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Some Common Illnesses May
Increase Suicide Risk for Elderly People
http://seniorjournal.com/NEWS/Eldercare/4-06-15illness.htm
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 Women’s
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 one’s 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
physician’s 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.
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