Late‐life suicide and depression in the primary care setting

Pearson, Jane L.; Conwell, Yeates; Lyness, Jeffrey M.

doi:10.1002/yd.2330247604

Cited by 25 publications

(20 citation statements)

References 134 publications

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“…On the basis of studies of psychological autopsies and record reviews from general practitioner sites, it has been recommended that detecting and treating depression in primary care may be effective in preventing elderly suicides, since a majority of older adults seek primary care services within a month of suicide (7). Others have recommended that improved detection and treatment of depression by primary care practitioners may reduce suicides among women, but not men, since women are more likely to seek health services (8).…”

mentioning

confidence: 99%

Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence

Luoma

Martin²,

Pearson

2002

AJP

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1,327

804

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Objective-This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide.Method-The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects.Results-Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults.Conclusions-While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men.Suicide is a serious public health problem. Among industrialized countries in 1990, suicide was among the top 10 causes of death (1). In 1998 approximately 30,000 people died by suicide in the United States, making it the eighth leading cause of death (2). Recently, the National Strategy for Suicide Prevention was issued (3), outlining specific goals intended to prevent suicide in the United States. Programs aimed at improving the ability of primary care and mental health professionals to identify and treat those at risk for suicide are recommended. A primary goal of this review was to consider the potential of such strategies. Although general estimates of service contact before suicide are often cited (4, 5), there has been no systematic review of how frequently different types of health care professionals HHS Public Access Author Manuscript Author Manuscript Author ManuscriptAuthor Manuscript have contact with various populations who eventually commit suicide. At least one review has examined contacts with health and mental health care providers before suicide (6); however, its usefulness was limited because it did not take into consideration specific populations that eventually commit suicide, such as older adults or youth, who may differ in their rates of health care contact.Despite limited systematic reviews of health care contacts before suicide, some prevention strategies involving health care providers have been suggested. On the basis of studies of psychological autopsies and record reviews from general practitioner sites, it has been recommended that detecting and treating depression in primary care ...

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mentioning

confidence: 99%

Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence

Luoma

Martin²,

Pearson

2002

AJP

Self Cite

1,327

804

View full text Add to dashboard Cite

show abstract

“…7 Depression increases the risk of suicide across age groups. 2,3,8 High severity of depression, as reflected by treatment setting, seems to be a predictor of suicidal behavior. 9 Suicide mortality in 35 536 individuals treated for depression within a health plan was 59 per 100 000 person-years of follow-up.…”

mentioning

confidence: 99%

Clinical Determinants of Suicidal Ideation and Behavior in Geriatric Depression

Alexopoulos¹,

Bruce²,

Hull³

et al. 1999

Arch Gen Psychiatry

193

119

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“…The association between marital discord and elderly suicide independent of mental disorders has been also reported (Rubenowitz et al, 2001). The majority of late-life suicides have contact with their primary care physician in the preceding months (Pearson et al, 1997). Medical services can play an important role in early identification and intervention.…”

Section: Discussionmentioning

confidence: 97%