concurring in part; dissenting in part.
I concur in the majority’s conclusion that claimant’s shoulder injury is compensable and that his depression was an “aggravation” of his compensable injury. However, because I believe that the majority misapplies ORS 656.156(1) as interpreted by this court in McGill v. SAIF, 81 Or App 210, 724 P2d 905, rev den 302 Or 461 (1986), I dissent from the holding regarding the suicide attempt.
My principal concern is that the majority has modified the causation principles articulated in McGill. It is my understanding, based on the language of the statute as well as this court’s decision in McGill that, in order to avoid the limitation of compensation in ORS 656.156(1), the underlying compensable injury and the conditions resulting therefrom must be the primary cause of the mental derangement which impaired the ability to resist the compulsion to take one’s own life. The majority decision relaxes the standard in McGill and requires only that the injury be a material factor in causing the mental derangement.
McGill involved the suicide of a physician, caused by a compensable occupational depressive disorder which resulted from two medical malpractice actions that had been filed *342against him. Before the actions, he had been a respected physician in the Portland medical community. There was no evidence or contention that non-employment influences or preexisting conditions caused his depression. We stated:
“We hold that a worker’s suicide resulting from work-related stress which produced a mental derangement that impaired his ability to resist the compulsion to take his own life cannot be said to have arisen from a ‘deliberate intention.’ ” 81 Or App at 214. (Footnote omitted; emphasis supplied.)
“Produce” means “to cause to have existence or to happen.” Webster’s Third New International Dictionary (1976). In McGill, the work-related disorder was the sole and exclusive cause of the decedent’s derangement. I believe McGill requires that the underlying injury be the primary cause of the derangement.
The facts of this case are in marked contrast to McGill. Here, claimant had a large number of physical and emotional problems that pre-dated the compensable injury. Approximately six months before the injury, he was involved in an automobile accident in which he lost an ear. He had a history of alcohol abuse; his wife stated that he had always been a heavy drinker. He had had several operations to correct circulatory problems. There were many problems within his family. In short, he was a troubled man before the industrial accident.
The psychiatric experts who examined him agreed that the compensable injuries contributed to the depression which led to his suicide attempt but that other factors — most notably pre-existing problems with family, health and alcohol — were also contributing factors. Dr. Colbach indicated: “Some of [claimant’s distress] can be attributed to the industrial injury, but some of it seems to predate this and be due to other factors.” Dr. Johnson believed that the depression and intoxication were the two major factors that led to his suicide attempt. Dr. Stolzberg did not directly relate the suicide attempt to the industrial injury. Those opinions indicate that the causal relationship between the injury and the suicide attempt required by McGill has not been met.
In this case, the work-related disorder was but one of several factors contributing to claimants’ depression. The referee correctly concluded:
*343“Both [psychiatrists Johnson and Stolzberg] indicate that to some degree the injury and its aftermath including the physical condition and discomfort, the resulting unemployment and strained financial circumstances, and the termination of compensation played some role in claimant’s mental state and suicide attempt. Other life circumstances including non-injury-related physical problems also weighed on claimant’s mind.” (Emphasis supplied.)
The facts indicate that the compensable injury was a factor contributing to, but was not the primary cause of, his mental condition, as McGill requires. Therefore, I would conclude that the medical expenses associated with the suicide attempt are noncompensable. Accordingly, I disagree with the majority’s contrary holding.