Side effects and non-compliance as causes of inpatient suicides – different assessments of caregivers and professionals

Objective: The relevance of side effects and non-compliance is discussed in a few studies regarding inpatient suicide. The perspective of the caregivers is mostly underestimated. Methods: A psychological autopsy study based on literature research, interviews of caregivers (n=9) and medical records was made concerning inpatient suicides of depressive and schizophrenic patients. Results: Two out of four caregivers of depressive inpatients named side effects as possible causes of the suicide, whereas in the medical records no indices of side effects could be found. The assessment of the five caregivers of schizophrenic patients regarding side effects was in correspondence with professionals' documentation in all five cases. Regarding compliance, one out of four caregivers of depressive inpatients and two out of five caregivers of schizophrenic inpatients noticed these problems, whereas any note is missing in the medical records of these patients. On the other hand, professionals noted in another one out of four depressive patients and in another two out of five schizophrenic patients compliance problems. Conclusions: The assessments of professionals and caregivers concerning psychopharmacological problems before inpatient suicide are different. In consequence, caregivers should be routinely asked for their perception regarding side effects and compliance. Their perspective should be considered for early detection of inpatients' suicidal tendencies.