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Abstract
The psychological autopsy approach to studying suicide is becoming an increasingly used research method. It presents considerable methodological problems. In order to assist future researchers in this field and to help readers assess reports of psychological autopsy studies the authors have reviewed these issues on the basis of their own experience and those of other workers. The areas covered include research design, identification of subjects, sources of information and the particular issues concerned with approaching relatives and other informants, choice and recruitment of controls, the difficulties of conducting psychological autopsy interviews with relatives, problems for interviewers, the selection of appropriate measures to obtain information, and achieving valid and reasonably reliable conclusions from diverse information sources.
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The psychological autopsy approach has limitations including issues relating to the choice (and selective non-response) of control subjects and the reliance on proxy reports, which are prone to recall bias and measurement error.
“In addition, there are several limitations inherent to the psychological autopsy approach,23–25 including issues relating to the choice (and selective non-response) of control subjects and the reliance on proxy reports—the latter being prone to recall bias and measurement error.”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [23]
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Sorted by citations
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CAVANAGH, J. T. O., CARSON, A. J., SHARPE, M., & LAWRIE, S. M. (2003) · Psychological Medicine · doi:10.1017/s0033291702006943 · Cited by 2,207 · see citing works
“395 type of intensive approach not only provides direct information but also aids the interpretation of studies employing other techniques (Hawton et al. 1998).”
ResultPsychiatric diagnoses in 3275 suicides: a meta-analysis
Arsenault-Lapierre, G., Kim, C., & Turecki, G. (2004) · BMC Psychiatry · doi:10.1186/1471-244x-4-37 · Cited by 985 · see citing works
Risk factors for suicide in China: a national case-control psychological autopsy study
Phillips, M. R., Yang, G., Zhang, Y., Wang, L., Ji, H., & Zhou, M. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11681-3 · Cited by 928 · see citing works
Sex-specific transcriptional signatures in human depression
Labonté, B., Engmann, O., Purushothaman, I., Menard, C., Wang, J., Tan, C., Scarpa, J. R., Moy, G., Loh, Y.-H. E., Cahill, M., et al. (2017) · Nature Medicine · doi:10.1038/nm.4386 · Cited by 748 · see citing works
Risk factors for suicide in later life
Conwell, Y., Duberstein, P. R., & Caine, E. D. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01347-1 · Cited by 701 · see citing works
“Psychological autopsy (PA) is the term used to describe the method by which information is gathered retrospectively about suicides from relatives, friends, caregivers, others familiar with the decedent, and relevant records (Hawton et al 1998) for use in case control studies.”
Suicide and Youth: Risk Factors
Bilsen, J. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00540 · Cited by 584 · see citing works
“In recent decades, several population-based psychological autopsy studies of suicides have been conducted, involving interviews with key informants and examination of records, as well as follow-up studies of people who have attempted suicide, revealing important information about the risk factors for youth suicide (15…”
BackgroundConwell, Y., Van Orden, K., & Caine, E. D. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.02.002 · Cited by 555 · see citing works
“Much of what we know about factors that place older adults at risk for suicide, or protect them from it, has been learned from retrospective analysis of the characteristics, backgrounds and circumstances of people who kill themselves, an approach known as the psychological autopsy (PA) method (4).”
