Elderly suicide attempters: characteristics and outcome

Abstract

SUMMARYPurpose We made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics. Methods Fifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt.The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files. Results Elderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt.The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression. Conclusion Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect.

Diagnóstico de enfermagem Risco de Suicídio em idosos: revisão integrativa

“…Regarding the physical factors, investigations on chronic-degenerative diseases and suicide of the elderly (22,26,28,39,38,60,(68)(69)82) reported significant associations of the self-destructive action with cardiovascular diseases; chronic lung disease; vision problems; diabetes mellitus; urinary incontinence; rheumatoid and terminal illnesses, especially prostate and lung cancer in man and breast cancer in women. In Brazil (45)(46)(78)(79) , sexual impotence was associated with the suicide of men.…”

“…In addition to these diseases, the occurrence of severe pain for more than six months increases the risk of suicide (28,32,68).…”

Premature Death Among Primary Care Patients With a History of Self-Harm

“…The rationale for imposing these age restrictions was that the determinants and implications of self-harm in children and older adults are distinct from those in the rest of the population, and therefore warrant separate consideration. Among older adults who harm themselves, specific mechanisms such as bereavement, loneliness, and social isolation, 20,21 and physical illness, multimorbidity, and impairment 21 play a greater role; children younger than 15 years who harm themselves may have less suicidal intent and a relatively low long-term risk of dying by suicide. 22 Our intention was to preclude prevalentcohort bias by delineating an incident cohort, 23,24 and we therefore required patients to have been registered with a contributing practice for at least 1 full year before their index episode.…”

Implementation Strategies for Improving the Care of Depressed Elderly Persons—Summary of an International Workshop

“…Suicide has been estimated to be a risk factor that is particularly salient in men [37]. However, Lebret et al [38] found that an elderly person who attempts suicide was most likely to be a widow suffering from social isolation, loneliness, and depression. This is supported by Stroebe et al [39], who also found that suicidal ideation was higher among widowed people in general and widows in particular.…”