Increasing attention has been directed to recent increases in suicide rates for children, adolescents, and young adults. Nevertheless, persons 65 years and older continue to commit suicide at a higher rate than any other age group in the United States. In this paper various aspects of suicide are examined by analyzing recent trends among young and elderly populations, cohort suicide rates, and future projection of the number of suicides in late life. Data are derived from US death certificates. Consideration of the epidemiologic data and projections may be helpful both to those interested in public policy and to clinicians serving the elderly. J Am Geriatr Soc 34:519–525, 1986

Mental health professionals can be trained to make judgments reliably about the cause (medical or psychological) of symptoms in hospitalized older medical patients. The "strict inclusive" and other diagnostic schemes for counting symptoms toward the diagnosis of depression have only marginal, if any, benefit compared with the current DSM-IV approach.

Patients admitted to an inpatient psychiatric service were screened to identify middle-aged (35 to 50 years of age) and elderly (60 years of age and over) patients suffering from a major depressive episode with melancholia. Thirty-seven subjects (18 middle-aged and 19 elderly) were identified. Criteria symptoms for depression and symptoms specifically associated with melancholic or endogenous depression did not differ across age groups, with few exceptions. Major depression with melancholia in this hospitalized population was symptomatically similar in the middle-aged and elderly. The syndrome is therefore relatively common on this inpatient service and should be easily recognized.

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