Elderly suicide in london: An analysis of coroners' inquests

Abstract

SUMMARYThe article describes the social, physical and psychological features of 104 consecutive elderly suicides, using information obtained from coroners' inquests. An age and sex matched cohort of 51 accidental deaths was used as a control. The suicide cohort was significantly more depressed and in pain, had experienced more previous depressive episodes and suicide attempts, and were less confused compared to the control group. The study confirms the importance of recognized risk factors: 61% were living alone, with 9% complaining of loneliness. Only one individual, on available data, attended a day hospital or day centre. Physical illness was common, with at least 56% having ill health prior to death and 63% showing postmortem abnormalities. Twenty-two per cent revealed abnormal cerebral pathology. Depressive illness was prominent, with 79% exhibiting depressive symptoms prior to death. Only 12 individuals were taking antidepressants and only one was on lithium. Despite contact with primary care services, only 20% had been seen by psychiatrists within three months of death. The roles of alcohol, drugs, abnormal cerebral changes and personality factors are discussed along with considerations for prevention.

Suicidal Thinking in Community Residents Over Eighty

“…The strong association between depressive disorder and suicide is already recognized (Cattell, 1988;Lindesay, 1991). However, we found no strong association between suicidal thinking and individual sociodemographic variables such as marital status and living arrangements.…”

Suicide in the elderly

“…In other studies, the relevance of ill health as a risk factor is reflected in associated findings. Cattell & Jolley (1995), for example, reported that within the 12 months preceding suicide, 23% of a series of 100 consecutive elderly suicides had been hospitalised for the investigation and treatment of physical disorders. Elwood & De Silva (1998), in a study of 67 subjects who had made contact with general hospital services but were unknown to psychiatric services, found the elderly to be overrepresented.…”

“…(Steering Committee, 1996) documented the original scrutiny of 240 suicides known to be in contact with psychiatric services between June 1993 and December 1994 and revealed that in England a total of 54 (22.5%) were aged over 60 years, with men accounting for 54% of this cohort. Cattell & Jolley (1995) reported that 20% of their series had contact within six months and 14% within one month. Osuna et al (1997) reported on a large elderly series from Madrid and found similar results of 16% and nearly 10%, respectively.…”

“…Information from several inquest studies shows low antidepressant treatment levels of around 10-25% (Cattell, 1988;Cattell & Jolley 1995;Duckworth & McBride, 1996), although a more optimistic finding has been reported from Sweden where 50% of a cohort of 75 elderly suicides had a documented history of treatment for affective disorder in the six months prior to death (Waern et al, 1966).…”

“…Larger samples may be analysed using information obtained from coroners' inquests and other sources. Several studies have focused specifically on the elderly in recent years (Cattell, 1988;Cattell & Jolley 1995;Duckworth & McBride, 1996;Osuna et al, 1997;Purcell et al, 1999).…”