Suicide within 12 months of contact with mental health services: national clinical survey
Appleby, L., Shaw, J., Amos, T., McDonnell, R., Harris, C., McCann, K., Kiernan, K., Davies, S., Bickley, H., & Parsons, R. (1999) · BMJ · doi:10.1136/bmj.318.7193.1235 · Cited by 469 · see citing works
Bereaved parents’ experience of research participation
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Psychological autopsy studies – a review
Isometsä, E. T. (2001) · European Psychiatry · doi:10.1016/s0924-9338(01)00594-6 · Cited by 379 · see citing works
Pelkonen, M. U. I., & MARTTUNEN, M. J. (2003) · Pediatric Drugs · doi:10.2165/00128072-200305040-00004 · Cited by 359 · see citing works
Conwell, Y., & Thompson, C. (2008) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2008.01.004 · Cited by 333 · see citing works
Favril, L., Yu, R., Uyar, A., Sharpe, M., & Fazel, S. (2022) · Evidence Based Mental Health · doi:10.1136/ebmental-2022-300549 · Cited by 336 · see citing works
Angst, J., Angst, F., Gerber-Werder, R., & Gamma, A. (2005) · Archives of Suicide Research · doi:10.1080/13811110590929488 · Cited by 317 · see citing works
Risk factors for suicide independent of DSM–III–R Axis I disorder
Foster, T., Gillespie, K., McLelland, R., & Patterson, C. C. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.2.175 · Cited by 273 · see citing works
“methodology Although the Northern Ireland Suicide Study shares the methodological limitations of all psychological autopsy studies (Hawton et al, 1998), evidence is accumulating in support of the validity and reliability of this method (Barraclough et al, 1974; Kelly & Mann, 1996).”
MethodSelf-citationAccess to Firearms and Risk for Suicide in Middle-Aged and Older Adults
Conwell, Y., Duberstein, P. R., L.Connor, K., Eberly, S. W., Cox, C., & Caine, E. D. (2002) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200207000-00007 · Cited by 263 · see citing works
Gender differences in suicide methods
Callanan, V. J., & Davis, M. S. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0393-5 · Cited by 258 · see citing works
“Despite the challenges inherent in an approach that relies on contacting survivors and other informants [65, 66], it is possible that these kinds of data would permit the analyst to tease out subtleties not discernable with death certificate or medical examiner data alone.”
BackgroundPoor social integration and suicide: Fact or artifact? A case-control study
DUBERSTEIN, P. R., CONWELL, Y., CONNER, K. R., EBERLY, S., EVINGER, J. S., & CAINE, E. D. (2004) · Psychological Medicine · doi:10.1017/s0033291704002600 · Cited by 246 · see citing works
“We used data collected via the psychological autopsy method (Hawton et al. 1998; Cavanagh et al. 2003) to examine this issue, as it has implications for risk identification and the development of suicide prevention programs.”
MethodCulture, risk factors and suicide in rural China: a psychological autopsy case control study
Zhang, J., Conwell, Y., Zhou, L., & Jiang, C. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00388.x · Cited by 235 · see citing works
“In order to obtain the maximum amount of information as well as to decrease recall bias about the case and selective recall or selective forgetting (24), we used two informants (a next of kin and colleague or neighbor) for each suicide case and two for each control plus the control him/ herself.”
MethodPsychological Autopsy Studies as Diagnostic Tools: Are They Methodologically Flawed?
Hjelmeland, H., Dieserud, G., Dyregrov, K., Knizek, B. L., & Leenaars, A. A. (2012) · Death Studies · doi:10.1080/07481187.2011.584015 · Cited by 232 · see citing works
“Some studies have found that, for instance, friends sometimes know more than parents about substance abuse, interpersonal problems, and=or suicidal ideation (e.g., Hawton et al., 1998).”
BackgroundResultInfluentialPsychological autopsy study of suicides by people aged under 35
Appleby, L., Cooper, J., Amos, T., & Faragher, B. E. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.2.168 · Cited by 227 · see citing works
Self-citationCritical Issues in Psychological Autopsy Studies
Pouliot, L., & De Leo, D. (2006) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2006.36.5.491 · Cited by 218 · see citing works
Suicidal behaviour and psychosocial problems in veterinary surgeons: a systematic review
Platt, B., Hawton, K., Simkin, S., & Mellanby, R. J. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0328-6 · Cited by 213 · see citing works
“This involves examining the coroners’ records for cases of suicide in the population of interest, and where possible interviewing relatives and other informants [39].”
BackgroundSelf-citationPsychological strains and youth suicide in rural China
Zhang, J., Wieczorek, W. F., Conwell, Y., & Tu, X. M. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.03.048 · Cited by 206 · see citing works
“Nonetheless, psychological autopsy may be the only cost-effectiveway to assess the background and experiences of the deceased before the suicide incident (Hawton et al., 1998).”
