Suicide attempts and burden of physical illness among depressed elderly inpatients

Objectives: To describe all elderly patients hospitalised with principal and secondary diagnoses of depression, and to determine whether a relationship can be demonstrated between psychosocial stressors, physical illness and type of depression. Method: A retrospective chart review of elderly patients admitted to a general hospital psychiatry ward over a 7-year period with principal or secondary diagnoses of depression was undertaken. Four broad diagnostic categories of depression were used: major depression, psychotic depression, minor depression, and organic depression. Chief outcome measures were: number of medical diagnostic categories, presence of psychosocial stressors, global clinical improvement, and length of stay. Results: Of 228 patients admitted with depression (194 principal diagnoses and 34 secondary diagnoses), 100 had major depression, 47 psychotic depression, 48 minor depression and 33 organic depression. Psychiatric comorbidi-ty occurred in 70%, about half of which was due to organic brain syndrome. Patients with psychotic depression had the fewest medical problems and those with organic depression the most, while patients with minor depression had the highest rate of family and marital problems, comorbid personality dysfunction and suicide attempts. Patients with psychotic depression had the longest admissions, while those with minor depression had the shortest. Overall, 89% showed significant clinical improvement. Conclusions: Elderly inpatients have a wide spectrum of depressive disorders with different psychosocial, medical and treatment profiles. Future studies of depression in old age should include all patients with clinical depression.

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PHYSICAL CONDITIONS ASSOCIATED WITH SUICIDE ATTEMPTS: DO RISKS DIFFER AMONG OUR OLDER VETERANS?

Innovation in Aging ◽

10.1093/geroni/igz038.3038 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S824-S824

Author(s):

Emily S Bower ◽

Kelsey Simons ◽

Patrick G Walsh ◽

Lisham Ashrafioun ◽

Kimberly A Van Orden ◽

...

Keyword(s):

Mental Health Treatment ◽

Suicide Attempts ◽

Neurodegenerative Disorder ◽

Oldest Old ◽

Secondary Data ◽

Later Life ◽

Physical Illness ◽

Retrospective Case ◽

Physical Conditions ◽

Young Old

Abstract Physical illness confers risk for late-life suicide, yet few studies report whether risks differ with older age and among Veterans. We examined age-stratified associations between physical illness and suicide attempt among Veterans 65+ years (n=8452, 97% male) from a larger retrospective case-control study that utilized secondary data from the Veterans Affairs Corporate Data Warehouse and Suicide Prevention Applications Network. Controls were matched by age, sex, and mental health treatment utilization. Risk estimates for 15 conditions and a combined comorbidity score were stratified by young-old (65-74), middle-old (75-84), and oldest-old (85+), adjusting for age and sex within strata. Neurodegenerative disorder (ORs=4.5, 6.0, 6.5) or dementia (ORs=5.0, 5.7, 4.4) diagnosis within 180 days conferred the highest risks across young-, middle-, and oldest-old. Cerebrovascular disorder was associated with higher risk among the oldest-old versus young-old (ORs=6.1 vs 2.2). Findings differ from reported risks for suicide death. Illness may be experienced differently across later-life.

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Physical Illnesses and Medically Serious Suicide Attempts in Rural China

Crisis ◽

10.1027/0227-5910/a000597 ◽

2020 ◽

Vol 41 (1) ◽

pp. 15-23

Author(s):

Shenghua Jin ◽

Yanzheng Liu ◽

Dwight A. Hennessy ◽

Long Sun ◽

Yuli Zang ◽

...

Keyword(s):

Risk Factor ◽

Suicide Attempts ◽

Rural China ◽

Significant Risk ◽

Female Gender ◽

Significant Risk Factor ◽

Physical Illness ◽

Emergency Rooms ◽

Suicide Attempters ◽

The Individual

Abstract. Background: Physical illness is a strong correlate of suicidal behavior. However, its impact on attempted suicide in rural China is under-studied. Aims: This study was designed to assess the influence of physical illness on risk of suicide attempts and to identify distinguishing characteristics among medically serious suicide attempters with physical illnesses from those without. Method: Participants were medically serious suicide attempters identified through hospital emergency rooms ( n = 659) as well as age- and gender-matched community controls ( n = 659) from Shandong Province, China. Face-to-face interviews with the respondents were conducted with a semistructured protocol that included sociodemographic and psychological measures. Results: Physical illness was a significant risk factor for medically serious suicide attempts ( OR = 1.739, 95% CI = 1.182–2.560). Older age was a significant risk factor, while female gender, no religion, and non-peasant occupations were significant protective factors for suicide attempts with physical illness. Limitations: Samples from only one province may not completely represent all serious suicide attempters in China. Furthermore, we did not assess the severity and the degree to which their physical illness limited the functioning of the individual. Conclusion: Physical illness is an important risk factor for suicide attempts in rural China. More efforts are needed to specifically target older people, males, those with religious beliefs, and peasant workers with physical illness.

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Suicide Attempts, Neurocognitive Dysfunctions and Clinical Correlates in Middle-Aged and Elderly Chinese Schizophrenia Patients

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.684653 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yuanyuan Huang ◽

Kai Wu ◽

Rui Jiang ◽

Xiaoying Zeng ◽

Sumiao Zhou ◽

...

