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Smith L, López Sánchez GF, Soysal P, Veronese N, Rahmati M, Tully MA, Yon DK, Alghamdi BS, Butler L, Ahluwalia S, Ball G, Shin JI, Koyanagi A. Association between sedentary behavior and wish to die among adults aged ≥50 years: Findings from the Irish Longitudinal Study on Ageing. J Psychiatr Res 2024; 178:173-179. [PMID: 39141997 DOI: 10.1016/j.jpsychires.2024.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/22/2024] [Accepted: 07/31/2024] [Indexed: 08/16/2024]
Abstract
We investigated the association between sedentary behavior (SB) and wish to die (WTD; i.e., feeling that one would be better off dead or wishing for one's own death), and the extent to which this can be explained by sleep problems, depression, anxiety, loneliness, perceived stress, and social network in a nationally representative sample of adults aged ≥50 years from Ireland. Cross-sectional data from Wave 1 of the Irish Longitudinal Study on Ageing 2009-2011 were analyzed. WTD was defined as answering affirmatively to the question "In the last month, have you felt that you would rather be dead?" SB was used as a continuous variable (hours/day), and also as a categorical (< or ≥8 h/day) variable. Multivariable logistic regression and mediation analyses were conducted. Data on 8163 adults aged ≥50 years were analyzed [mean (SD) age 63.6 (9.1) years; 48.0% males]. Overall, ≥8 (vs. <8) hours/day of SB was associated with a significant 2.04 (95%CI = 1.50-2.76) times higher odds for WTD, while a 1-h increase in SB per day was associated with 1.11 (95%CI = 1.06-1.16) times higher odds for WTD. Mediation analysis showed that sleep problems, depression, loneliness, perceived stress, and social network explained a modest proportion of the association between SB and WTD (mediated percentage 9.3%-14.8%). The present cross-sectional study found that increasing or higher levels of SB is positively associated with WTD. Addressing the identified potential mediators may reduce WTD among people who are sedentary. However, future longitudinal and intervention studies are needed to make concrete recommendations.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Badrah S Alghamdi
- Department of Physiology, Neuroscience Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; King Fahd Medical Research Center, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Sanjiv Ahluwalia
- School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Graham Ball
- Medical Technology Research Centre, Anglia Ruskin University, Chelmsford, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea; Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
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Avieli H. Suicidal Ideation Among Older Adults in Prison: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241276561. [PMID: 39271487 DOI: 10.1177/00302228241276561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Suicide is a serious public health concern, and people who are incarcerated represent a particularly high-risk group. Although research on the suicidality of persons in prison has gained interest in recent decades, the issue of suicide among older adults in prison has been understudied. Therefore, the aim of the present study was to explore the ways in which older adults in prison understood their experiences of suicidal ideation. Interpretive phenomenological analysis was utilized to analyze interviews with 16 incarcerated older adults. The analysis of the findings revealed four themes: (1) Suicide intentions as a control strategy; (2) Suicide intentions as an act of resistance; (3) Suicide intentions as a means of self-redemption, and (4) Suicide intentions in the absence of other choices. Guided by the life course perspective, the findings suggest that suicidal ideation serves as a means of expressing distinct emotional states that may be unique to older adults in carceral environments.
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Affiliation(s)
- Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
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Nieuwenhuijs B, Gorus E, Portzky G, De Witte N. Risk and protective factors of a wish to die and suicidal ideation in community-dwelling, older, Flemish adults: results of the Belgian ageing studies. Aging Ment Health 2024; 28:1262-1269. [PMID: 38708865 DOI: 10.1080/13607863.2024.2345779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES This study aims to increase the understanding of suicidality in older adults by investigating the prevalence, characteristics, risk and protective factors of suicidal phenomena in community-dwelling older adults (60+) in Flanders, specifically of a current wish to die (WTD) and lifetime suicidal ideation and behaviour (LSIB). METHOD Cross-sectional data from the Belgian Ageing Studies (BAS) is used (N = 3050). The BAS aims to monitor the needs and quality of life of community-dwelling older adults through a standardised survey. Statistical methods used are bivariate analyses and binary logistic regression. RESULTS Prevalence rates of 4.8% for WTD and 8.2% for LSIB are found. LSIB is the biggest predictor of a current WTD, followed by requiring support on three domains, elder abuse, depression and subjective cognitive complaints, and elder abuse were significant risk factors for both WTD and LSIB. Limited effects of protective factors were found. CONCLUSION Previous research regarding risk factors to be confirmed in this study, and new insights on the effect of elder abuse, subjective indicators of cognitive complaints and requiring support are added. Further research into protective factors and underlying mechanisms is required.