BackgroundApples to oranges?: A direct comparison between suicide attempters and suicide completers
DeJong, T. M., Overholser, J. C., & Stockmeier, C. A. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.10.020 · Cited by 198 · see citing works
“As recommended for psychological autopsy procedures (Ebert, 1987; Hawton et al., 1998), the final diagnostic evaluation included information from the coroner's report, laboratory findings of recent substance use, suicide notes, employment history, educational attainment, and family history of psychiatric disorders.”
Foster, T. (2011) · Archives of Suicide Research · doi:10.1080/13811118.2011.540213 · Cited by 181 · see citing works
Self-citationSerious Suicide Attempts: Systematic Review of Psychological Risk Factors
Gvion, Y., & Levi‐Belz, Y. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00056 · Cited by 183 · see citing works
Elderly suicide in Hong Kong—a case-controlled psychological autopsy study
Chiu, H. F. K., Yip, P. S. F., Chi, I., Chan, S., Tsoh, J., Kwan, C. W., Li, S. F., Conwell, Y., & Caine, E. (2004) · Acta Psychiatrica Scandinavica · doi:10.1046/j.1600-0447.2003.00263.x · Cited by 180 · see citing works
Suicide in young people aged 15–24: a psychological autopsy study
Houston, K., Hawton, K., & Shepperd, R. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00175-0 · Cited by 177 · see citing works
“…using analysis was to determine if there are any differences the psychological autopsy approach (Shneidman, in demographic or psychiatric characteristics be1981; Brent et al., 1988; Clark and Horton-Deutsch, tween young males who self harm and survive and 1992; Hawton et al., 1998a). those who die.”
BackgroundMethodSelf-citationChildhood Predictors of Completed and Severe Suicide Attempts
Sourander, A., Klomek, A. B., Niemelä, S., Haavisto, A., Gyllenberg, D., Helenius, H. Y. M., Sillanmäki, L. H., Ristkari, T., Kumpulainen, K., Tamminen, T., et al. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.21 · Cited by 168 · see citing works
Suicide and mental disorders: A discourse of politics, power, and vested interests
Hjelmeland, H., & Knizek, B. L. (2017) · Death Studies · doi:10.1080/07481187.2017.1332905 · Cited by 176 · see citing works
“This is emphasized in the instruction in some of the diagnostic manuals, as well as by influential professionals and experienced researchers in the field, including conductors of some of the “classic” PA studies (e.g., Hawton et al., 1998).”
BackgroundAdolescent Substance Use and Suicidal Behavior: A Review With Implications for Treatment Research
Esposito-Smythers, C. L., & Spirito, A. (2004) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000127417.99752.87 · Cited by 169 · see citing works
Conner, K. R., & Duberstein, P. R. (2004) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000127410.84505.2a · Cited by 169 · see citing works
Violence, Alcohol, and Completed Suicide: A Case-Control Study
Conner, K. R., Cox, C., Duberstein, P. R., Tian, L., Nisbet, P. A., & Conwell, Y. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.10.1701 · Cited by 168 · see citing works
“The case-control approach assumes that variables distinguishing suicide victims from an appropriate comparison group are likely to be risk factors for suicide (22).”
BackgroundDementia and suicidal behavior: a review of the literature
Haw, C., Harwood, D., & Hawton, K. (2009) · International Psychogeriatrics · doi:10.1017/s1041610209009065 · Cited by 166 · see citing works
“Hawton, K. et al. (1998). The psychological autopsy”
BackgroundSelf-citationLongitudinal Effects of Parental Bereavement on Adolescent Developmental Competence
Brent, D. A., Melhem, N. M., Masten, A. S., Porta, G., & Payne, M. W. (2012) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.717871 · Cited by 162 · see citing works
“Psychiatric assessment of the proband was conducted using a psychological autopsy procedure (Hawton et al., 1998).”
