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      Effects of suicide bereavement on mental health and suicide risk

      , , ,
      The Lancet Psychiatry
      Elsevier BV

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          Abstract

          Between 48 million and 500 million people are thought to experience suicide bereavement every year. Over the past decade, increased policy attention has been directed towards suicide bereavement, but with little evidence to describe the effect of exposure or to provide appropriate responses. We used a systematic approach to carry out a narrative review of studies of the effect of suicide bereavement on mortality, mental health, and social functioning, and compared them with effects from other bereavements. We found 57 studies that satisfied strict inclusion criteria. Results from these studies suggested that exposure to suicide of a close contact is associated with several negative health and social outcomes, depending on an individual's relationship to the deceased. These effects included an increased risk of suicide in partners bereaved by suicide, increased risk of required admission to psychiatric care for parents bereaved by the suicide of an offspring, increased risk of suicide in mothers bereaved by an adult child's suicide, and increased risk of depression in offspring bereaved by the suicide of a parent. Some evidence was shown for increased rejection and shame in people bereaved by suicide across a range of kinship groups when data were compared with reports of relatives bereaved by other violent deaths. Policy recommendations for support services after suicide bereavement heavily rely on the voluntary sector with little input from psychiatric services to address described risks. Policymakers should consider how to strengthen health and social care resources for people who have been bereaved by suicide to prevent avoidable mortality and distress.

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          Most cited references78

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              Psychological autopsy studies of suicide: a systematic review.

              The psychological autopsy method offers the most direct technique currently available for examining the relationship between particular antecedents and suicide. This systematic review aimed to examine the results of studies of suicide that used a psychological autopsy method. A computer aided search of MEDLINE, BIDS ISI and PSYCHLIT, supplemented by reports known to the reviewers and reports identified from the reference lists of other retrieved reports. Two investigators systematically and independently examined all reports. Median proportions were determined and population attributable fractions were calculated, where possible, in cases of suicide and controls. One hundred and fifty-four reports were identified, of which 76 met the criteria for inclusion; 54 were case series and 22 were case-control studies. The median proportion of cases with mental disorder was 91% (95 % CI 81-98%) in the case series. In the case-control studies the figure was 90% (88-95%) in the cases and 27% (14-48%) in the controls. Co-morbid mental disorder and substance abuse also preceded suicide in more cases (38%, 19-57%) than controls (6%, 0-13%). The population attributable fraction for mental disorder ranged from 47-74% in the seven studies in which it could be calculated. The effects of particular disorders and sociological variables have been insufficiently studied to draw clear conclusions. The results indicated that mental disorder was the most strongly associated variable of those that have been studied. Further studies should focus on specific disorders and psychosocial factors. Suicide prevention strategies may be most effective if focused on the treatment of mental disorders.
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                Author and article information

                Journal
                The Lancet Psychiatry
                The Lancet Psychiatry
                Elsevier BV
                22150366
                June 2014
                June 2014
                : 1
                : 1
                : 86-94
                Article
                10.1016/S2215-0366(14)70224-X
                26360405
                3ba9463c-757e-41da-b5c3-d14799ec44f6
                © 2014
                History

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