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Affiliation(s)
- Beau Nieuwenhuijs
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Gwendolyn Portzky
- Unit for Suicide Research, Department Head and Skin, Ghent University, Gent, Belgium
| | - Nico De Witte
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- School of Healthcare, HOGENT University of Applied Sciences and Arts, Ghent, Belgium
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Ward M, Briggs R, Kenny RA. Social disconnection correlates of a "Wish to Die" among a large community-dwelling cohort of older adults. Front Public Health 2024; 12:1436218. [PMID: 39234069 PMCID: PMC11371793 DOI: 10.3389/fpubh.2024.1436218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/24/2024] [Indexed: 09/06/2024] Open
Abstract
Introduction Social disconnection and deaths by suicide among older adults are both important public health concerns, particularly in the context of ageing populations. The association between death ideation and behaviours, and social disconnection is well established and both functional and structural social relationships have been identified as predictive of suicide-related thoughts and behaviours. The "Wish to Die" (WTD) involves thoughts of or wishes for one's own death or that one would be better off dead is a commonly used indicator to capture death ideation. It has been shown to be as predictive as active ideation of future suicide attempt. Methods Data were from a large cohort of community-dwelling older adults aged 50+, The Irish Longitudinal Study on Ageing (TILDA). Cross-sectional analyses of the association between numerous markers of social disconnection (loneliness, social isolation, living alone, marital status, social participation, volunteering, and attending religious service) and WTD were conducted. Results Multiple markers of social disconnection were associated with a "wish to die". However, loneliness was the strongest risk factor while attendance of religious services was an important protective behaviour. Discussion There is a strong association between social disconnection and a WTD among older adults. There is also a strong association between depression and a WTD, while attending religious services or similarly prosocial settings may protect older adults from experiencing negative thoughts about dying.
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Affiliation(s)
- Mark Ward
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
- Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
- Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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Jung HW, Jang JS. Constructing prediction models and analyzing factors in suicidal ideation using machine learning, focusing on the older population. PLoS One 2024; 19:e0305777. [PMID: 39038039 PMCID: PMC11262681 DOI: 10.1371/journal.pone.0305777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/04/2024] [Indexed: 07/24/2024] Open
Abstract
Suicide among the older population is a significant public health concern in South Korea. As the older individuals have long considered suicide before committing suicide trials, it is important to analyze the suicidal ideation that precedes the suicide attempt for intervention. In this study, six machine learning algorithms were employed to construct a predictive model for suicidal thinking and identify key variables. A traditional logistic regression analysis was supplementarily conducted to test the robustness of the results of machine learning. All analyses were conducted using a hierarchical approach to compare the model fit of each model in both machine learning and logistic regression. Three models were established for analysis. In Model 1, socioeconomic, residential, and health behavioral factors were incorporated. Model 2 expanded upon Model 1 by integrating physical health status, and Model 3 further incorporated mental health conditions. The results indicated that the gradient boosting algorithm outperformed the other machine learning techniques. Furthermore, the household income quintile was the most important feature in Model 1, followed by subjective health status, oral health, and exercise ability in Model 2, and anxiety and depression in Model 3. These results correspond to those of the hierarchical logistic regression. Notably, economic and residential vulnerabilities are significant factors in the mental health of the older population with higher instances of suicidal thoughts. This hierarchical approach could reveal the potential target population for suicide interventions.
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Affiliation(s)
- Hyun Woo Jung
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Republic of Korea
- Yonsei Institute of Health and Welfare, Yonsei University Mirae Campus, Wonju, Republic of Korea
| | - Jin Su Jang
- Human Behavior & Genetic Institute, Associate Research Center, Korea University, Seoul, Republic of Korea
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Ki M, Lapierre S, Gim B, Hwang M, Kang M, Dargis L, Jung M, Koh EJ, Mishara B. A systematic review of psychosocial protective factors against suicide and suicidality among older adults. Int Psychogeriatr 2024; 36:346-370. [PMID: 38305360 DOI: 10.1017/s104161022300443x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults. METHOD First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis. RESULTS A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures. CONCLUSION Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.
