A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara; Erlangsen, Annette; Lapierre, Sylvie; Lindner, Reinhard; Draper, Brian; Gallo, Joseph J.; Wong, Christine; Wu, Jing; Duberstein, Paul R.; Wærn, Margda

doi:10.1080/13607863.2015.1083945

Cited by 304 publications

(247 citation statements)

References 120 publications

(242 reference statements)

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“…We recently reviewed the litterature on this topic [39] and could find no clinical reports of physical disabilities in older women and men with non-fatal suicidal behavior for comparison.…”

Section: Discussionmentioning

confidence: 99%

Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above

Wiktorsson

Sterner

Fässberg

et al. 2017

Preprint

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Relatively little research attention has been paid to sex issues in late life suicidal behaviour.The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt.There were no sex differences in depression and anxiety, but women were more likely to report that they found their situation hopeless (67.9% vs. 43.8%, p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men (p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1 %, p = 0.64). The unexpected lack of sex differences might be influenced by cultural context in which sex norms play a part.

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“…We recently reviewed the litterature on this topic [39] and could find no clinical reports of physical disabilities in older women and men with non-fatal suicidal behavior for comparison.…”

Section: Discussionmentioning

confidence: 99%

Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above

Wiktorsson

Sterner

Fässberg

et al. 2017

Preprint

Self Cite

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“…They once prepared us to fight or flee: the heart rate and breathing accelerate, the blood pressure increases and the muscles tense [1-3,6,12,13,15-17]. Today, it is unusual to encounter a survival situation at the corner of a university corridor [18,19]. This is why symptoms such as heavy sweating, headaches (caused by blood pressure), urge to urinate, and stomach upset (caused by muscle contraction) are often more disturbing than necessary.…”

Section: Negative and Positive Side Of Stressmentioning

confidence: 99%

Stress: Two Sides of a Coin

S¹,

Rekgai²

2018

J Transl Neurosci

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“…Among community discharged patients, 39.0% received 30-day follow-up outpatient mental health care, which was most strongly predicted by an ED diagnosis of mental disorder (ARR = 2.65, 99% CI = 2.25-3.12) and prior outpatient mental health care (ARR = 2.62, 99% CI = 2.28-3.00). Among community discharged patients, 39.0% received 30-day follow-up outpatient mental health care, which was most strongly predicted by an ED diagnosis of mental disorder (ARR = 2.65, 99% CI = 2.25-3.12) and prior outpatient mental health care (ARR = 2.62, 99% CI = 2.28-3.00).…”

mentioning

confidence: 99%

Deliberate self‐harm in older adults: A national analysis of US emergency department visits and follow‐up care

Schmutte

Olfson

Xie

et al. 2019

Int J Geriat Psychiatry

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Objective To examine mental health care received by older adults following emergency department (ED) visits for deliberate self‐harm. Methods This retrospective cohort analysis examined 2015 Medicare claims for adults ≥65 years of age with ED visits for deliberate self‐harm (N = 16 495). We estimated adjusted risk ratios (ARR) for discharge disposition, ED coding of mental disorder, and 30‐day follow‐up mental health outpatient care. Results Most patients (76.9%) were hospitalized with lower likelihoods observed for African American patients (ARR = 0.86, 99% CI = 0.79‐0.94) and patients with either one medical comorbidity (ARR = 0.91, 99% CI = 0.83‐0.99) or two to three comorbidities (ARR = 0.93, 99% CI = 0.88‐0.99). Hospitalization was associated with recent depression (ARR = 1.09, 99% CI = 1.03‐1.16) and recent psychiatric inpatient care (ARR = 1.13, 99% CI = 1.04‐1.22). Among patients discharged to the community (n = 3818), 56.4% received an ED mental disorder diagnosis. Predictors of an ED mental disorder diagnosis included younger age (65‐69 years; ARR = 1.53, 99% CI = 1.31‐1.78), recent mental health care in ED (ARR = 1.50, 99% CI = 1.29‐1.74) or outpatient (ARR = 1.62, 99% CI = 1.44‐1.82) settings, recent diagnosis of mental disorder (ARR = 1.61, 99% CI = 1.43‐1.80), and other/unknown lethality methods of self‐harm (ARR = 1.24, 99% CI = 1.01‐1.52). Among community discharged patients, 39.0% received 30‐day follow‐up outpatient mental health care, which was most strongly predicted by an ED diagnosis of mental disorder (ARR = 2.65, 99% CI = 2.25‐3.12) and prior outpatient mental health care (ARR = 2.62, 99% CI = 2.28‐3.00). Conclusion Most older adult Medicare beneficiaries who present to EDs with self‐harm are hospitalized. Of those who are discharged to the community, many are not diagnosed with mental disorder in the ED or receive timely follow‐up mental health care.

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A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

Cited by 304 publications

References 120 publications

Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above

Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above

Stress: Two Sides of a Coin

Deliberate self‐harm in older adults: A national analysis of US emergency department visits and follow‐up care

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