Keyword(s):

Suicide Attempts ◽

Clinical Symptoms ◽

Neurocognitive Function ◽

Middle Aged ◽

Story Recall ◽

Female Patients ◽

Neuropsychological Status ◽

Syndrome Scale ◽

Elderly Chinese ◽

Elderly Inpatients

Background: Suicide is a common and complex symptom of schizophrenia that may be related to clinical variables and neurocognitive function. This study aimed to investigate the associated correlates of suicide attempts in Chinese middle-aged and elderly inpatients with schizophrenia, including demographic and clinical characteristics and cognitive level, which has not yet been reported.Methods: A total of 426 schizophrenia inpatients were recruited for this study. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Neurocognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).Results: The prevalence of suicide attempts in middle-aged and elderly Chinese schizophrenia patients was 13.3%. Female patients had a higher suicide rate than male patients. Patients with suicide attempts had significantly higher PANSS-positive subscores, depressive subscores, and RBANS-story recall than non-attempter patients (all p < 0.05). Multiple logistic regression showed that gender, positive subscore, depressive subscore and RBANS-story recall (OR = 1.10–2.19, p < 0.05) were independently associated with suicide attempts in middle-aged and elderly schizophrenia patients.Conclusions: Our study showed that the rate of suicide attempts in Chinese middle-aged and elderly schizophrenia patients is high. Compared to non-attempters, there are less cognitive impairments, more clinical symptoms, and more female patients in the suicide attempters.

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How Predictable Are Predictors of Suicide?

The Final Months ◽

10.1093/med-psych/9780195029116.003.0008 ◽

1981 ◽

pp. 407-422

Author(s):

Eli Robins

Keyword(s):

Suicide Attempts ◽

Demographic Factors ◽

Physical Illness ◽

Psychiatric Diagnoses ◽

Completed Suicide

This chapter explores predictors that correlate with completed suicide, including demographic factors in combination with psychiatric diagnoses, communication of intent, previous suicide attempts, loss of affectional relationships, antecedent circumstances, and physical illness.

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Adolescents’ self-mutilation - Relationship with dependent behaviour

Swiss Journal of Psychology ◽

10.1024/1421-0185.62.4.241 ◽

2003 ◽

Vol 62 (4) ◽

pp. 241-249 ◽

Cited By ~ 8

Author(s):

M. Bolognini ◽

B. Plancherel ◽

J. Laget ◽

P. Stéphan ◽

O. Halfon

Keyword(s):

Suicide Attempts ◽

Clinical Sample ◽

Control Sample ◽

Clinical Population ◽

Control Group ◽

Clinical Group ◽

Self Mutilation ◽

Self Harm ◽

Partial Overlap ◽

The Relationship

The aim of this study, which was carried out in the French-speacking part of Switzerland, was to examine the relationship between suicide attempts and self-mutilation by adolescents and young adults. The population, aged 14-25 years (N = 308), included a clinical sample of dependent subjects (drug abuse and eating disorders) compared to a control sample. On the basis of the Mini Neuropsychiatric Interview ( Sheehan et al., 1998 ), DSM-IV criteria were used for the inclusion of the clinical population. The results concerning the occurrence of suicide attempts as well as on self-mutilation confirm most of the hypotheses postulated: suicidal attempts and self-mutilation were more common in the clinical group compared to the control group, and there was a correlation between suicide attempts and self-mutilation. However, there was only a partial overlap, attesting that suicide and self-harm might correspond to two different types of behaviour.

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Suicidal Behavior in German Adolescents

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000331 ◽

2015 ◽

Vol 43 (1) ◽

pp. 39-45 ◽

Cited By ~ 4

Author(s):

Joana Straub ◽

Ferdinand Keller ◽

Nina Sproeber ◽

Michael G. Koelch ◽

Paul L. Plener

Keyword(s):

Suicidal Behavior ◽

Suicide Attempts ◽

Depression Scale ◽

Epidemiological Studies ◽

Present Sample ◽

Manic Symptoms ◽

Symptoms Of Depression ◽

Adolescent Sample ◽

History Of ◽

Sum Scores

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.

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Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽

10.1027/0227-5910/a000399 ◽

2016 ◽

Vol 37 (4) ◽

pp. 265-270 ◽

Cited By ~ 10

Author(s):

Meshan Lehmann ◽

Matthew R. Hilimire ◽

Lawrence H. Yang ◽

Bruce G. Link ◽

Jordan E. DeVylder

Keyword(s):

Young Adults ◽

Suicide Attempts ◽

Self Esteem ◽

High Risk Population ◽

High Functioning ◽

People With Mental Illness ◽

History Of ◽

The Individual ◽

The Impact ◽

The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

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Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽

10.1027/0227-5910/a000361 ◽

2016 ◽

Vol 37 (2) ◽

pp. 155-160 ◽

Cited By ~ 2

Author(s):

Jin Kim ◽

Han Joon Kim ◽

Soo Hyun Kim ◽

Sang Hoon Oh ◽

Kyu Nam Park

Keyword(s):

Emergency Department ◽

Medical Records ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Interview ◽

Clinical Variables ◽

Completed Suicide ◽

Number Of Patients ◽

Group A ◽

Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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