MethodHealth status and suicide in the second half of life
Conwell, Y., Duberstein, P. R., Hirsch, J. K., Conner, K. R., Eberly, S., & Caine, E. D. (2010) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2348 · Cited by 159 · see citing works
“Recent studies using the case control psychological autopsy (PA) method (Hawton et al., 1998) have contributed greatly to our understanding of risk factors for suicide in older adults (Conwell et al., 2000; Harwood et al., 2001; Beautrais, 2002; Waern et al., 2002b; Chiu et al., 2004).”
Risk factors for suicide in Hungary: a case-control study
Almasi, K., Belsó, N., Kapur, N., Webb, R. T., Cooper, J., Hadley, S., Kerfoot, M., Dunn, G., Sótonyi, P., Rihmer, Z., et al. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-45 · Cited by 156 · see citing works
“We used a psychological autopsy methodology [6].”
Self-citationSuicide in children and young people in England: a consecutive case series
Rodway, C., Tham, S.-G., Ibrahim, S. A., Turnbull, P., Windfuhr, K. L., Shaw, J. J., Kapur, N., & Appleby, L. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30094-3 · Cited by 150 · see citing works
Self-citationPhillips, M. R., Yang, G., Li, S., & Li, Y. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17061-x · Cited by 147 · see citing works
Harwood, D., Hawton, K. E., Hope, T., Harriss, L., & Jacoby, R. J. (2006) · Psychological Medicine · doi:10.1017/s0033291706007872 · Cited by 142 · see citing works
“Several other types of bias can affect the validity and reliability of information obtained through psychological autopsy interview (Hawton et al. 1998).”
BackgroundSelf-citationHawtdn, K., Houston, K., & Shepperd, R. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.3.271 · Cited by 142 · see citing works
Recognising and responding to suicidal crisis within family and social networks: qualitative study
Owens, C., Owen, G., Belam, J., Lloyd, K., Rapport, F., Donovan, J., & Lambert, H. (2011) · BMJ · doi:10.1136/bmj.d5801 · Cited by 138 · see citing works
Understanding the unique characteristics of suicide in China: national psychological autopsy study.
Yang, G., Phillips, M. R., Zhou, M., Wang, L., Zhang, Y.-P., & Xu, D. (2005) · PubMed · Cited by 138 · see citing works
Suicide and no axis I psychopathology
Ernst, C., Lalovic, A., LESAGE, A. D., Séguin, M., Tousignant, M., & Turecki, G. (2004) · BMC Psychiatry · doi:10.1186/1471-244x-4-7 · Cited by 136 · see citing works
“The standard method to assess psychopathology in suicide completers is the psychological autopsy [6].”
BackgroundMethodThe role of alcohol in suicide: a case-control psychological autopsy study
Kõlves, K., Värnik, A., Tooding, L., & Wasserman, D. (2006) · Psychological Medicine · doi:10.1017/s0033291706007707 · Cited by 134 · see citing works
“‘Psychological autopsy’ may be regarded as a reliable method for post-mortem psychiatric diagnosis (Brent et al. 1993; Kelly & Mann, 1996; Hawton et al. 1998; Schneider et al. 2004).”
MethodMilner, A. J., Svetičič, J., & Leo, D. D. (2012) · International Journal of Social Psychiatry · doi:10.1177/0020764012444259 · Cited by 133 · see citing works
“Following the suggestions of past methodological reviews (Hawton et al., 1998; Pouliot & De Leo, 2006), most recent PA studies use a control group and a standardized method of collecting information from proxy informants.”
MethodCho, S.-E., Na, K.-S., Cho, S.-J., Im, J.-S., & Kang, S.-G. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.008 · Cited by 133 · see citing works
“Given that the previous studies addressed the methodological issues in psychological autopsies (Conner et al., 2011, 2012; Hawton et al., 1998), the assessment consisted of the following eight criteria: (1) if the study was designed prospectively or retrospectively, (2) the recruitment protocol,…”
BackgroundMethodPsychiatric disorders in male prisoners who made near-lethal suicide attempts: case–control study.
