Suicide in Scotland 1988-1989. Psychiatric and physical morbidity according to primary care case notes

Background: The aim was to identify the amount of psychiatric and physical morbidity identified in suicide victims prior to death.Method: A survey was made of primary care records of Scottish suicide victims in the years 1988 and 1989.Results: Less morbidity was encountered than in previous studies. Single persons and persons from lower socio-economic groups were less likely to have a diagnosis of depression. No association was found between physical and psychiatric morbidity. Depressed single persons and depressed persons from lower socio-economic groups were less likely to receive antidepressants. GPs prescribed lower dosages of antidepressants than psychiatrists. Patients receiving antidepressants were more likely to die by drug overdose.Conclusions: There are groups in whom depression may be being overlooked and others in whom depression could be treated more vigorously. There are risks in prescribing antidepressants which are potentially fatal in overdose.