الفهرس 
Historical background of psychological autopsyOnly 14 pages are availabe for public view
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Abstract
Psychological autopsy is a retrospective reconstruction of the history of the decedent, which includes examinations of the physical, psychological and environmental details of the decedent’s life to determine more accurately the manner of death and get a better knowledge of the death process and the victim’s role in affecting his own death.
The term ‘Psychological autopsy’ was coined in 1958 by Edwin Shneidman to describe this post-death evaluation. He defined a psychological autopsy as ‘‘nothing less than a thorough retrospective investigation of the intention of the decedent’’.
Psychological autopsy (PA) requires extensive information gathering. Two major sources of information include survivor interviews and review of collateral records. The overriding principle is that the greater the amount of relevant data analyzed, the more accurate the investigator’s conclusions are likely to be.
Time of the interview for research purposes is recommended to be 2–6 month after the suicide. One should avoid approaching a relative close to the anniversary of the death, the birthday of the deceased or at occasions.
There are many ethical considerations to be taken while designing and carrying out such investigation, a written informed consent had to be elicited to minimize the potential harmful effects to the informant by giving the informants the chance to weigh the benefits and risks to themselves in terms of the stress and emotional upheaval of taking part in the research. Confidentiality should be ensured in psychological autopsy, respect for autonomy, beneficence and non-malefience should be taken in consideration during performing psychological autopsy.
Psychological autopsy has been used in both criminal and civil courts in potential litigation following death from unclear reasons in which a retrospective analysis of death is useful as in insurance claims that allow financial recovery for accidents but not suicides, legal actions related to worker’s compensation benefits, product liability claims, malpractice actions alleging suicide and criminal prosecution in which homicide by a third party versus suicide of the decedent is alleged.
Psychological autopsy has been found to have therapeutic effects on informants which include: Search for meaning and decline in guilt feelings, participation as an altruistic gesture, support derived, reestablishing a benevolent connection to others, accepting the loss as real and enhanced capacity for self-understanding.
There are two major fields where psychological autopsy can be applied: suicide psychological autopsy (SPA) and equivocal death psychological autopsy (EDPA).
An equivocal death may be one in which the manner of death is questionable, or the circumstances surrounding the death are otherwise unclear. Psychological autopsy can be a helpful tool to assist medical examiners and investigators in approaching equivocal deaths as in autoerotic asphyxia, suicide by cop, drug related deaths, vehicular deaths, drowning and russian roulette.
Psychological autopsy suicide research approach is regarded as a promising way to enhance understanding of suicide. It offers the most direct technique currently available for examining the relationship between particular risk factor and suicide and remains the only practical and validated approach to evaluate precursors to suicide.
Results of psychological autopsy studies show that the elderly (above 65 years) and the younger (15-30 years) age groups are at increased risk of suicide. Females tend to show higher rates of reported nonfatal suicidal attempts but males have a much higher rate of completed suicide. Whites and Asians were nearly 2.5 times more likely to kill themselves than were blacks or Hispanics. Divorced and separated persons were over twice as likely to commit suicide as married individuals. As regard socioeconomic factors the higher the socioeconomic class, the lower the suicide rate. Social factors including deficits in social support, stressful life events and unemployment are associated strongly with suicide attempts. Previous attempts are the strongest risk factors for further attempt.
Physical and sexual abuse are considered risk factors for suicide, religion is a protective factor of suicide.
Psychological autopsy studies reported that mental disorder is the most strongly associated variable of those that have been studied. The most common are:
1- Major depressive disorders: Many studies have shown that up to 86% of those who commit suicide are in episodes of major depression at the time of suicide.
2- Bipolar disorder: Suicide mortality in bipolar disorders is high, as it causes serious shifts in mood, energy, thinking, and behavior from the highs of mania on one extreme, to the lows of depression on the other.
3- Schizophrenia: It is estimated that 10%–13% of all persons suffering from schizophrenia commit suicide.
4- Substance (alcohol) related disorders: Alcohol dependence is a risk factor for suicide, and in the general population alcohol consumption alone or co-morbid with other psychiatric illness and suicide rates are known to be associated.
5- Personality disorders: In psychological autopsy studies, individuals with personality disorders are frequently found among suicide victims. Personality disorders represent a major risk and contributing factor for suicide death in both males and females especially cluster B personality disorder.