suicide cases than non-dementia suicide cases. Further research should clarify whether suicide in dementia is a response to worsening dementia or an underappreciation of psychiatric symptoms by clinicians.


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eLetters:

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Suicide by drowning in dementia
Emad Salib
BJP Online, 25 Feb 2009 [Full text]
Suicide in dementia
Camilla Haw
BJP Online, 26 May 2009 [Full text]
Authors' reply
Nitin B Purandare, et al.
BJP Online, 4 Jun 2009 [Full text]