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Affiliation(s)
- Myung Ki
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Boeun Gim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Minji Hwang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
| | - Minku Kang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Luc Dargis
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Myoungjee Jung
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Emily Jiali Koh
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
| | - Brian Mishara
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
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Kim EY, Jeong YW, Lim J, Kang DR. Factors Related to Suicidal Ideation by Gender and Age Group in Korean Adults. J Korean Med Sci 2023; 38:e376. [PMID: 38111279 PMCID: PMC10727917 DOI: 10.3346/jkms.2023.38.e376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/14/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND According to the results of the age-standardized suicide rate (suicide deaths per 100,000 population) published by Organization for Economic Cooperation and Development countries from 2003 to 2019, the suicide rate in Korea is ranked first almost every year, so it should be managed at the national level. To reduce the suicide rate, many scholars are studying suicide. The suicidal process begins with suicidal ideation, progresses through suicide attempts, and ends with suicide. Among them, the frequency of suicidal thoughts was found to be highly correlated with suicide plans and attempts, and it is said that 60% of those who change from suicidal ideation to attempts appear within one year. Therefore, research related to suicidal ideation to lower the suicide rate will contribute to preventing suicide at an early stage. METHODS This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among them, data from 2013, 2015, 2017, and 2019 surveyed adults were compared for suicidal ideation among 18,339 adults. Considering the characteristics of the KNHANES data, complex sample analysis was performed considering the primary extraction unit (region), stratification variables, and weights. The Rao-Scott χ² test was stratified by age group to confirm the distribution of suicidal ideation according to general characteristics. Univariate and multiple logistic regression analyses were performed to understand the effect on suicidal ideation. RESULTS Among all subjects, the rate of suicidal ideation was 4.75%, and among the age groups, the rate of suicidal thoughts was the highest among those over 80 years old (10.39%). Compared to those who were 50s, those in their 30s had the lowest suicidal ideation (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.39-0.70), and those in their 80s had the highest rate of suicidal ideation (OR, 1.97; 95% CI, 1.38-2.82). Except for those in their 20s, the rate of suicidal ideation tends to increase with age. Overall, the lower 25% of the Euro Quality of Life-5 Dimensions (EQ-5D) index, depression lasting more than two weeks, and subjects with poor subjective health or high stress were more likely to have suicidal ideation. In particular, EQ-5D Index (OR, 5.86; 95% CI, 3.73-9.20), depressive symptoms (OR, 19.65; 95% CI, 9.94-38.83) in 20s, and stress in 80s (OR, 10.87; 95% CI, 5.63-20.96) was the highest, and those had the good subjective health perception in 30s (OR, 0.10; 95% CI, 0.05-0.20) was lowest. Participants in their 30s, 40s, and 60s who were divorced or widowed and those in their 50s and 60s who had never married or lived together were more likely to consider suicide ideation. Except for those in their 20s and 80s, the rate of suicidal ideation tends to increase with lower household income levels. CONCLUSIONS In the results of this study, it can be seen that a combination of factors such as a person's personality traits, stress or coping ability to various events, social support, and mental or physical limitations influence suicidal behavior. Suicidal ideation is not simply affected by a single factor but may be influenced by multiple factors.
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Affiliation(s)
- Eun Young Kim
- Department of Biomedical Laboratory Science, Songho University, Hoengseong, Korea
| | - Yong Whi Jeong
- Department of Medical Informatics and Biostatistics, Graduate School, Yonsei University, Seoul, Korea
| | - Jihye Lim
- Department of Medical Informatics and Biostatistics, Graduate School, Yonsei University, Seoul, Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
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Jung JH, Lee H. Childhood Adversity and Passive Suicidal Ideation in Later Life in the United States: Does Religious Attendance Matter? JOURNAL OF RELIGION AND HEALTH 2023; 62:3739-3759. [PMID: 37773487 DOI: 10.1007/s10943-023-01917-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 10/01/2023]
Abstract
This study examines whether adverse childhood experiences are associated with passive suicidal ideation in later life and whether religious attendance moderates this association among U.S. older adults. To this end, logistic regression analyses were conducted using data from the 2016 Health and Retirement Study. The results show that poor childhood health, lack of parental affection, and childhood trauma are all positively associated with passive suicidal ideation in later life. However, religious attendance modifies the association between childhood health and passive suicidal ideation. For instance, poor childhood health is associated with greater odds of passive suicidal ideation only for older adults who never attend religious services, while this is not the case for those who attend religious services. Yet, the associations of parental affection and childhood trauma with passive suicidal ideation do not appear to differ by religious attendance. We discuss the theoretical implications of these findings for views about childhood adversity, religion, and suicide risk in later life.
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Affiliation(s)
- Jong Hyun Jung
- Department of Sociology, Sungkyunkwan University, 25-2 Sungkyunkwan-ro, Jongno-gu, Seoul, 03063, South Korea.
| | - Haena Lee
- Department of Sociology, Sungkyunkwan University, 25-2 Sungkyunkwan-ro, Jongno-gu, Seoul, 03063, South Korea
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Smith L, Shin JI, Haro JM, Jacob L, López Sánchez GF, Tully MA, Oh H, Carvalho AF, Barnett Y, Butler L, Koyanagi A. Physical multimorbidity and wish to die among adults aged ≥65 years: A cross-sectional analysis of the Irish Longitudinal Study on Ageing. J Affect Disord 2022; 313:263-269. [PMID: 35764230 DOI: 10.1016/j.jad.2022.06.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/21/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical multimorbidity (i.e., ≥2 chronic conditions) may induce feelings of wish to die (WTD), but there is limited literature on this topic, while the mediators in this association are largely unknown. Thus, the aim of the present study was to investigate this association and its mediators among older Irish adults. METHODS Cross-sectional, nationally representative data from Wave 1 of the Irish Longitudinal Study on Ageing 2009-2011 were analyzed. Information on self-reported lifetime diagnosis of 14 chronic physical conditions were obtained. WTD was defined as answering affirmatively to the question "In the last month, have you felt that you would rather be dead?" Multivariable logistic regression and mediation analyses were conducted. RESULTS Data on 2941 adults aged ≥65 years [mean (SD) age 73.2 (5.2) years; 45.0 % males] were analyzed. Physical multimorbidity was associated with 3.39 (95%CI 1.58, 7.28) times higher odds for WTD. This association was largely explained by pain (% mediated 28.1 %), followed by depression (19.4 %), sleep problems (18.4 %), perceived stress (13.0 %), loneliness (10.4 %), anxiety (8.1 %), and disability (7.2 %). CONCLUSIONS Multimorbidity was associated with increased odds for WTD among Irish older adults. Addressing the identified mediators may contribute to reducing feelings of WTD among older adults with multimorbidity.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 8044, 120-752 Seoul, Seoul, Republic of Korea
