Suicide is one of the leading causes of premature death in Western countries. In Slovenia rate of suicide is still above the European average. Risk for suicide is greater among those who suffer from psychiatric illness, particularly depressive or schizophrenic disorder.
The focus of our study was evaluation of compliance of suicide victims with mental illness, who committed suicide in years 2015-2017, to prescribed antidepressants and/or antipsychotics. We included 385 suicide victims from western Slovenia in this retrospective 3 – year study (from 1.1. 2015 to 31.12.2017). Demographyc data (age, gender) toxicology findings, alcholometric analysis and other variables were provided by the Institute for Forensic Medicine of the Medical Faculty of Ljubljana. Data on prescribed medicines with effect on the central nervous system were provided by the National Institute for Public Health. Data analysis disclosed that drug adherence could be assessed in 179 victims of suicide who were prescribed antidepressants and/or antipsychotics at least five years before their death. We found out that only 43 (24 %) suicide victims with prescribed antidepressants and/or antipsychotics were compliant to the treatment up to three months before suicide. There was no statistical significant difference in adherence to antidepressants and antipsychotics in regard to gender, different age groups, additional/no chronic diseases, cancer and substance abuse. We found out that the proportion of those who had attempted suicide in the past was greater in the group of suicide victims with prescribed antidepressants and/or antipsychotics compared to to those with no therapy. Treatment of mental illness from one pharmacodynamic group versus treatment with a combination of antidepressants and antipsychotics, i.e. from several pharmacodynamic groups, had no statistically significant effect on compliance. We have also not found a significant relation between frequent therapy modifications and lesser adherence. Frequent and long-term use of anxiolytics, hypnotics, and sedatives was observed in suicide victims with prescribed medication with effect on the central nervous system. We concluded that treatment guidelines with anxiolytics, hypnotics and sedatives were not followed by the treating physicians.
Poor adherence to prescribed therapy for mental illness represents a major impediment in achieving the desired clinical results and greatly increases the risk of suicide. In order to reduce suicidality, monitoring patient adherence among those who suffer from mental illnesses is of great importance.