Sociodemographic and Clinical Differences Between Suicide Ideators and Attempters: A Study of Mood Disordered Patients 50 Years and Older

Abstract

Our study sought to characterize mood disordered suicide ideators and attempters 50 years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48 hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46 years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12 months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk.

Suicide Ideation Is Related to Therapeutic Alliance in a Brief Therapy for Attempted Suicide

“…Furthermore, patients with suicide ideation and patients who attempt suicide do not differ in a number of variables generally known to be risk factors for suicide (Pompili et al, 2014). Therefore, BSS scores can be taken as an indirect proxy for actual suicide risk.…”

Suicide in Older Adults: The Role of Emotions and Cognition

“…Compared to middle-aged and older inpatient suicide ideators, middle-aged and older suicide attempters have lower social support, an older age of onset of mood disorders (≥46 years), and lower incidence of pharmacotherapy during the index episode [27]. Compared to inpatient and outpatient non-attempters, older adults who attempted suicide had an earlier age at onset of depression, greater number of depression episodes, more severe depression, greater number of psychotic symptoms and more left-sided white matter lesions [28].…”

“…Suicide intent in cognitively impaired older adults may also be expressed as passive self-harm behaviors, including refusal to eat, drink or take medications [37]. Future research needs to focus on these passive self-harm behaviors that are more prevalent in demented patients, are unlikely to be recorded as suicides, and are associated with mortality [33, 27]. …”

Child abuse and the prevalence of suicide attempts among those reporting suicide ideation

“…Only the presence of a suicide plan [3, 12] and a history of self-harm or suicide have consistently been shown to predict the progression from suicide ideation to an attempt [3, 14, 16, 17]. Factors, such as mental illness [3, 12, 14, 18–21], substance abuse [3, 12, 19], sex [3, 12, 20–22], age [3, 12, 21, 22], marital status [3, 19], social interactions and belonging [14, 19], and life stressors [14, 18] have had conflicting findings. Other potential risk factors, such as financial strain [23, 24] and physical illness [25, 26], have not been studied as factors that may distinguish suicide ideators and attempters.…”