Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-27T18:33:32.698Z Has data issue: false hasContentIssue false
  • English
  • Français

Determinants of thoughts of death or suicide in depressed older persons

Published online by Cambridge University Press:  09 August 2013

Ista C. H. M. Bogers ,
Marij Zuidersma ,
Marjolein L. Boshuisen ,
Hannie C. Comijs  and
Richard C. Oude Voshaar
Ista C. H. M. Bogers*
Affiliation:
Lentis/Dignis, Mental Health Organisation, Groningen, the Netherlands
Marij Zuidersma
Affiliation:
University Center of Psychiatry (UCP), and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
Marjolein L. Boshuisen
Affiliation:
Lentis/Dignis, Mental Health Organisation, Groningen, the Netherlands
Hannie C. Comijs
Affiliation:
GGZ inGeest/Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
Richard C. Oude Voshaar
Affiliation:
University Center of Psychiatry (UCP), and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
*
Correspondence should be addressed to: Ista C.H.M. Bogers, Lentis/Dignis, Post Office Box 128, Zuidlaren 9470AC, the Netherlands. Phone: 0031-50-4097911. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In depressed persons, thoughts of death and suicide are assumed to represent different degrees of a construct: suicidality. However, this can be questioned in older persons facing physical and social losses. Thoughts of death in depressed older persons are hardly examined in the absence of suicidal ideation. Furthermore, most depression instruments do not discriminate suicidal ideation from thoughts of death only. We examined whether determinants of thoughts of death differ from determinants of suicidal ideation in late life depression.

Methods:

Past month's thoughts of death and suicidal ideation were assessed with the Composite International Diagnostic Interview in 378 depressed older persons (>60 years of age). Multinomial logistic regression analyses adjusted for age and depression severity were used to identify socio-demographic, lifestyle, clinical and somatic determinants of past month's thoughts of death, and suicidal ideation.

Results:

Compared with patients without thoughts of death or suicide (n = 267), patients reporting thoughts of death but no suicidal ideation (n = 74) were older (OR (95% confidence interval) = 1.04 (1.00–1.08)) and more severely depressed (OR = 1.06 (1.04–1.08)), whereas patients with suicidal ideation (n = 37) were also more severely depressed (OR = 1.09 (1.06–1.13)), but not older. This latter group was further characterized by more psychiatric comorbidity (dysthymia OR = 2.28 (1.08–4.85)), panic disorder (OR = 2.27 (1.00–518)), at-risk alcohol use (OR = 4.10 (1.42–11.90)), lifetime suicide attempts (OR = 3.37 (1.46–7.75)), loneliness (OR = 1.24 (1.07–1.43)), and recent life events (OR = 3.14 (1.48–6.67)).

Conclusions:

In depressed older persons thoughts of death and suicide differ in relevant demographic, social, and clinical characteristics, suggesting that the risks and consequences of the two conditions differ.

