Suicidal behaviour in old age - results from the Ibadan study of ageing

BMC Psychiatry

Oye Gureje²  Taiwo Abiona¹  Bibilola Oladeji²  Akin Ojagbemi² 

[1] Department of Preventive Medicine and Primary Care, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, P.M.B 5017 (GPO), Nigeria;Department of psychiatry, College of Medicine, University of Ibadan, Ibadan, P.M.B 5017 (GPO), Nigeria

关键词: Social isolation;    Aged;    Suicidal ideation;    Suicide;   

Others  :  1124113
DOI  :  10.1186/1471-244X-13-80

 received in 2012-11-02, accepted in 2013-02-25,  发布年份 2013

【 摘 要 】

Background

An important reason for the high risk of suicide in the elderly is the determination with which they act out their suicidal thoughts. Early identification of suicidal behaviours in the elderly is therefore important for suicide prevention efforts in this population.

Method

Data are from the Ibadan Study of Ageing (ISA), a household multi-stage probability sample of 2149 Yoruba Nigerians aged 65 years or older conducted between 2003 and 2004. We used the third version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to explore suicidal experiences and behaviours. In this report, only those experiences or behaviours reported to have occurred after the age of 65 years are the focus of analysis. Derived weights were applied to the data in accordance with the study design and associations were explored using logistic regression. The results are presented as odds ratios (ORs) with 95% confidence intervals.

Result

In all, 4.0% (95% C.I= 3.1-4.2) of the subjects had suicidal ideation occurring after the age of 65 years, while 0.7% (95% C.I=0.4-1.3) and 0.2% (95% C.I= 0.1-0.4) reported suicidal plans and attempts, respectively. There was a significantly elevated likelihood of suicidal ideation among persons who had experienced spousal separation through death or divorce (O.R=4.9., 95% C.I= 1.5-15) or who were residing in rural settings (O.R=2.5, 95% C.I=1.3-4.8).

Conclusion

Suicidal ideation is common among the elderly. About 20% and 6% of those with ideation proceed to plans and attempts, respectively. Circumstances of social isolation and exclusion are important correlates of suicidal behaviour in the elderly.

