Discrepant Comorbidity between Minority and White Suicides: A National Multiple Cause-of-Death Analysis

Ian Rockett, West Virginia University
Yinjuan Lian, University of Pittsburgh
Steven Stack, Wayne State University
Alan M. Ducatman, West Virginia University

Self-report and records data for the general population indicate that proximate mental health of minority suicides was at least as poor as that of white suicides. This cross-sectional mortality study uses data from Multiple Cause-of-Death (MCOD) public use files for 1999-2003 to describe and evaluate comorbidity among black, Hispanic, and white suicides. One or more mentions of comorbid psychopathology are documented on the death certificates of 8% of white suicides compared to 4% and 3% of black and Hispanic counterparts, respectively. Corresponding female figures are 10%, 8%, and 6%. Multivariate analyses indicate that MCOD data reliably predict suicide-associated comorbid psychopathologies. Cross-validation with National Violent Death Reporting System data reveals gross relative underenumeration of comorbid depression/mood disorders and relative overenumeration of schizophrenia on the death certificates of minority suicides. Such discrepancies underscore need for training, and routinization of psychological autopsies in all cases of suicide and suspected suicide.