Duodenal ulcer, suicide, psychopathology and alcoholism

The incidence of suicide in a consecutive series of 1,000 patients, who underwent Billroth II resection for duodenal ulcer, has been estimated. After an observation period of 21-29 years 13.7% of those who had died had committed suicide. The psychiatric morbidity in this ulcer group was found to be very high. Among the psychiatric diseases alcoholism was dominating, but also non-psychotic conditions such as neurosis and psychopathy were frequent. Fifty per cent of the persons who had committed suicide were alcoholics, and the alcohol abuse seemed to develop after surgery. Gastric resection for duodenal ulcer may have pathogenetic importance in the development of alcoholism, which is known as a predictor of suicide. The importance of considering psychiatric disturbances in the postoperative follow-up is stressed.