Citation

Ertle AR. Ann. Intern Med. 2018; 169(1): 47-49.

Copyright

(Copyright © 2018, American College of Physicians)

DOI

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PMID

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Abstract

I read the article by Betz, et. al., with interest. However, I was disappointed to find that the actual size of the problem of suicide by firearms in patients with dementia (PWD) was not clarified. There is only a theoretical context in that there is a growing number of patients with dementia, some of whom will commit suicide by firearm, and lots of households with firearms. In 2011 an article was published by Seyfried, et. al., that described a 2001-2005 retrospective analysis of the Department of Veterans Affairs data of 294,952 patients (97.2% male) who had dementia and they found that there were 241 suicides during that period, 72.6% by firearms.1 This is estimated to be 11.9 suicides by firearm per 100,000 PWDs per year. There were potential predictors identified including male gender, white race, depression, a history of an inpatient psychiatric stay, prescriptions for antidepressants, and prescriptions for antianxiety medications. The authors of this study also indicate that suicide was much more likely early in the diagnosis. While suicide by firearms is not common in PWD, it does occur, and this is likely to be similar to other patients who are told of a terminal diagnosis or other serious illness. While the general recommendations seem sound, the Betz article would have been more useful if the scope were broadened to discuss the issue of suicide by firearms in all patients given a terminal or serious diagnosis.

See: DOI: 10.7326/M18-0140

Language: en