Psychological autopsy studies of physician and nurse suicide: A narrative summary and synthesis of circumstantial and psychological aspects of death

The aim of this review was to identify and examine psychological autopsy studies of physician and nurse suicide, with the overriding goal of better understanding circumstantial and psychological aspects of death. To the best of our knowledge, this represents the first review to examine psychological autopsy studies of physicians and nurses. A variety of search strategies were utilized. A literature search was conducted using medical databases, reference lists from articles were hand-searched, articles from academic websites were hand-searched, and articles from organizational websites were hand-searched. In total, eight psychological autopsy studies on physician suicide and one psychological autopsy study on nurse suicide were included. Physician and nurse suicide decedents from England and Wales, Finland, Thailand, and the United States were examined using psychological autopsy. Sociodemographic characteristics, occupational status, method(s) of suicide, location of suicide, and presence of a suicide note were inconsistently reported. Alternatively, histories, contributing factors, and circumstances preceding death were consistently reported. Specifically, physician and nurse suicide decedents often had history of mental health concerns, psychiatric hospitalization, and suicide attempt(s). Physician and nurse suicide decedents also often experienced current mental health concerns at time of death, particularly depressive disorders. Alcohol and substance use disorder sometimes occurred concomitantly. Taken together, additional research may be important in updating the evidence base. Additional psychological autopsy studies that include physician and nurse suicide decedents from different global regions may also be important in building the evidence base and in determining the generalizability of findings. Collectively, additional research is important, as psychological autopsy studies may provide important implications for research, surveillance, prevention, and intervention.

Duke Scholars

Author Elizabeth Merwin School of Nursing