Rivlin, A., Hawton, K., Marzano, L., & Fazel, S. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.077883 · Cited by 127 · see citing works
“12 13–15 In this study, we addressed this limitation by assessing psychiatric disorders in male prisoners who made near-lethal suicide attempts and comparing them with those of a matched control group of prisoners who had never made a similar attempt in prison.”
Self-citationReactive aggression and suicide
Conner, K. R., Duberstein, P. R., Conwell, Y., & Caine, E. D. (2003) · Aggression and Violent Behavior · doi:10.1016/s1359-1789(02)00067-8 · Cited by 130 · see citing works
Pham, S., Porta, G., Biernesser, C. L., Payne, M. W., Iyengar, S., Melhem, N., & Brent, D. A. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.17070792 · Cited by 129 · see citing works
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Self-citationHawton, K. E., Malmberg, A., & Simkin, S. (2004) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(03)00372-6 · Cited by 126 · see citing works
Self-citationMental pain and its communication in medically serious suicide attempts: an “impossible situation”
Levi, Y., Horesh, N., Fischel, T., Treves, I., Or, E., & Apter, A. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.02.022 · Cited by 125 · see citing works
“and deliberate self harm (DSH) (Kreitman, 1977; WHO, 1995) or to gather information on victims post factum (psychological autopsy) (Apter et al., 1993; Hawton et al., 1998).”
BackgroundZhang, J., Conwell, Y., Wieczorek, W. F., Jiang, C. Q., Jia, S., & Zhou, L. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000081613.03157.d9 · Cited by 121 · see citing works
“Methodological guidelines for determining postmortem psychiatric diagnoses and other risk factors have been offered (Brent et al., 1988b; Clark et al., 1992; Ebert, 1987; Hawton et al., 1998) and initiated in China but require empirical validation.”
BackgroundSuicide Note Themes and Suicide Prevention
Foster, T. (2003) · The International Journal of Psychiatry in Medicine · doi:10.2190/t210-e2v5-a5m0-qlju · Cited by 121 · see citing works
“The psychological autopsy method [5, 6] involves detailed interviews with bereaved relatives and friends of suicides, interviews with healthcare professionals, and pooling of information from a variety of documentary sources, including coroners’ files which contain suicide notes.”
MethodSelf-citationStudying Survivors of Nearly Lethal Suicide Attempts: An Important Strategy in Suicide Research
Hawton, K. E. (2002) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.32.1.5.76.24215 · Cited by 119 · see citing works
Self-citationConner, K. R., Conwell, Y., & Duberstein, P. R. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00091.x · Cited by 115 · see citing works
Portzky, G., Audenaert, K., & van Heeringen, K. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0977-x · Cited by 113 · see citing works
“The psychological autopsy approach is the most informative method of studying the causes of suicide [21, 35].”
MethodUnderstanding suicide risk: identification of high‐risk groups during high‐risk times
Overholser, J. C., Braden, A. L., & Dieter, L. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20859 · Cited by 110 · see citing works
The Next Generation of Psychological Autopsy Studies: Part I. Interview Content
Conner, K. R., Beautrais, A. L., Brent, D. A., Conwell, Y., Phillips, M. R., & Schneider, B. (2011) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2011.00057.x · Cited by 110 · see citing works
Life events preceding suicide by young people
Cooper, J., Appleby, L., & Amos, T. (2002) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270200019 · Cited by 108 · see citing works
Self-citationSuicide Prevention: State of the Art Review
Stone, D. M., & Crosby, A. E. (2014) · American Journal of Lifestyle Medicine · doi:10.1177/1559827614551130 · Cited by 103 · see citing works
“Much of the information about risk factors for suicide comes from psychological autopsy studies, retrospective analyses of the characteristics, backgrounds, and circumstances of people who die by suicide.(24) These studies have advantages such as being very in depth and disadvantages such as relying on key informants…”
BackgroundConcordance of DSM-IV Axis I and II diagnoses by personal and informant's interview
Schneider, B., Maurer, K., Sargk, D., Heiskel, H., Weber, B., Frölich, L., Georgi, K., Fritze, J., & Seidler, A. (2004) · Psychiatry Research · doi:10.1016/j.psychres.2004.02.015 · Cited by 105 · see citing works
“method, referred to as the ‘psychological autopsy’ (Hawton et al., 1998) when used in post-mortem”
MethodLife trajectories and burden of adversity: mapping the developmental profiles of suicide mortality
SÉGUIN, M., LESAGE, A., TURECKI, G., BOUCHARD, M., CHAWKY, N., TREMBLAY, N., DAIGLE, F., & GUY, A. (2007) · Psychological Medicine · doi:10.1017/s0033291707000955 · Cited by 101 · see citing works
“These include factors related to third-party assessments (Hawton et al. 1998), such as recall biases and inaccurate information (Burgess et al.”