【 授权许可】

   
2013 Ojagbemi et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]De Leo D, Burgis S, Bertolote JM: Definitions of suicidal behaviour. In Suicidal behaviour; Theories and research findings. Edited by De Leo D, Bille-Brahe U, Kerkhof A. Cambridge: Hogrefe & Huber; 2004:17-40.
• [2]Jamison KR: Night Falls Fast: Understanding Suicide. Edited by Alfred K. New York; 1999.
• [3]World Health Organization: World report on violence and health. Geneva: WHO; 2002.
• [4]Mello-Santos C, Bertolote JM, Wang YP: Epidemiology of suicide in Brazil (1980–2000): characterization of age and gender rates of suicide. Rev Bras Psiquiatr 2005, 27:131-134.
• [5]The National Survey on Drug Use and Health (NSDUH) report, 2009. Suicidal Thoughts and Behaviours among Adults; http://oas.samhsa.gov/ webcite
• [6]Lapierre S, Erlangsen A, Waern M, De Leo D, Oyama H, Scocco P, Gallo J, Szanto K, Conwell Y, Draper B, Quinnett P, International Research Group for Suicide among the Elderly: A systematic review of elderly suicide prevention programs. Crisis 2011, 32(2):88-98.
• [7]Shah A, Bhat R, Mackenzie S, Koen C: Elderly Suicide rates: cross-national comparison of trends over a 10 years period. International Psychogeriatrics 2008, 20:673-678.
• [8]Abraham VJ, Abraham S, Jacob KS: Suicide in the elderly in Kaniyambadi block, Tamil Nadu, South India. Int J Geriatr Psychiatry 2005, 20(10):953-955.
• [9]Conwell Y, Duberstein PR, Connor K: Access to firearms and risks for suicide in middle-aged and older adults. Am J Geriatr Psychiatry 2002, 10:16-407.
• [10]Beck AT, Brown G, Steer RA: Suicide ideation at its worst point: a predictor of eventual suicide in psychiatric outpatients. Suicide Life Threat Behav 1999, 29:1-9.
• [11]Lapierre S, Boyer R, Desjardins S, Dube M, Lorrain D, Preville M, Brassad J: Daily hassles, physical illness, and sleep problems in older adult with wish to die. International Psychogeriatrics 2012, 24(2):243-245.
• [12]Conwell Y: Suicide in later life: a review and recommendations for prevention. Suicide and Life-Threatening Behaviour 2001, 31(Suppl):32-47.
• [13]Ayalon L, Litwin H: What cognitive functions are associated with passive suicidal ideation? Finding from a national sample of community dwelling isrealis. Int J Geriatr Psychiatry 2009, 24:472-478.
• [14]Conwell Y, Duberstein PR, Cox C, Hermann J, Forbes N, Caine ED: Age differences in behavior leading to completed suicide. American Journal of Geriatric Psychiatry 1998, 6:122-126.
• [15]Kjolseth I, Ekeberg O: When elderly people give warning of suicide. International Psychogeriatrics 2012, 24(9):1393-1401.
• [16]Gureje O, Ogunniyi S, Kola L, Afolabi E: Functional disability among elderly Nigerians: results from the Ibadan Study of Ageing. J Am Geriatr Soc 2006, 54(11):1784-1789.
• [17]Gureje O, Kola L, Afolabi E: Epidemiology of major depressive disorder in elderly Nigerians in the Ibadan Study of Ageing: a community-based survey. Lancet 2007, 370(9591):64-957.
• [18]Kish L: A Procedure for Objective Respondent Selection within the Household. J Am Stat Assoc 1949, 44(247):380-387.
• [19]Kessler RC, Ustun TB: The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods Psychiatric Research 2004, 13:93-121.
• [20]American Psychiatric Association: DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington DC: American Psychiatric Association; 1994.
• [21]Ferguson BD, Tandon A, Gakidou E: Estimating permanent income using indicator variables. In Health Systems Performance Assessment: Debates, Methods and Empiricism. Edited by Murray CJL, Evans DB. Geneva: World Health Organization; 2003:747-760.
• [22]StataCorp: Stata Statistical Software, version 7.0 for windows. Texas, Stata, College Station; 2001.
• [23]Hosmer DW, Lemeshow S: Applied logistic regression. New York: John Wiley & Sons; 2000.
• [24]Oladeji BD, Gureje O: Parental mental disorders and suicidal behaviour in the Nigerian survey of mental health and well-being. Arch Suicide Res 2011, 15(4):83-372.
• [25]Corna LM, Cairney J, Streiner DL: Suicide ideation in older adults: Relationship to mental health problems. Gerontologist 2010, 50(6):785-795.
• [26]Cook JM, Pearson JL, Thompson T, Black BS, Rabins PV: Suicidality in Older African Americans: Findings from the EPOCH Study. Am J Geriatr Psychiatry 2002, 10(4):437-446.
• [27]Bernal M, Haro JM, Bernet S, Brugha T, de Graff R: Risk factor for suicidality in Europe; result from ESEMED study. J Affect Disord 2007, 101:27-34.
• [28]Scocco P, Meneghel G, Caon F, Buono M, De Leo D: Death ideation and its correlates: survey of an over-65-year-old population. J Nerv Ment Dis 2001, 189:210-218.
• [29]O’Connell H, Chin AV, Cunningham C: Recent developments: suicide in older people. BMJ 2004, 329:8-895.
• [30]Vanlaere P, Bouckart F, Gartsman C: care for suicidal people: current clinical-ethical consideration. J med Ethics 2007, 33:376-381.
• [31]Yip PS, Chi I, Chiu H, Wai KC, Conwell Y, Caine E: A prevalence study of suicide ideation among older adults in Hong Kong SAR. Int J Geriatr Psychiatry 2003, 18:1056-1062.
• [32]Middleton N, Whitley E, Frankel S, Dorling D, Sterne J, Gunnell D: Suicide risk in small areas in England and Wales, 1991–1993. Soc Psychiatry Epidemiol 2004, 39:45-52.
• [33]Yip PSF, Callanan C, Yuen HP: Urban/rural and gender differentials in suicide rates: east and west. J Affect Disord 2000, 57:106-199.
• [34]Shah A, Bhat R, Zarate-Escudero S: Elderly Suicide rates: the importance of a non-linear relationship with distal risk and protective factors. International psychogeriatrics 2012, 25(9):1363-1367.
• [35]Préville M, Boyer R, Grenier S: Scientific Committee of the ESA Study. The epidemiology of psychiatric disorders in Quebec older adult population Can J Psychiatry 32, 53(12):822.
• [36]Jorm A, Henderson A, Scott R, Korten A, Christensen H, Mackinnon A: Factors associated with the wish to die in elderly people. Age and Ageing 1995, 24:389-392.