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Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide

Published online by Cambridge University Press:  15 April 2020

B. Wagner ,
J. Müller  and
A. Maercker
B. Wagner*
Affiliation:
University Clinic for Psychotherapy and Psychosomatic Medicine, University Hospital Leipzig, Semmelweisstr. 10, 04103Leipzig, Germany
J. Müller
Affiliation:
Department of Psychiatry, University Hospital Zurich, Culmannstr. 8, 8091Zurich, Switzerland
A. Maercker
Affiliation:
Department of Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050Zurich, Switzerland
*
*Corresponding author. Tel.: +49 341 9718861. E-mail address:birgit.wagner@medizin.uni-leipzig.de
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Abstract

Background

Despite continuing political, legal and moral debate on the subject, assisted suicide is permitted in only a few countries worldwide. However, few studies have examined the impact that witnessing assisted suicide has on the mental health of family members or close friends.

Methods

A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. Full or partial Post-Traumatic Distress Disorder (PTSD; Impact of Event Scale–Revised), depression and anxiety symptoms (Brief Symptom Inventory) and complicated grief (Inventory of Complicated Grief) were assessed at 14 to 24 months post-loss.

Results

Of the 85 participants, 13% met the criteria for full PTSD (cut-off≥35), 6.5% met the criteria for subthreshold PTSD (cut-off≥25), and 4.9% met the criteria for complicated grief. The prevalence of depression was 16%; the prevalence of anxiety was 6%.

Conclusion

A higher prevalence of PTSD and depression was found in the present sample than has been reported for the Swiss population in general. However, the prevalence of complicated grief in the sample was comparable to that reported for the general Swiss population. Therefore, although there seemed to be no complications in the grief process, about 20% of respondents experienced full or subthreshold PTSD related to the loss of a close person through assisted suicide.

Keywords

Assisted suicideEuthanasiaComplicated griefPosttraumatic stress disorderDepression
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 7 , October 2012 , pp. 542 - 546
Copyright
Copyright © European Psychiatric Association 2012

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References

Anderson, W.G.Arnold, R.M.Angus, D.C.Bryce, C.L.Posttraumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Inter Med. 2008; 23(11): 1871–1876.CrossRefGoogle ScholarPubMed
Azoulay, E.Pochard, F.Kentish-Barnes, N.Chevret, S.Aboab, J.Adrie, C.et al.Risk of posttraumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005; 200409:.CrossRefGoogle Scholar
Ben-Ezra, M.Palgi, Y.Essar, N.Impact of war stress on posttraumatic stress symptoms in hospital personnel. Gen Hosp Psychiatry. 2007; 29(3): 264–266.CrossRefGoogle ScholarPubMed
Bosshard, G.Jermini, D.Eisenhart, D.Bär, W.Assisted suicide bordering on active euthanasia. Int. J. Legal Med. 2003; 117(2): 106–108.CrossRefGoogle ScholarPubMed
Bosshard, G.Ulrich, E.Bar, W.748 cases of suicide assisted by a Swiss right-to-die organisation. Swiss Med. Weekly. 133 21–22: 2003 310–317.Google ScholarPubMed
Derogatis, L.R.The brief symptom inventory (BSI): administration, scoring & procedures manual-II. Towson, MD: Clinical Psychometric Research; 1992.Google Scholar
American Psychiatric Association DSM-IV. D. Statistical Manual of Mental Disorders. Washington: American Psychiatric Association; 1994.Google Scholar
Forstmeier, S.Maercker, A.Comparison of two diagnostic systems for complicated grief. J Affect Disord. 99 1–3: 2007 203–211.CrossRefGoogle ScholarPubMed
Kaltman, S.Bonanno, G.A.Trauma and bereavement: examining the impact of sudden and violent deaths. J. Anxiety Disord. 2003; 17(2): 131–147.CrossRefGoogle ScholarPubMed
Kersting A, Brähler E, Glaesmer H, Wagner B. Prevalence of complicated grief in a representative population-based sample. J Affect Disord, in press.Google Scholar
Maercker, A.Forstmeier, S.Enzler, A.Krüsi, G.Hörler, E.Maier, C.Adjustment disorders, posttraumatic stress disorder, and depressive disorders in old age: findings from a community survey. Compr Psychiatry. 2007; 49(2): 113–120.CrossRefGoogle ScholarPubMed
Maercker, A.Forstmeier, S.Enzler, A.Krusi, G.Horler, E.Maier, C.et al.Adjustment disorders, posttraumatic stress disorder, and depressive disorders in old age: findings from a community survey. Compr Psychiatry. 2008; 49(2): 113–120.CrossRefGoogle ScholarPubMed
Maercker, A.Schützwohl, M.Assessment of post-traumatic stress reactions: The Impact of Event Scale-Revised (IES-R). Diagnostica. 1998; 44(3): 130–141.Google Scholar
Neal, L.A.Busuttil, W.Rollins, J.Herepath, R.Turnbull, G.Strike, P.Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. J Trauma Stress. 1994; 7(3):.CrossRefGoogle Scholar
Prigerson, H.G.Jacobs, S.C. Traumatic grief as a distinct disorder: a rationale, consensus criteria and a preliminary empirical test. Handbook of bereavement research: consequences, coping, and care. 2001 p. 613–45.CrossRefGoogle Scholar
Prigerson, H.G.Maciejewski, P.K.Reynolds, C.F.Bierhals, A.J.Newsom, J.T.Fasiczka, A.et al.Inventory of complicated grief: a scale to measure maladaptive symptoms of loss. Psychiatry Res. 59 1–2: 1995 65–79.CrossRefGoogle ScholarPubMed
Prigerson, H.G.Shear, M.K.Jacobs, S.C.Reynolds, C.F. 3rd Maciejewski, P.K.Davidson, J.R.et al.Consensus criteria for traumatic grief. A preliminary empirical test. Br J Psychiatry. 1999; 174(1): 67.CrossRefGoogle ScholarPubMed
Siegel, M.D.Hayes, E.Vanderwerker, L.C.Loseth, D.B.Prigerson, H.G.Psychiatric illness in the next of kin of patients who die in the intensive care unit. Crit Care Med. 2008; 36(6): 1722–1728.CrossRefGoogle ScholarPubMed
Swarte, N.B.van der Lee, M.L.van der Bom, J.G.van den Bout, J.Heintz, A.P.M.Effects of euthanasia on the bereaved family and friends: a cross sectional study. Br. Med. J. 2003; 327(7408): 189.CrossRefGoogle ScholarPubMed
Wagner, B.Maercker, A.An internet-based cognitive-behavioral preventive intervention for complicated grief: a pilot study. G Ital Med Lav Ergon. 2008; 30: 47–53.Google ScholarPubMed
Ware, J.E. Jr.Kosinski, M.Keller, S.D.A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996; 34(3): 220.CrossRefGoogle ScholarPubMed
Weiss, D.S.Marmar, C.R. The impact of event scale-revised. Assessing psychological trauma and PTSD. 1997 p. 399–411.CrossRefGoogle Scholar
Ziegler, S.J.Bosshard, G.Role of non-governmental organisations in physician assisted suicide. BMJ. 2007; 334(7588): 295.CrossRefGoogle ScholarPubMed
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