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Newtownabbey, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
| | - Andre F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Yvonne Barnett
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Laurie Butler
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
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A scoping review exploring the ‘grey area’ of suicide-related expression in later life: Developing a conceptual framework for professional engagement. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
As the body of research on suicide in later life has developed, so has its vocabulary. This has generated a high level of overlap in concepts and terminology used to articulate suicide and how it might present, as well as ‘grey area’ behavioural terms that are both specific to older adults and less well-defined (e.g. ‘hastening of death’ or ‘completed life’). A better understanding of individual experiences and pathways to suicide can help to inform assessment and interventions, and increase the potential to relate any theoretical concepts to the implementation of such. Here, we adopted a scoping review to search systematically literature on specific presentation, features, circumstances and outcomes of these grey areas of suicide in later life. Fifty-three articles (quantitative, qualitative and theoretical) were reviewed. A narrative approach was used to merge and translate this body of knowledge into a new conceptual framework based on four key themes: (a) a sense of completed life or existential loneliness; (b) death thoughts, wishes and ideation; (c) death-hastening behaviour and advanced directives; and (d) self-destructive or self-injurious behaviour. We discuss the importance of integrating this understanding into current knowledge and suicide prevention strategies for older adults. Recommendations are made for unifying research with policy themes on healthy ageing, person-centredness within service provision and citizen participation.
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Rodríguez Ruzafa M, Carrasco Picazo JP, Junquera Fernández G, Aguilar García-Iturrospe EJ. EUROLD: preliminary results of the ecological study on suicide and its associated socioeconomic variables in people over 85 in Europe. Int Psychogeriatr 2022; 34:1-3. [PMID: 35225213 DOI: 10.1017/s1041610222000072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present study aims to compare the suicide rates in people over 85 years of age in relation to overall suicide rates in different European countries. In addition, the study aims to perform a preliminary analysis of which socioeconomic factors could explain higher suicide rates in this age group in Europe. An analysis of the Eurostat database has been made. In this pilot phase, certain socioeconomic variables representative of people over 85 years of age were chosen based on criteria of suitability, according to the bibliography available for other regions and availability of the information provided. The conditional suicide rate in this age group with respect to the overall suicide rate in each country has been calculated. Furthermore, Spearman correlations between the suicide rates in this age group and the chosen socioeconomic factors were performed. Conditional suicide rates in people over 85 years of age show a marked difference between southern and northern European countries. In the correlational analysis, suicide in this age group was associated with different economic ratios, the old-age dependency ratio, and the self-perceived health ratio. After performing a multivariate regression, the model that best explained the differences between the European countries included the variables "old-age dependency ratio" and "economic impossibility to buy new clothes ratio." Different socioeconomic factors, specifically poverty and economic inequality, added to the old-age dependency ratio, could explain huge differences between the suicide rates in people over 85 years of age in the different European countries.
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Affiliation(s)
| | | | | | - Eduardo Jesús Aguilar García-Iturrospe
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, Valencia 46010, Spain
- Department of Psychiatry, Faculty of Medicine of Valencia, Valencia 46010, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Biomedical Research Institute INCLIVA, Valencia 46010, Spain
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Heisel MJ, Flett GL. Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen. Aging Ment Health 2022; 26:392-406. [PMID: 33327729 DOI: 10.1080/13607863.2020.1857690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen). METHODS A series of psychometric analyses was conducted, assessing the internal consistency, test-retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173). RESULTS Overall findings demonstrated strong internal consistency, test-retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings. CONCLUSION Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.
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Affiliation(s)
- Marnin J Heisel
- Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, USA
| | - Gordon L Flett
- Department of Psychology, York University, Toronto, Ontario, Canada
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13
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Poorolajal J, Goudarzi M, Gohari-Ensaf F, Darvishi N. Relationship of religion with suicidal ideation, suicide plan, suicide attempt, and suicide death: a meta-analysis. J Res Health Sci 2021; 22:e00537. [PMID: 36511249 PMCID: PMC9315464 DOI: 10.34172/jrhs.2022.72] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Suicide is a significant public health problem and one of the leading causes of death worldwide. The effect of religion on suicidal behaviors (i.e., ideation, plan, attempt, and death) is an important issue worthy of consideration. METHODS Major electronic databases, including MEDLINE, Web of Science, and Scopus, were searched for the articles published until 26 April 2021. Reference lists were also screened. Observational studies addressing the associations between religion and suicidal behaviors were also examined. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The probability of publication bias was explored using the Begg and Egger tests, as well as trim-and-fill analysis. The effect size was expressed as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model. RESULTS Out of 11 389 identified studies, 63 articles were eligible, involving 8,053,697 participants. There was an inverse association between religion and suicidal ideation OR = 0.83 (95% CI: 0.78, 0.88; P < 0.001), suicidal plan OR = 0.93 (95% CI: 0.83, 1.04; P = 0.200), suicide attempt OR = 0.84 (95% CI: 0.79, 0.89; P < 0.001), and completed suicide OR = 0.31 (95% CI: 0.14, 0.72; P = 0.006). There was a no evidence of publication bias. CONCLUSIONS The results of this meta-analysis support the notion that religion can play a protective role against suicidal behaviors. Nonetheless, the effect of religion on suicidal behaviors varies across countries with different religions and cultures. Although this association does not necessarily imply causation, an awareness of the relationship between religion and suicide risk can be of great help in suicide prevention policies and programs.
