Mind the past: A systematic review on psychological autopsy

Psychological Autopsy (PA) has become widespread to the point of being applied in many diverse fields. However, it is difficult to identify a standard model. In this systematic review, we focused on PA studies assessing mental illness as a major risk factor for suicide. The research, performed on Scopus, Embase, and Pubmed to cover the last 20 years led to 321 reports of which 15 met the inclusion criteria. Results confirmed mental illness as the main risk factor for suicide, followed by specific socio-demographic factors and life events. The analysis of methodologies depicted a still highly heterogeneous scenario, especially regarding data collection and variables included. However, concerning psychiatric evaluations, an initial standardization process of PA models emerged. In conclusion, the approach is in evolution, and novel guidelines are needed to promote the application of PA as a fundamental tool to inform suicide prevention efforts and to assist forensic examiners in court.