Keywords

depressionsuicidepsychogeriatricsrisk factors
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 11 , November 2013 , pp. 1775 - 1782
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Bruce, M. L., Hull, J., Sirey, J. A. and Kakuma, T. (1999). Clinical determinants of suicidal ideation and behavior in geriatric depression. Archives General Psychiatry, 56, 1048–1053.CrossRefGoogle ScholarPubMed
American Psychiatric Association (APA). (2000). Diagnostic and Statistic Manual of Mental Disorders, 4th edn.Washington, DC: American Psychiatric Association.Google Scholar
Awata, S.et al. (2005). Factors associated with suicidal ideation in an elderly urban Japanese population: a community-based, cross-sectional study. Psychiatry and Clinical Neurosciences, 59, 327–336.CrossRefGoogle Scholar
Babor, T. F., Kranzler, H. R. and Lauerman, R. J. (1989). Early detection of harmful alcohol consumption: comparison of clinical, laboratory, and self-report screening procedures. Addictive Behaviors, 14, 139–157.CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G. and Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.CrossRefGoogle ScholarPubMed
Brugha, T., Bebbington, P., Tennant, C. and Hurry, J. (1985). The list of threatening experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychological Medicine, 15, 189–194.CrossRefGoogle ScholarPubMed
Centraal Bureau voor de Statistiek (2007). Zelfdoding in Nederland: een statistisch overzicht; http://www.cbs.nl/NR/rdonlyres/84CFEED4-01C2-4FE4-9F81-44DF3F43728F/0/2007k4b15p73art.pdf; last accessed 3 July 2013.Google Scholar
Chwastiak, L. A. and Von Korff, M. (2003). Disability in depression and back pain: evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Journal of Clinical Epidemiology, 56, 507–514.CrossRefGoogle Scholar
Claassen, C. A.et al. (2007). Clinical differences among depressed patients with and without a history of suicide attempts: findings from the STAR*D trial. Journal of Affective Disorders, 97, 77–84.CrossRefGoogle ScholarPubMed
Comijs, H. C.et al. (2011). The Netherlands study of depression in older persons (NESDO); a prospective cohort study. BMC Research Notes, 4, 524 doi:10.1186/1756-0500-4-524.CrossRefGoogle ScholarPubMed
Corna, L. M., Cairney, J. and Streiner, D. L. (2010). Suicide ideation in older adults: relationship to mental health problems and service use. Gerontologist, 50, 785–797.CrossRefGoogle ScholarPubMed
De Graaf, R., Bijl, R. V., Ten Have, M., Beekman, A. T. and Vollebergh, W. A. (2004). Pathways to comorbidity: the transition of pure mood, anxiety and substance use disorders into comorbid conditions in a longitudinal population-based study. Journal of Affective Disorders, 82, 461–467.CrossRefGoogle Scholar
De Jong Gierveld, J. and Kamphuis, F. H. (1985). The development of a rash type loneliness scale. Applied Psychological Measurements, 9, 289–299.CrossRefGoogle Scholar
Dennis, M., Baillon, S., Brugha, T., Lindesay, J., Stewart, R. and Meltzer, H. (2007). The spectrum of suicidal ideation in Great Britain: comparisons across a 16–74 years age range. Psychological Medicine, 37, 795–805.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Hintikka, J.et al. (2009). Are factors associated with suicidal ideation true risk factors? A 3-year prospective follow-up study in a general population. Social Psychiatry and Psychiatric Epidemiology, 44, 29–33.CrossRefGoogle ScholarPubMed
Jeste, N. D., Hays, J. C. and Steffens, D. C. (2006). Clinical correlates of anxious depression among elderly patients with depression. Journal of Affective Disorders, 90, 37–41.CrossRefGoogle ScholarPubMed
Katz, C., Yaseen, Z. S., Mojtabai, R., Cohen, L. J. and Galynker, I. I. (2011). Panic as an independent risk factor for suicide attempt in depressive illness: findings from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry, 72, 1628–1635.CrossRefGoogle Scholar
Kriegsman, D. M., Penninx, B. W., van Eijk, J. T., Boeke, A. J. and Deeg, D. J. (1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 1407–1417.CrossRefGoogle Scholar
Lenze, E. J.et al. (2000). Comorbid anxiety disorders in depressed elderly patients. American Journal of Psychiatry, 157, 722–728.CrossRefGoogle ScholarPubMed
Levine, D. W., Kaplan, R. M., Kripke, D. F., Bowen, D. J., Naughton, M. J. and Shumaker, S. A. (2003). Factor structure and measurement invariance of the Women's Health Initiative Insomnia Rating Scale. Psychological Assessment, 15, 123–136.CrossRefGoogle ScholarPubMed
Montgomery, S. A. and Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British. Journal of. Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Nakagawa, A., Grunebaum, M. F., Oquendo, M. A., Burke, A. K., Kashima, H. and Mann, J. J. (2009). Clinical correlates of planned, more lethal suicide attempts in major depressive disorder. Journal of Affective Disorders, 112, 237–242.CrossRefGoogle ScholarPubMed
Office for National Statistics (2012). Suicide rates in the United Kingdom, 2006 to 2010; http://www.ons.gov.uk/ons/dcp171778_254113.pdf; last accessed 3 July 2013.Google Scholar
Pearlin, L. I. and Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.CrossRefGoogle ScholarPubMed
Rowe, J. L., Conwell, Y., Schulberg, H. C. and Bruce, M. L. (2006). Social support and suicidal ideation in older adults using home healthcare services. American Journal of Geriatric Psychiatry, 14, 758–766.CrossRefGoogle ScholarPubMed
Rurup, M. L., Deeg, D. J., Poppelaars, J. L., Kerkhof, A. J. and Onwuteaka-Philipsen, B. D. (2011). Wishes to die in older people: a quantitative study of prevalence and associated factors. Crisis, 32, 194–203.CrossRefGoogle ScholarPubMed
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B. and Trivedi, M. H. (1996). The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychological Medicine, 26, 477–486.CrossRefGoogle ScholarPubMed
Seo, H. J.et al. (2011). Distinctive clinical characteristics and suicidal tendencies of patients with anxious depression. Journal of Nervous and Mental Disease, 199, 42–48.CrossRefGoogle ScholarPubMed
Tan, L. L. and Wong, H. B. (2008). Severity of depression and suicidal ideations among elderly people in Singapore. International Psychogeriatrics, 20, 338–346.CrossRefGoogle ScholarPubMed
Ten Have, M.et al. (2009). Incidence and course of suicidal ideation and suicide attempts in the general population. Canadian Journal of Psychiatry, 54, 824–833.CrossRefGoogle ScholarPubMed
Ullman, S. E. and Najdowski, C. J. (2009). Correlates of serious suicidal ideation and attempts in female adult sexual assault survivors. Suicide and Life-Threatening Behavior, 39, 47–57.CrossRefGoogle ScholarPubMed
Vanderhorst, R. K. and McLaren, S. (2005). Social relationships as predictors of depression and suicidal ideation in older adults. Aging and Mental Health, 9, 517–525.CrossRefGoogle ScholarPubMed
Wisocki, P. A., Handen, B. and Morse, C. K. (1986). The worry scale as a measure of anxiety among homebound and community active elderly. Behavior Therapist, 5, 91–95.Google Scholar
Wittchen, H. U. (1994). Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research, 28, 57–84.CrossRefGoogle ScholarPubMed
Zimmerman, M. and Chelminski, I. (2003). Generalized anxiety disorder in patients with major depression: is DSM-IV's hierarchy correct? American Journal of Psychiatry, 160, 504–512.CrossRefGoogle ScholarPubMed