Diagnosis may have prevented suicide

SYDNEY - Charmaine Dragun's suicide could probably have been prevented if the talented newsreader had been diagnosed with a bipolar disorder, a coroner has found.

Deputy state coroner Malcolm MacPherson said easy access to the Sydney cliff edge where Ms Dragun jumped to her death had also played a part in the 29-year-old's suicide.

An "indirect cause" of her suicide was that she was not made properly aware of the side effects of her new depression medication regime, Mr MacPherson said today at Glebe Coroners Court.

Mr MacPherson was delivering his findings at the inquest into the Network Ten newsreader's death at east Sydney's notorious suicide spot, The Gap, on November 2, 2007.

He described her as a talented and successful woman, who had a loving partner, supportive friends and family, and "seemingly everything to live for".

But the "emotionally troubled" perfectionist was beset by negative thinking and feelings of hopelessness - all signs of her being at an increased risk of suicide.

Outside the court, her mother Estelle Dragun welcomed the coroner's recommendations for changes in mental health care and management.

"Hopefully the medical profession will read and take in the findings and we will see a difference in medical health care," she said.

"My daughter, then, has not died in vain."

Charmaine's long-term love, Simon Struthers - whom she planned to marry on her 30th birthday - also hoped the inquest would raise awareness of mental health in the community.

At 3.52pm on November 2, he received a text message from Charmaine saying: "Sime, I'm so sorry for what I'm about to do. I can't conquer my thoughts. Please know this is no one's fault but mine."

At 3.54pm, he rang her phone, which was on top of her handbag at the cliff edge, but she had already jumped.

Ms Dragun took antidepressants since she was 18 after first being diagnosed with an anxiety disorder with depressive symptoms.

She had moved to Sydney from Perth in 2005 and saw a number of health professionals for her worsening emotional condition.

The coroner found the diagnosis of depression was "almost certainly wrong" and she probably had a Bipolar 2 Disorder, which is associated with "a very high risk of suicide".

In 2007, Ms Dragun saw psychologist Dr Belinda Khong 16 times and on one visit raised her concerns about her mood swings, asking whether she could have a bipolar condition.

"Dr Khong consulted a book, read though the criteria for 'mania' and reassured Charmaine that she did not meet the criteria," Mr MacPherson said.

"This was a very cursory exploration of a very significant issue."

In September, Dr Khong referred Ms Dragun to another psychiatrist, Dr Wai Mun Tang, who was not told of Ms Dragun's suicidal thoughts.

Dr Tang decided to reduce and then stop the antidepressant Efexor, which did not appear to be working, and introduce another antidepressant, Lexapro, with a lower side-effect profile.

The coroner said the "cross-tapering" of the drugs needed very careful monitoring, as side effects included increased agitation and suicidality.

In the days before her death, Ms Dragun was seen to be distracted, confused and distant - conditions probably related to the drug side effects.

The coroner said this in turn probably increased her agitation and hopelessness.

The failure to properly alert her to the drug effects was "an indirect cause of Charmaine's suicide".

He concluded that if the health professionals had made the correct bipolar diagnosis, Ms Dragun "would have been properly treated with a mood stabiliser".

"... and she probably would not have committed suicide," he said.

His recommendations included funding for the completion of a A$2 million suicide minimisation plan for The Gap.

He also listed factors that should be taken into account when health professionals treat people with signs and symptoms of depression, including the need to exclude a bipolar disorder.

- AAP