Suicidal ideation and related factors among dementia patients

Koyama, Asuka; Fujise, Noboru; Matsushita, Mitsunori; Ishikawa, Tomohisa; Hashimoto, Mamoru; Ikeda, Manabu

doi:10.1016/j.jad.2015.02.019

Cited by 24 publications

(28 citation statements)

References 31 publications

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“…In this study, the persons with dementia and reported suicidal ideation also had severe neuropsychiatric symptoms (except euphoria, motor disturbance and night-time behaviour disturbances). This is consistent with the results of Koyama et al (2015). However, only the BPSD delusion and depression, as well as anti-dementia medication, had an independent association with suicidal ideation in the multivariate analysis in this study.…”

Section: Discussionsupporting

confidence: 92%

“…This occurrence is lower than that reported in a previous study, by Shah et al, in which self-reported prevalence of "feels that life is not worth living" and "suicidal ideation" was 38% and 29%, respectively, in persons with dementia (Shah et al, 1998). Our figure is higher than the findings by Koyama et al, of 10.1% reported by proxy (Koyama et al, 2015), and Draper et al where self-reported prevalence of " … feels that life is not worth living" was 5.4%, "wished to die or had thoughts of death" 3.2% and "suicide ideations or gestures" 0.9% (Draper, MacCuspie-Moore, & Brodaty, 1998). Our results are close to the results of Rubin and Kinscherf, who found "suicidal thoughts", as reported by proxy, in 15% of participants (Rubin & Kinscherf, 1989).…”

Section: Discussioncontrasting

confidence: 83%

“…This possibly indicates that suicidal ideation or threats may lead to a higher level of burden for caregivers even if not so common. In another study, caregivers of persons with dementia with suicidal ideation experienced a higher degree of caregiver burden than did caregivers of persons with dementia without suicidal ideation, even after adjusting for BPSD score (Koyama et al, 2015). Experiencing high levels of caregiver burden may also result in poor health-related QoL for the caregiver (Lethin et al, 2018).…”

Section: Discussionmentioning

confidence: 98%

“…Psychiatric disorders and suicidal behaviour have been studied across dementia subtypes, and the highest prevalence of suicidal ideation, plans and/or attempts was found in frontotemporal dementia, followed by vascular dementia (VaD) (Lai, Kaup, Yaffe, & Byers, 2018). A Japanese study reporting suicidal ideation in about 10% of 634 outpatients with dementia (Koyama et al, 2015), showed that patients with suicidal ideation had a higher rate of behavioural and psychological symptoms of dementia (BPSD). Besides depression/dysphoria, the findings particularly showed high delusion, agitation/aggression, and anxiety severity.…”

Section: Introductionmentioning

confidence: 99%

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Associated factors of suicidal ideation among older persons with dementia living at home in eight European countries

Holmstrand

Hallberg

Saks

et al. 2020

Aging & Mental Health

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Objectives: This study aimed to investigate the occurrence of suicidal ideation and associated factors in older persons with dementia living at home in eight European countries, and its association with quality of life. Furthermore, changes in suicidal ideation over time were investigated. Methods: This cohort study (n ¼ 1,223) was part of the European "RightTimePlaceCare" project conducted in 2010-2013. Participating countries were Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden and the United Kingdom. Baseline and follow-up data were analysed using bivariate and multivariate logistic regression. Results: The occurrence of suicidal ideation in the participating countries varied between 6% and 24%. Factors significantly (p < 0.0018) associated with suicidal ideation using bivariate analysis were: nationality, depressive symptoms, delusions, hallucinations, agitation, anxiety, apathy, disinhibition, irritability, night-time behaviour disturbances, anxiolytics and anti-dementia medication. In the multivariate regression analysis, country of origin, moderate stage of the dementia, depressive and delusional symptoms, and anti-dementia medication were significantly associated with suicidal ideation (p < 0.05). Over time, suicidal ideation decreased from severe to mild or became absent in 54% of the persons with dementia. Conclusion: It is essential that professionals identify older persons with dementia and suicidal ideation and depressive and other psychological symptoms in order to give them appropriate treatment and provide relief for their informal caregivers. We emphasize the importance of identifying suicidal ideation, irrespective of depressive symptoms, and specifically of paying attention to persons with moderate dementia. Living with the informal caregiver seems to be associated with staying stable without suicidal ideation.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Associated factors of suicidal ideation among older persons with dementia living at home in eight European countries

Holmstrand

Hallberg

Saks

et al. 2020

Aging & Mental Health

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“…Patients suffering from organic mental disorders who previously underwent inpatient treatment complete suicide 10 times more often than outpatients [ 12 ]. Among ICD-10 F0 diagnoses, dementia constitutes a moderate risk if not more [ 99 , 100 , 101 , 102 , 103 , 104 ], including pre-emptive suicide [ 105 , 106 ].…”

Section: Suicide and Mental Illnessmentioning

confidence: 99%

Epidemiology of Suicide and the Psychiatric Perspective

Bachmann

2018

IJERPH

983

646

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Suicide is a worldwide phenomenon. This review is based on a literature search of the World Health Organization (WHO) databases and PubMed. According to the WHO, in 2015, about 800,000 suicides were documented worldwide, and globally 78% of all completed suicides occur in low- and middle-income countries. Overall, suicides account for 1.4% of premature deaths worldwide. Differences arise between regions and countries with respect to the age, gender, and socioeconomic status of the individual and the respective country, method of suicide, and access to health care. During the second and third decades of life, suicide is the second leading cause of death. Completed suicides are three times more common in males than females; for suicide attempts, an inverse ratio can be found. Suicide attempts are up to 30 times more common compared to suicides; they are however important predictors of repeated attempts as well as completed suicides. Overall, suicide rates vary among the sexes and across lifetimes, whereas methods differ according to countries. The most commonly used methods are hanging, self-poisoning with pesticides, and use of firearms. The majority of suicides worldwide are related to psychiatric diseases. Among those, depression, substance use, and psychosis constitute the most relevant risk factors, but also anxiety, personality-, eating- and trauma-related disorders as well as organic mental disorders significantly add to unnatural causes of death compared to the general population. Overall, the matter at hand is relatively complex and a significant amount of underreporting is likely to be present. Nevertheless, suicides can, at least partially, be prevented by restricting access to means of suicide, by training primary care physicians and health workers to identify people at risk as well as to assess and manage respective crises, provide adequate follow-up care and address the way this is reported by the media. Suicidality represents a major societal and health care problem; it thus should be given a high priority in many realms.

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