BackgroundMethodInfluentialSuicídio entre pessoas idosas: revisão da literatura
Minayo, M. C. D. S., & Cavalcante, F. G. (2010) · Revista de Saúde Pública · doi:10.1590/s0034-89102010000400020 · Cited by 110 · see citing works
Axis I disorders and personality disorders as risk factors for suicide
Schneider, B., Wetterling, T., Sargk, D., Schneider, F. W., Schnabel, A., Maurer, K., & Fritze, J. (2005) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-005-0593-7 · Cited by 100 · see citing works
Maselko, J., & Patel, V. (2008) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2007.069351 · Cited by 100 · see citing works
Conner, K. R., Duberstein, P. R., & Conwell, Y. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00405.x · Cited by 97 · see citing works
Suicide in police--a critical review.
Hem, E., Berg, A., & Ekeberg, A. O. (2001) · Suicide and Life-Threatening Behaviour · doi:10.1521/suli.31.2.224.21513 · Cited by 107 · see citing works
Epigenetic Regulation of the Kappa Opioid Receptor by Child Abuse
Lutz, P.-E., Gross, J. A., Dhir, S. K., Maussion, G., Yang, J., Bramoulle, A., Meaney, M. J., & Turecki, G. (2018) · Biological Psychiatry · doi:10.1016/j.biopsych.2017.07.012 · Cited by 96 · see citing works
Giner, L., Blasco-Fontecilla, H., Pérez-Rodríguez, M. M., Nieto, R. G., Giner, J., Guija, J. A., Rico, A. R., Barrero, E., Luna, M. A., de León, J., et al. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.06.029 · Cited by 94 · see citing works
“The most frequent method of suicide attempt among females was drug overdose (73.2%), whereas female completers most frequently died by hanging (34.5”
InfluentialSuicide in adolescents: Using life charts to understand the suicidal process
Fortune, S. A., Stewart, A., Yadav, V., & Hawton, K. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.10.022 · Cited by 93 · see citing works
“One valuable approach has been the use of psychological autopsy studies (Hawton et al., 1998).”
BackgroundSelf-citationSuicide prevention: A study of patients' views
Eagles, J., Carson, D. P., Begg, A., & Naji, S. A. (2003) · The British Journal of Psychiatry · doi:10.1192/bjp.182.3.261 · Cited by 90 · see citing works
Suicide and its Prevention among Older Adults
Heisel, M. J. (2006) · The Canadian Journal of Psychiatry · doi:10.1177/070674370605100304 · Cited by 89 · see citing works
“Retrospective research typically uses the so-called PA methodology (14), involving collection of all-source information from medical and mental health record review, coroner and (or) police reports, and interviews with family, caregivers, and acquaintances of those who died by suicide.”