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Affiliation(s)
- Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran,Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahmoud Goudarzi
- Department of Family Counseling, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Fatemeh Gohari-Ensaf
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Darvishi
- Department of Psychology, School of Human Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran,Corresponding author: Nahid Darvishi (MSc) E-mail: Zipcode: 6616935391 Tel:+98 87 3328 8661
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14
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Greig F, Perera G, Tsamakis K, Stewart R, Velayudhan L, Mueller C. Loneliness in older adult mental health services during the COVID-19 pandemic and before: Associations with disability, functioning and pharmacotherapy. Int J Geriatr Psychiatry 2021; 37:10.1002/gps.5630. [PMID: 34614534 PMCID: PMC8646648 DOI: 10.1002/gps.5630] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Loneliness is associated with psychiatric morbidity. Restrictions placed on the population during the first COVID-19 lockdown may have disproportionately affected older adults, possibly through increasing loneliness. We sought to investigate this by examining loneliness in referrals to mental health of older adults (MHOA) services during the first UK COVID-19 lockdown. METHODS Referrals to MHOA services from a large South London catchment area were identified for the 16-week period of the UK lockdown starting in March 2020 and for the corresponding period in 2019. A natural language processing algorithm identified loneliness in the patients' records. We applied logistic regression models adjusted for age, gender, ethnicity and diagnosis, to examine associations of loneliness in the study population. RESULTS 1991 referrals were identified, 56.9% of whom were female, with a mean age of 77.9 years. Only 26.9% occurred during the 2020 lockdown, but with a higher prevalence of loneliness (22.0 vs. 17.7%, p = 0.028). In the whole sample, loneliness was associated with non-accidental self-injury (Odds ratio [OR]: 1.65), depressed mood (OR: 1.73), psychotic symptoms (OR: 1.65), relationship problems (OR: 1.49), problems with daytime activities (OR: 1.36), and antidepressant use (OR: 2.11). During lockdown, loneliness was associated with non-accidental self-injury (OR: 2.52), problem drinking or drug-taking (OR 2.33), and antidepressant use (OR 2.10). CONCLUSIONS Loneliness is associated with more severe symptoms of affective illness, worse functional problems and increased use of antidepressant medication in older adults. During lockdown, loneliness in referrals to MHOA services increased and was associated with increased risk-taking behaviour. Loneliness is a potential modifiable risk factor for mental illness, and efforts to minimise it in older adults should be prioritised as we emerge from the pandemic.
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Affiliation(s)
- Flora Greig
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Gayan Perera
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Konstantinos Tsamakis
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Second Department of PsychiatryNational and Kapodistrian University of Athens‘Attikon’ University General HospitalAthensGreece
| | - Robert Stewart
- South London and Maudsley NHS Foundation TrustLondonUK
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Latha Velayudhan
- South London and Maudsley NHS Foundation TrustLondonUK
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Christoph Mueller
- South London and Maudsley NHS Foundation TrustLondonUK
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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15
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Passive Suicidal Ideation in Older Adults from 12 European Countries. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Holmstrand C, Rahm Hallberg I, Saks K, Leino-Kilpi H, Renom Guiteras A, Verbeek H, Zabalegui A, Sutcliffe C, Lethin C. Associated factors of suicidal ideation among older persons with dementia living at home in eight European countries. Aging Ment Health 2021; 25:1730-1739. [PMID: 32223443 DOI: 10.1080/13607863.2020.1745143] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the occurrence of suicidal ideation and associated factors in older persons with dementia living at home in eight European countries, and its association with quality of life. Furthermore, changes in suicidal ideation over time were investigated. METHODS This cohort study (n = 1,223) was part of the European "RightTimePlaceCare" project conducted in 2010-2013. Participating countries were Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden and the United Kingdom. Baseline and follow-up data were analysed using bivariate and multivariate logistic regression. RESULTS The occurrence of suicidal ideation in the participating countries varied between 6% and 24%. Factors significantly (p < 0.0018) associated with suicidal ideation using bivariate analysis were: nationality, depressive symptoms, delusions, hallucinations, agitation, anxiety, apathy, disinhibition, irritability, night-time behaviour disturbances, anxiolytics and anti-dementia medication. In the multivariate regression analysis, country of origin, moderate stage of the dementia, depressive and delusional symptoms, and anti-dementia medication were significantly associated with suicidal ideation (p < 0.05). Over time, suicidal ideation decreased from severe to mild or became absent in 54% of the persons with dementia. CONCLUSION It is essential that professionals identify older persons with dementia and suicidal ideation and depressive and other psychological symptoms in order to give them appropriate treatment and provide relief for their informal caregivers. We emphasize the importance of identifying suicidal ideation, irrespective of depressive symptoms, and specifically of paying attention to persons with moderate dementia. Living with the informal caregiver seems to be associated with staying stable without suicidal ideation.
