Factors Associated With High Frequency of Suicidal Ideation in Medically Ill Veterans

Abstract

Suicide is a leading cause of death, and rates are especially high among medically ill, older individuals. Health-related psychosocial correlates of suicidal ideation (SI) may be particularly important for medically ill older adults as they may clarify who may benefit from interventions to reduce SI. This study examined whether demographic, physical health, and/or health-related psychosocial factors were associated with high frequency of SI in older, medically ill Veterans experiencing elevated anxiety or depression. This cross-sectional study included 302 Veterans with (1) a cardiopulmonary condition and functional impairment and (2) elevated symptoms of depression and/or anxiety. Participants were classified as having either no, low, or high SI, based on self-reported ideation, from the Patient Health Questionnaire-9. SI was reported in 26.8% of the full sample and high SI was reported by 12.6% of participants. Logistic regression analyses predicting high versus no SI found the odds of high SI increased 4.7 times (95% confidence interval, 2.6-8.3) for each 1-unit increase in maladaptive coping and 4.1 times (95% confidence interval, 1.2-14.3) for each 1-unit increase in physical health severity/functional limitations. Older, medically ill Veterans with comorbid depression and/or anxiety frequently reported SI and were at greater risk of experiencing a high frequency of SI if they engaged in maladaptive coping strategies and/or had high levels of functional impairment. Effective interventions to reduce SI for this population should focus on reducing maladaptive coping and minimizing negative behavioral, cognitive, and emotional reactions to functional limitations.

Idosos e suas estratégias de enfrentamento em saúde mental

“…Conforme Wendell et al (2016), idosos com doenças crônicas e que fazem uso de estratégias de enfrentamento mal adaptadas, tem uma probabilidade maior de desenvolverem ideação suicida e uma estratégia que fazem com que eles comecem a pensar diferente é o apoio da família nesse momento difícil em que estão passando. Pessoas idosas com sofrimento emocional e que apresentam falhas cognitivas, costumam usar de estratégias de enfrentamento disfuncional, demonstrando sentimentos de negação (Leung et al, 2018).…”