Suicide and Mental Illness in the Elderly

Abstract

This report deals with the relation of suicide to mental illness in the elderly. Our investigation of this relation proceeds from the following two points of view: First, we asked whether the fact that the elderly are most at risk of committing suicide is confounded with their increased psychiatric morbidity. Second, we asked to what extent suicides of older mentally ill persons are definitely created by their mental illness. The sample includes 310 suicides of psychiatric in-patients. These were explored in the course of a multicentre study of 6 psychiatric state hospitals in the south of the Federal Republic of Germany. The method of analysis involved the motives of the suicidal acts. Results demonstrate that the age is an autonomous risk factor and not to be confounded with the psychiatric morbidity. Psychiatric morbidity of older suicides is not sufficient to explain the suicidal act. Moreover, we found that if mental illness played a part, motives reflecting aspects of chronicity predominated motives reflecting psychopathology (i.e. feeling of being persecuted, loosing mind) of the suicidal patients. Results are discussed with special reference to preventing and managing suicides in the elderly.

Characteristics of Chinese suicide attempters admitted to a geropsychiatric unit

“…Exploring the motives for suicide attempts revealed an average of 2.2 per person, similar to Vogel and Wolfersdorf's (1989) reported 1.9 per person, suggesting that elderly suicide is multi-factorial. Family problems accounted for about half of the attempts.…”

“…Regarding the motivation of suicide, psychotic symptoms were also commonly revealed, with persecutory delusions or auditory hallucinations reported as the causes for suicide attempts for 13 of these patients. In a Western study of suicides, the motives,`delusory fear',`imperious voices', were suspected as fundamental motives for suicide in 25% of older psychiatric patients (Vogel and Wolfersdorf, 1989). Previous follow-up studies of delusional patients also demonstrated increased risk of suicide, 31.5 times greater than the general population (Jorgensen, 1994).…”

Changes in elderly suicides in the USA and the developed world 1974–87: Comparison with current homicide

“…Probably not. In an important clinical study of elderly suicides, Vogel and Wolfersdorf (1989) did not find the predominance of psychiatric features that might have been expected, but identified a high level of psychosocial disruption. The key factors were bereavement, terminal illness, and a very strong subjective sense of isolation.…”

Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide

“…Based upon Western international research, there is general agreement that the most important factor associated with suicide is mental illness (1-6), followed by substance abuse and personality disorder (7,8), with the dominant affect being depression and hopelessness (9,10). Whilst there is some debate about the different emphases, this dynamic appears to be linked to those social stress factors which are secondarily associated with suicide ( 11 ), such as age (12,13), child abuse (14), divorce (13,15), HIV/AIDS ( 16) and unemployment (17)(18)(19). However, all of these social features are dwarfed by the consistent finding that men kill themselves significantly more often than their female counterparts, irrespective of age or ethnicity (20,21 ).…”