Depression and personality disorders drive psych patients to euthanasia

July 27, 2015

Depression and personality disorders are the most common diagnoses among Belgian psychiatric patients requesting help to die, on the grounds of unbearable suffering, finds research published in the online journal BMJ Open.

Drugs, given either by mouth or administered intravenously, are used to perform euthanasia in Belgium, where the practice has been legal since 2002.

The researchers wanted to find out if there were any discernible patterns in requests for euthanasia among mentally ill patients in Belgium in a bid to inform recommendations for future research.

So they tracked requests for help to die, made by patients receiving treatment for psychiatric problems in outpatient clinics in the Dutch speaking part of Belgium between 2007 and 2011, and followed up to the end of 2012.

During this period, 77 women and 23 men asked for euthanasia on the grounds of unbearable suffering associated with mental illness. Their average age was 47, but this ranged from 21 to 80.

Most (91) of the patients had been referred for counselling. Seventy three had been deemed medically unfit to work, and 59 were living alone.

Ninety had more than one mental health issue, with depression (58 patients) the most frequent diagnosis, followed by personality disorder (50).

Thirty eight patients required further tests and/or treatment, 13 of whom were specifically tested for autistic spectrum disorders. Twelve were subsequently diagnosed with Asperger's syndrome, a form of high functioning autism.

In all, 48 of the requests were accepted, and 35 carried out. Among the remaining 13, eight cancelled or delayed the procedure on the grounds that simply having the option gave them enough peace of mind to continue living.

By December 2012, 43 of the patients had died, including six who had taken their own lives. Among this group, one patient committed suicide because she found the approvals process too long, while another did so because her family had objected to euthanasia. A third woman killed herself after a spell in a psychiatric ward.

Another had died as a result of palliative sedation by the end of 2012, and one had died of the eating disorder, anorexia nervosa.

Thirty patients died surrounded by family/friends, and in a serene and positive atmosphere, "which would have been impossible to attain in the case of unassisted traumatic suicide," note the authors.

In 2010 and 2011, 2086 patients died by euthanasia in Belgium, accounting for 1% of all deaths during that period, with those who were not terminally ill making up less than 10% of the total.

But as yet, there is no consensus on what constitutes 'unbearable suffering,' nor are there any guidelines in Belgium on how best to deal with requests for help to die from those who are mentally ill, say the researchers.

"Taking into account the ongoing fierce ethical debates, it is essential to develop such guidelines, and translate them into clear and detailed protocols that can be applied in practice," they conclude.


Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to