MethodRisk factors for suicide in China's youth: a case-control study
Li, X. Y., Phillips, M. R., Zhang, Y. P., Xu, D., & Yang, G. H. (2007) · Psychological Medicine · doi:10.1017/s0033291707001407 · Cited by 89 · see citing works
“…controls (Vijaykumar & Rajkumar, 1999; Mortensen et al. 2000 ; Beautrais, 2001), but dead controls have methodological advantages (Brent, 1989; Hawton et al. 1998) because the source of information used to assess risk factors – proxy informants who * Address for correspondence : Dr X. Y. Li,…”
BackgroundMethodTales of biographical disintegration: how parents make sense of their sons’ suicides
Owens, C. V., Lambert, H., Lloyd, K. R., & Donovan, J. (2007) · Sociology of Health & Illness · doi:10.1111/j.1467-9566.2007.01034.x · Cited by 88 · see citing works
Lee, Y. J., Kim, S., Gwak, A. R., Kim, S. J., Kang, S., Na, K., Son, Y., & Park, J. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.02.013 · Cited by 84 · see citing works
“among the factors most strongly associated with suicide [1,2].”
BackgroundDying online: live broadcasts of Chinese emerging adult suicides and crisis response behaviors
Ma, J., Zhang, W., Harris, K. M., Chen, Q., & Xu, X. (2016) · BMC Public Health · doi:10.1186/s12889-016-3415-0 · Cited by 83 · see citing works
The association between depression and suicide when hopelessness is controlled for
Zhang, J., & Zi-yao, L. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.03.004 · Cited by 86 · see citing works
“The most important source, however, is interview of relatives and other key informants [12].”
BackgroundMultiple substance use and self-reported suicide attempts by adolescents in 16 European countries
Kokkevi, A., Richardson, C., Olszewski, D., Matias, J., Monshouwer, K., & Bjarnason, Þ. (2012) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-012-0276-7 · Cited by 81 · see citing works
“The close association of both of these behaviors with completed suicide [19, 20, 40] and their comorbid relationship with other high-risk behaviors indicates that they should be considered as early signs of health-compromising outcomes and of an eventually lethal one.”
BackgroundCoimbra, D. G., Silva, A. C. P. E., de Sousa‐Rodrigues, C. F., Barbosa, F. T., Figueredo, D. D. S., Santos, J. L. A., Barbosa, M. R., Alves, V. D. M., Nardi, A. E., & de Andrade, T. G. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.02.036 · Cited by 77 · see citing works
“In despite of the proportion of completed suicides be twice higher in men than women, the rate of suicide attempts are more prevalent in women, particularly for young people (Hawton et al., 1998; Iribarren et al., 2000; Parra Uribe et al., 2013; Younes et al., 2015).”
BackgroundMalmberg, A., Simkin, S., & Hawton, K. E. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.2.103 · Cited by 78 · see citing works
Self-citationTanti, A., Kim, J. J., Wakid, M., Davoli, M.-A., Turecki, G., & Mechawar, N. (2017) · Molecular Psychiatry · doi:10.1038/mp.2017.231 · Cited by 76 · see citing works
Bell, J., Bailey, L., & Kennedy, D. (2015) · Mortality · doi:10.1080/13576275.2015.1083693 · Cited by 76 · see citing works
“In line with good ethical practice, interview questions with the most potential to elicit painful memories were asked near the beginning of the interview (Cooper, 1999; Hawton et al., 1998).”
BackgroundInfluentialDouglas, J., Cooper, J., Amos, T., Webb, R. T., Guthrie, E., & Appleby, L. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00391-9 · Cited by 73 · see citing works
“however, are subject to a number of biases because information must be obtained from an informant (Hawton et al., 1998).”
BackgroundSelf-citationThe increased use of antidepressants has contributed to the worldwide reduction in suicide rates
Isacsson, G., Rich, C. L., Jureidini, J. N., & Raven, M. K. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.076166 · Cited by 74 · see citing works
Geoffroy, M., Gunnell, D., & Power, C. (2013) · Psychological Medicine · doi:10.1017/s003329171300189x · Cited by 72 · see citing works
“A standard approach to investigate the causes of suicide is the psychological autopsy (interviews with friends/family/colleagues/carers associated with the deceased) which has been informative about the psychological and contextual circumstances near to suicide (Gould et al. 1996; Hawton et al. 1998; Foster et al. 199…”
BackgroundNademin, E., Jobes, D. A., Pflanz, S. E., Jacoby, A. M., Ghahramanlou‐Holloway, M., Campise, R. L., Joiner, T. E., Wagner, B. M., & Johnson, L. G. (2008) · Archives of Suicide Research · doi:10.1080/13811110802324847 · Cited by 71 · see citing works
Conner, K. R., Houston, R. J., Swogger, M. T., Conwell, Y., You, S., He, H., Gamble, S. A., Watts, A., & Duberstein, P. R. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.07.013 · Cited by 71 · see citing works
“Postmortem psychological autopsy studies (Hawton et al., 1998; Pouliot and De Leo, 2006) consistently document that interpersonal stressful life events (SLEs) precede suicide among adults with AUD.”
