Psychological autopsy studies as diagnostic tools: are they methodologically flawed?

Area of Science:

• Psychiatry
• Psychology
• Public Health

Background:

• The established link between suicide and mental disorders is largely based on psychological autopsy (PA) studies.
• PA studies infer mental health conditions in individuals who have died by suicide through interviews with proxies.

Purpose of the Study:

• To critically evaluate the reliability and validity of psychological autopsy methods in diagnosing mental disorders in individuals who died by suicide.
• To challenge the established assumption that a high percentage of suicides are linked to mental disorders based on current PA methodologies.

Main Methods:

• Scrutiny of the diagnostic process within psychological autopsy studies.
• Analysis of the reliability of proxy interviews for assigning psychiatric diagnoses posthumously.
• Critique of the validity of conclusions drawn from PA studies regarding suicide and mental illness.

Main Results:

• Psychological autopsy studies lack reliability and validity for diagnosing mental disorders in deceased individuals.
• Proxy interviews, especially when conducted long after the event, yield unreliable data for diagnostic purposes.
• The evidence base linking mental disorders to suicide derived from PA studies is fundamentally flawed.

Conclusions:

• Psychological autopsy studies cannot validly establish a strong relationship between mental disorders and suicide.
• The use of psychological autopsies as a diagnostic tool in suicidology should be discontinued.
• Recommends shifting towards qualitative research methods that explore suicide narratives from multiple informants to understand the phenomenon beyond mental disorders.