Eva Rubenowitz | PubMed Health

PubMed2002

Mental disorder in elderly suicides: a case-control study.

OBJECTIVE: The authors' goal was to study the importance of different psychiatric disorders in relation to suicide in individuals 65 years old or older. METHOD: The psychological autopsy approach was used to study 85 cases of suicide among subjects who were 65 years old or older; 153 living comparison subjects from the same age group who were randomly selected from the tax register were interviewed face-to-face. Retrospective axis I diagnoses were made according to DSM-IV on the basis of interview data and medical records. RESULTS: Ninety-seven percent of the suicide victims fulfilled criteria for at least one DSM-IV axis I diagnosis, compared with 18% of the living comparison subjects. Recurrent major depressive disorder was a very strong risk factor for suicide, as was substance use disorder. An elevated risk was also associated with minor depressive disorder, dysthymic disorder, psychotic disorder, single-episode major depressive disorder, and anxiety disorder. Comorbid axis I disorders were observed in 15 (38%) of the 39 elderly subjects with major depressive disorder who had committed suicide. CONCLUSIONS: Although recurrent major depressive disorder was the mental disorder most strongly associated with suicide, the findings of this study suggest that elderly individuals who commit suicide represent a heterogeneous group with regard to mental disorders, implying a need for differentiated prevention strategies.

Age Factors↗

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Predictors of suicide in the old elderly.

BACKGROUND: Seniors aged 75 and above have the highest suicide rates of all age groups in most industrialized countries. However, research concerning risk factors for suicide in the old elderly is sparse. OBJECTIVE: The purpose was to determine predictors for suicide among the old elderly (75+). Data concerning the young elderly (65-74 years) are shown for comparison. METHODS: 85 consecutive cases of suicide that occurred in western Sweden and 153 control persons with the same sex, birth year, and zip code as the suicide cases were randomly selected from the tax register. The old elderly group included 38 cases and 71 controls; the young elderly group included 47 cases and 82 controls. Data concerning the suicide cases were collected through interviews with close informants; controls were interviewed in person. The interview included questions on past-year life events and mental and physical health. Medical records were reviewed for cases and controls. The Cumulative Illness Rating Scale - Geriatrics was used to rate illness burden. RESULTS: Family conflict, serious physical illness, loneliness, and both major and minor depressions were associated with suicide in the 75+ group. Economic problems predicted suicide in the younger but not in the older elderly. Old elderly suicide victims with depression (major or minor) were less likely to have received depression treatment than their younger counterparts. CONCLUSIONS: Better recognition and treatment of both major and minor depression should constitute an important target for the prevention of suicide in the old elderly. Intervention studies with large numbers of senior participants are sorely needed.

Aged↗