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Affiliation(s)
- Cecilia Holmstrand
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden
| | | | - Kai Saks
- Faculty of Medicine, Department of Internal Medicine, University of Tartu, Tartu, Estonia
| | - Helena Leino-Kilpi
- Department of Nursing Science and Turku University Hospital, University of Turku, Turku, Finland
| | - Anna Renom Guiteras
- Faculty of Health, Department of Nursing Science, University of Witten/Herdecke, Witten, Germany.,Geriatrics Department, University Hospital Parc de Salut Mar, Barcelona, Spain
| | - Hilde Verbeek
- Department of Health Services Research, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands
| | | | - Caroline Sutcliffe
- Personal Social Services Research Unit, Faculty of Biology, Medicine and Health, Division of Population Health, University of Manchester, Manchester, United Kingdom
| | - Connie Lethin
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden.,Faculty of Medicine, Department of Clinical Sciences, Clinical Memory Research Unit, Lund University, Lund/Malmö, Sweden
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17
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Ragab I, Ward M, Moloney D, Kenny RA, Briggs R. 'Wish to die' is independently associated with cardiovascular mortality in later life. Data from TILDA. Int J Geriatr Psychiatry 2021; 36:1004-1010. [PMID: 33792969 DOI: 10.1002/gps.5550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is an established bidirectional relationship between mental and heart health in later life but the link between wish to die (WTD) and cardiovascular mortality is less well-defined. METHODS This is a longitudinal study examining the association between WTD and mortality over 9-year follow-up in a large population-representative sample of older adults. Individual-level survey data was linked to official death registration data, divided into cardiovascular and noncardiovascular causes. WTD was defined as answering affirmatively when asked 'In the last month, have you felt that you would rather be dead?' Regression models were used to obtain hazard ratios for the association between WTD at Wave 1 and mortality. Kaplan-Meier plots were used to compare survival across groups. RESULTS Just over 3% (275/8124) of participants reported WTD. Mortality data was available for 9% of participants (755/8124). WTD was significantly associated with all-cause mortality, with a hazard ratio of 1.41 (95% confidence interval [CI]: 1.00-1.99). Findings were attenuated and no longer significant after excluding participants with heart disease or depression/anxiety/other psychiatric illness. WTD was significantly associated with cardiovascular mortality (hazard ratio: 2.14 [95% CI: 1.21-3.78]), even after excluding participants with depression/anxiety/other illnesses but not heart disease. WTD was not associated with an increased risk of death due to non-cardiovascular causes. CONCLUSIONS Older people who report a wish to die have double the risk of death from cardiovascular disease in the following 9 years, even when those with depression, anxiety or other mental health problems are excluded.
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Affiliation(s)
- Inas Ragab
- Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Mark Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - David Moloney
- Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Robert Briggs
- Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
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18
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Briggs R, Ward M, Kenny RA. The 'Wish to Die' in later life: prevalence, longitudinal course and mortality. Data from TILDA. Age Ageing 2021; 50:1321-1328. [PMID: 33570600 PMCID: PMC7929464 DOI: 10.1093/ageing/afab010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND 'Wish to Die' (WTD) involves thoughts of or wishes for one's own death or that one would be better off dead. OBJECTIVE To examine the prevalence, longitudinal course and mortality-risk of WTD in community-dwelling older people. DESIGN Observational study with 6-year follow-up. SETTING The Irish Longitudinal Study on Ageing, a nationally representative cohort of older adults. SUBJECTS In total, 8,174 community-dwelling adults aged ≥50 years. METHODS To define WTD, participants were asked: 'In the last month, have you felt that you would rather be dead?' Depressive symptoms were measured using the CES-D. Mortality data were compiled by linking administrative death records to individual-level survey data from the study. RESULTS At Wave 1, 3.5% of participants (279/8,174) reported WTD. Both persistent loneliness (OR 5.73 (95% CI 3.41-9.64)) and depressive symptoms (OR 6.12 (95% CI 4.33-8.67)) were independently associated with WTD.Of participants who first reported WTD at Wave 1 or 2, 72% did not report WTD when reassessed after 2 years, and the prevalence of depressive symptoms (-44%) and loneliness (-19%) was more likely to decline in this group at follow-up.Fifteen per cent of participants expressing WTD at Wave 1 died during a 6-year follow-up. CONCLUSIONS WTD amongst community-dwelling older people is frequently transient and is strongly linked with the course of depressive symptoms and loneliness. An enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a public health priority, particularly in the current context of the Covid-19 pandemic.
