A New Autopsy Interview for the Assessment of Factors Potentially Related to Death in Depressed Medical Patients

Abstract

This study tests the reliability and validity of the Bio-Psycho-Social Autopsy (BPSA), a new interview to assess physical, psychopathological, and social factors potentially related to mortality in depressed medical patients. The authors completed special procedures to provide support for the face and content validity of the interview. They built the psychopathological and social sections on the Standardized Polyvalent Psychiatric Interview (SPPI) but gave self-neglect special emphasis. They tested the BPSA on close relatives of 48 deceased patients, both depressed and nondepressed. They calculated interrater reliability coefficients and took preliminary steps to document the construct validity by means of epidemiological and clinical variables. Interrater reliability coefficients were acceptable (M κ = 0.82). In support of the construct validity, a multivariate analysis showed that BPSA items in the psychopathological section were able to differentiate the expected direction between deceased patients who were depressed and nondepressed. Therefore, the authors considered the BPSA interview to be a reliable assessment of factors potentially associated with death in depressed medical patients, and data presented support the validity of the psychopathological section.

Keywords:

• depression
• medical comorbidity
• mortality
• psychological autopsy
• self-neglect