Epidemiology of suicide among persons with AIDS

In spite of the attention devoted by researchers and clinicians to the suicidal risk of AIDS patients, the magnitude of the phenomenon has not yet been clarified. Indeed, some authors have found a rate of suicide among subjects with AIDS 66 times higher than that of the general population (Marzuk et al., 1988a), whereas others report that the number of documented suicides represents only a small proportion of all deaths in AIDS patients (Engelman et al., 1988). Methodological differences in the sampling strategies, in the definition of suicidality and in the criteria followed to ascertain a suicide case can account, at least in part, for such discrepancies. Several potential risk factors (neuropsychiatric morbidity, alcohol and drug abuse, behavioural disorders, etc.) are currently believed to increase the suicide risk of AIDS patients. Their role, however, is still controversial. This paper summarizes the literature published on completed suicide in AIDS subjects, with special emphasis on the methodological problems that can be identified in this research area.