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Affiliation(s)
- Robert Briggs
- Address correspondence to: Robert Briggs. Tel: +35314103000; Fax: +35314284622.
| | - Mark Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- Mercers Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical gerontology, Trinity College Dublin, Dublin, Ireland
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Kim J, Park MJ. Multilevel Effect of Neighborhood Social Cohesion and Characteristics on Suicidal Ideation Among Korean Older Adults. Community Ment Health J 2021; 57:522-528. [PMID: 32676878 DOI: 10.1007/s10597-020-00678-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/04/2020] [Indexed: 11/29/2022]
Abstract
This study examined the effect of neighborhood factors on suicidal ideation of community-dwelling older adults in Korea. To understand the effect of neighborhood factors (neighborhood social cohesion, satisfaction with neighborhood safety, living environment, suicide rate, proportion of social welfare agencies, proportion of social welfare expenses) and individual factors (health, social relationships) on suicidal ideation of older adults, we conducted a multilevel logistic regression analysis. The 2017 Community Health Survey of Korea included data on 67,820 people aged 65 years or older and in 255 neighborhoods. At the individual level, the presence of suicidal ideation was associated with less education attainment, lower family income, not living with a spouse, fewer social networks, fewer social activities, more depressive symptoms, and lower health-related quality of life. At the neighborhood level, lack of social cohesion, a higher suicide rate, and a smaller social welfare budget were significantly effect related to the probability of suicidal ideation.
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Affiliation(s)
- Jin Kim
- Department of Aging and Social Work, Catholic University of Pusan, #57 Oryundae-ro, Geumjeong-gu, Busan, 609-757, South Korea
| | - Mi Jin Park
- Department of Aging and Social Work, Catholic University of Pusan, #57 Oryundae-ro, Geumjeong-gu, Busan, 609-757, South Korea.
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20
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The role of ageing in the wish to be dead: disentangling age, period and cohort effects in suicide ideation in European population. Epidemiol Psychiatr Sci 2021; 30:e17. [PMID: 33597061 PMCID: PMC8061246 DOI: 10.1017/s2045796021000020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS To investigate potential age, period and birth cohort effects in the prevalence of suicide ideation in European ageing population. METHODS A total of 50 782 community-dwelling adults (aged + 50) from 20 different European countries were collected in the Survey Health Ageing and Retirement study. A multilevel logistic regression model of repeated measures was modelled to assess the effects of age and other variables, including the variability of observations over three levels: birth cohort groups, time period assessment and individual differences. RESULTS The larger effect of variability was attributed to individual-level factors (57.8%). Youngest-old people (65-79 years) showed lower suicide ideation than middle-aged people (50-64 years). No significative differences were found for suicide ideation between middle-aged people and oldest-old (80 + years). Only 0.85% and 0.13% of the total variability of suicide ideation accounted for birth cohort and period effects, respectively. Cohorts born between 1941 and 1944 possessed the lowest estimates of suicide ideation. Conversely, suicide ideation started to rise with post-War generations and reached a significant level for people born from 1953-1957 to 1961-1964. Regarding the time period, participants assessed in 2006-2007 showed a lower likelihood of suicide ideation. The rest of the cohorts and period groups did not show any significant effect on the prevalence of suicide ideation. CONCLUSIONS Our results suggest that age and suicide ideation relationship is not linear in middle and older age. The European Baby boomers born from 50s to mid-60s might report higher suicide ideation than their ancestors. This scenario would imply a greater need for mental healthcare services for older people in the future.
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21
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Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies. J Affect Disord 2020; 274:880-896. [PMID: 32664029 DOI: 10.1016/j.jad.2020.05.004] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Suicide and suicidal behaviour are global health concerns with complex aetiologies. Given the recent research and policy focus on loneliness, this systematic review aimed to determine the extent to which loneliness predicts suicidal ideation and/or behaviour (SIB) over time. METHODS A keyword search of five major databases (CINHAL, Medline, PsychArticles, PsychInfo and Web of Knowledge) was conducted. Papers for inclusion were limited to those using a prospective longitudinal design, written in English and which measured loneliness at baseline and SIB at a later time-point. RESULTS After duplicates were removed, 947 original potential papers were identified, with 22 studies meeting the review criteria. Meta-analysis revealed loneliness was a significant predictor of both suicidal ideation and behaviour and there was evidence that depression acted as a mediator. Furthermore, studies which consisted of predominantly female participants were more likely to report a significant relationship, as were studies where participants were aged 16-20 or >55 years at baseline. LIMITATIONS There was considerable variability in measures, samples and methodologies used across the studies. Middle-aged adults were under-represented, as were individuals from minority ethnic backgrounds. All studies were conducted in countries where self-reliance and independence (i.e. individualism) are the cultural norm. CONCLUSIONS Loneliness predicts later SIB in select populations. However, due to the heterogeneity of the studies further research is needed to draw more robust conclusions. Suicide death also needs to be included as an outcome measure. A focus on more collectivist countries is also required.
