Original Research Suicide Cases in New Brunswick From April 2002 to May 2003: The Importance of Better Recognizing Substance and Mood Disorder Comorbidity

prevalence rates of psychopathology in the deceased. Method: We used 2 psychological autopsy methods: direct proxy-based interviews and medical chart reviews, together with telephone contacts with informants. Consensus DSM-IV diagnoses were formulated by clinical panels on the basis of the Structured Clinical Interviews I and II for DSM-IV complemented by medical charts. Results: Of the 109 suicide deaths identified by the coroner at the time of the study, we were able to investigate 102. At time of death, 65 % of the suicide victims had a mood disorder, 59 % had a substance-related disorder, and 42 % had concurrent mood and substance-related disorders. The lifetime prevalence of substance-related disorders among these suicide victims was 66%. Finally, 52 % of the suicide victims presented with a personality disorder; one-half of these were of the cluster B type. Conclusions: Although treatment of depression has frequently been recognized as the focal point of clinically based suicide-prevention efforts, our results underscore substance-related disorders as a key dimension of completed suicide. Suicide-prevention programs should be designed to address this problem more directly. (Can J Psychiatry 2006;51;581–586) Information on funding and support and author affiliations appears at the end of the article