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Some Common Illnesses May Increase Suicide Risk for
Elderly People
June 15, 2004 - Elderly people kill themselves at a
higher rate than others and a recent study has identified illnesses
which may increase the suicide risk. Suicide ranks number 11 in the
leading causes of death in the United States.
Many of the illnesses associated with suicide risk
are common, according to an article in the June 14 issue of The
Archives of Internal Medicine, one of the JAMA/Archives journals.
Medical illnesses may predispose to suicide, but few studies have
examined the association between suicide and specific illnesses, the
article states.
David N. Juurlink, M.D., Ph.D., of Sunnybrook and
Womens College Health Sciences Centre, Toronto, Ontario, and colleagues
examined the relationship between treatment for several illnesses and
the risk of suicide in elderly patients.
The researchers examined the prescription records
of all Ontario residents 66 years and older who committed suicide
between January 1, 1992 and December 31, 2000. For each resident who
committed suicide, the researchers also looked at the prescription
records of four living controls matched for age, sex, residential area,
and income to determine the presence or absence of 17 illnesses
potentially related to suicide.
Among the 1,329 elderly persons who committed
suicide (1,012 men; 317 women), the most common methods involved
firearms (28 percent), hanging (24 percent), and self-poisoning (21
percent). Depression, bipolar disorder (manic-depressive illness) and
severe pain were associated with the largest increases in suicide risk.
However, several other chronic illnesses including seizure disorder,
congestive heart failure, and chronic lung disease, were also associated
with an increased risk for suicide.
The researchers also found that treatment for
multiple illnesses was strongly related to an increased risk of suicide,
and that most of the patients who committed suicide visited a physician
in the month before death, about half of them during the preceding week.
Our findings have important implications for
prevention because most elderly patients who commit suicide visit a
physician shortly beforehand, and many of them have clinically
recognizable features of depression at the time, the authors write.
Physicians, nurses, and other health care professionals should be alert
to the possible threat of suicide in elderly patients with chronic
illness, particularly in patients with multiple illnesses, symptoms of
depression, or other risk factors for suicide.
Editorial: Preventing Suicide in Elderly
Patients
Eve K. Moscicki, Sc.D., M.P.H., of the National
Institute of Mental Health, Bethesda, Md., and Eric D. Caine, M.D., of
Rochester, N.Y., write, While suicide may seem to many to be a
quintessentially individual problem resulting from intensely personal
decisions to end ones life, empirical evidence over the past two
decades has shifted this view toward one of suicide as a broader,
population-based phenomenon with discernible common patterns that can be
used to help define generalized risk and protective factors.
They write that Juurlink et al find that the
likelihood of suicide or nonfatal suicidal behaviors increases with an
increasing number of risk factors as well as with specific medical
conditions such as depression or severe pain. The findings from this
epidemiologic work can now form the basis for a different type of study
to examine the mechanisms by which depression and general medical
disorders may interact.
The editorialists state that the findings by
Juurlink et al point in three different directions for future research:
describing the mechanisms that protect individuals with medical
disorders, depression and pain who do not kill themselves; understanding
how those who killed themselves appeared in their physicians offices
and what a physician should look for; and finally, developing preventive
and therapeutic interventions to help those identified as at increased
risk for suicide. |
