A semi-structured interview for psychological autopsy in suicide cases.

OBJECTIVE To investigate the applicability and the interrater reliability of a Semi-Structured Interview for psychological autopsy in cases of suicide. METHOD The Semi-Structured Interview for Psychological Autopsy (SSIPA) proposed in this paper consists of four modules which evaluate key-topics associated to suicide. In order to evaluate the instrument's applicability, a sample formed by 42 subjects related to 21 suicide cases was used. The interviews were tape-recorded first and then transcribed. The related material as well as the police inquiry data were presented to four judges. Evaluation of information has been performed with the help of a four-module formulary for decision making: precipitants and/or stressors, motivation, lethality, and intentionality. Data processing, whenever possible, has been accomplished using kappa statistics. When kappa statistic was not applicable, concordance percentage has been used. RESULTS The SSIPA is applicable because it provides information containing a significant degree of agreement between evaluators, found in one hundred and twenty measurements of judgements made by four judges. There has been significant statistical agreement between the judges in three modules (precipitants and/or stressors, motivation, and intentionality) of the model for decision, except in one step of each module, which did not interfere in the final agreement on the present evaluation. In the lethality evaluation module, there has been a 100% agreement between judges. The judgement made by the raters on the four modules have allowed to reach a final agreement regarding the death mode as suicide. CONCLUSION The results of this study show that it is possible to use a semi-structured instrument for psychological autopsy in cases of suicide, when the interviewees are relatives who accepted to provide information.