One-hundred cases of suicide in Budapest: a case-controlled psychological autopsy study

The authors performed a case-controlled psychological autopsy study of 100 successive suicides in Budapest, examining the presence of major depression, alcohol, and drug and/or medicament dependency/ abuse according to DSM-IV. The presence of somatic diseases, psychosocial stress, oppressive experiences, and interpersonal relationship disorders within the period of 1 month previous to death was also examined. The control group of 100 people who died of natural causes was identical with the suicide group in respect of number, sex, and age.

Among those committing suicide, psychosocial stress, oppressive experiences, and interpersonal relationship disorders were much more frequent and behavioral changes occurred more often in the weeks preceding death compared to the control group. A single suicide attempt during one's life span did not prove to be predictive for a later fatal action, but multiple attempts did. Major depression was diagnosed in 36% of the cases in the suicide group and 17% in the control group. Half of major-depressed suicides (18 persons) and almost all in the control group (16 persons) suffered from reactive (secondary) major depression as a result of somatic disease. Severe alcoholism was found in 33% of the suicide cases and in 44% of the control group. Drug and/or medicament consumption (misuse and/or abuse) occurred in 14% and 8% of the cases, respectively. The data emphasize again that alcoholism seems to be one of the most serious problems in Hungary both in psychological and somatic illnesses.