BackgroundSuicide Outside the Care of Mental Health Services
Owens, C. V., Booth, N. J., Briscoe, M., Lawrence, C. J., & Lloyd, K. R. (2003) · Crisis · doi:10.1027//0227-5910.24.3.113 · Cited by 71 · see citing works
“Unfortunately, there is no way to compare responding and nonresponding controls (Hawton et al., 1998), except that they were matched by age and sex to the same individuals.”
BackgroundResultInfluentialShibre, T., Hanlon, C., Medhin, G., Alem, A., Kebede, D., Teferra, S., Kullgren, G., Jacobsson, L. H., & Fekadu, A. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-150 · Cited by 70 · see citing works
“Over 90% of all suicides are believed to occur in the context of mental disorders [2-7] mostly mood disorders, and alcohol and substance use disorders [7,8].”
BackgroundA qualitative study of help seeking and primary care consultation prior to suicide.
Owens, C. V., Lambert, H., Donovan, J., & Lloyd, K. R. (2005) · Europe PMC (PubMed Central) · Cited by 69 · see citing works
The Next Generation of Psychological Autopsy Studies
Conner, K. R., Beautrais, A. L., Brent, D. A., Conwell, Y., Phillips, M. R., & Schneider, B. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2011.00073.x · Cited by 67 · see citing works
Suicide Terrorists: Are They Suicidal?
Townsend, E. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.1.35 · Cited by 66 · see citing works
Séguin, M., LESAGE, A. D., Chawky, N., Guy, A., Daigle, F., Girard, G., & Turecki, G. (2006) · The Canadian Journal of Psychiatry · doi:10.1177/070674370605100906 · Cited by 65 · see citing works
Kung, H.-C., Pearson, J. L., & Wei, R. (2004) · Annals of Epidemiology · doi:10.1016/j.annepidem.2004.09.011 · Cited by 63 · see citing works
Religion and Suicide in Patients with Mental Illness or Cancer
Panczak, R., Spoerri, A., Zwahlen, M., Bopp, M., Gutzwiller, F. F., & Egger, M. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12009 · Cited by 60 · see citing works
The Schizophrenia Suicide Risk Scale (SSRS): development and initial validation
Taiminen, T. J., Huttunen, J., Heilä, H., HENRIKSSON, M. M., Isometsä, E. T., Kähkönen, J., Tuominen, K., Lönnqvist, J. K., Addington, D. E., & Helenius, H. Y. M. (2001) · Schizophrenia Research · doi:10.1016/s0920-9964(00)00126-2 · Cited by 58 · see citing works
- Authors
- Hawton, K. E., Appleby, L., Platt, S., Foster, T., Cooper, J., Malmberg, A., & Simkin, S.
- Affiliations
- Warneford Hospital (GB)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1998-09
- Volume
- 50
- Issue
- 2-3
- Pages
- 269-276
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1732968872
- Cited by
- 324
- References
- 0
- Citations by year
- 2025: 5 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 9 · 2019: 5 · 2018: 9 · 2017: 10 · 2016: 13 · 2015: 18 · 2014: 11 · 2013: 18 · 2012: 35
- FWCI
- 9.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- psychological autopsy, suicide, research design, informant selection, control selection, interview validity, reliability statistics, information sources
- MeSH terms
- Autopsy, Cause of Death, Data Collection, Family Relations, Humans, Research Design, Suicide
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