Psychiatric diagnoses were obtained using Structured Clinical Interviews for DSM-III-R I (ref. 47) adapted for psychological autopsies, which is a validated method for reconstructing psychiatric history by means of extensive proxy-based interviews, as described elsewhere48. History of severe childhood sexual and/or physical abuse or severe neglect was determined by means of structured interviews using the Childhood Experience of Care and Abuse49 questionnaire adapted for psychological autopsies45.