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22
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Cabello M, Miret M, Ayuso-Mateos JL, Caballero FF, Chatterji S, Tobiasz-Adamczyk B, Haro JM, Koskinen S, Leonardi M, Borges G. Cross-national prevalence and factors associated with suicide ideation and attempts in older and young-and-middle age people. Aging Ment Health 2020; 24:1533-1542. [PMID: 30990056 DOI: 10.1080/13607863.2019.1603284] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: To report prevalence estimates of 12-month suicide ideation and attempts in young-and-middle age adults and older people, as well as their respective associated factors.Methods: A total of 52,150 community-dwelling adults who completed the adapted version of the Composite International Diagnostic Interview-Depression Module were included from SAGE and COURAGE in Europe studies. The presence of 12-month suicide ideation and attempts was measured among the participants who screened positively in the Depression Module. Global and national prevalence estimates of 12-month suicide ideation and attempts were calculated according to the total sample. Logistic regression analyses were conducted to separately determine factors associated with suicidal ideation and with suicide attempts in young-and-middle age adults and older adults.Results: Higher estimates of 12-month suicidal ideation were found for high-income countries and people aged 65 years and older. Higher negative affect, higher disability, and presence of food insecurity were associated with 12-month suicidal ideation and suicide attempts for young-and-middle-adults and older adults. Higher isolation, being female, and greater number of chronic health conditions were also related to 12-month suicidal ideation in both age groups. Younger age was associated with 12-month suicidal ideation for older people, and with suicide attempts in the young-and-middle age group. Finally, higher income was related to lower rates of 12-month suicidal ideation for the young-and-middle age group.Conclusions: Older people are at increased risk of suicidal ideation globally and of suicide attempts in some countries. There were common and different factors related to suicide in adults and older adults.
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Affiliation(s)
- Maria Cabello
- Department of Psychiatry, Universidad Autonoma de Madrid, Arzobispo Morcillo, Madrid, Spain.,Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Monforte de Lemos, Madrid, Spain
| | - Marta Miret
- Department of Psychiatry, Universidad Autonoma de Madrid, Arzobispo Morcillo, Madrid, Spain.,Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Monforte de Lemos, Madrid, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autonoma de Madrid, Arzobispo Morcillo, Madrid, Spain.,Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Monforte de Lemos, Madrid, Spain
| | - Felix Feliz Caballero
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autonoma de Madrid, Arzobispo Morcillo, Madrid, Spain.,Instituto de Salud Carlos III, CIBER of Epidemiology and Public, Health (CIBERESP), Monforte de Lemos, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research Unit, World Health Organization, Geneva, Switzerland
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland
| | - Josep Maria Haro
- Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Monforte de Lemos, Madrid, Spain.,Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr. Antoni Pujadas, Barcelona, Spain
| | - Seppo Koskinen
- Ageing, Disability and Functioning Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Guilherme Borges
- National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico
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23
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Cheng X, Bu H, Duan W, He A, Zhang Y. Measuring character strengths as possible protective factors against suicidal ideation in older Chinese adults: a cross-sectional study. BMC Public Health 2020; 20:439. [PMID: 32245407 PMCID: PMC7118809 DOI: 10.1186/s12889-020-8457-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/04/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Suicide is a global issue among the elderly. The number of older people committing suicide is proliferating, and the elderly suicide rate is the highest among all age groups in China. A better understanding of the possible protective factors against suicidal ideation is necessary to facilitate prevention and intervention efforts. The objectives of the present study are threefold. First, this study aims to examine the psychometric properties of the three-dimensional inventory of character strengths (TICS) with a sample of older adults. Second, this study intends to investigate correlations among suicide ideation, wellbeing, and character strengths. Third, the study seeks to explore the possible protective roles of the three character strengths and wellbeing in explaining suicidal ideation among older adults. METHODS A cross-sectional study comprising 308 older adults aged at least 50 years old from nursing homes was conducted. Four questionnaires, namely, the TICS, the Geriatric Suicide Ideation Scale-10 items, the Brief Inventory of Thriving, and the Satisfaction with Life Scale, were used. Exploratory structural equation modeling, intraclass correlation coefficients, partial correlations, and sets of hierarchical regressions were adopted to estimate and report the results. RESULTS TICS could be used to assess the character strengths (i.e., caring, inquisitiveness, and self-control) among older adults with an acceptable goodness-of-fit (chi square = 157.30, df = 63, p < 0.001, CFI = 0.94, TLI = 0.90, RMSEA = 0.07, 90% CI = [0.06, 0.08]). Wellbeing and character strengths exhibited a negative association with suicidal ideation among older adults. Moreover, character strengths showed an independently cross-sectional relationship with suicidal ideation, explaining 65.1% of the variance of suicidal ideation after controlling for the wellbeing and demographics. CONCLUSION This study indicated that character strengths were associated with low levels of suicidal ideation. Therefore, the protective factors against suicidal ideation among older adults should be given additional attention.
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Affiliation(s)
- Xinfeng Cheng
- Economics and Management Department, Xi'an Technological University, Xi'an, China.,School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - He Bu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Wenjie Duan
- Social and Public Administration School, East China University of Science and Technology, Shanghai, China.
| | - Along He
- Department of Sociology, Wuhan University, Wuhan, China
| | - Yaping Zhang
- Goizueta Business School, Emory University, Atlanta, Georgia
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Zhuo LB, Yao W, Yan Z, Giron MST, Pei JJ, Wang HX. Impact of effort reward imbalance at work on suicidal ideation in ten European countries: The role of depressive symptoms. J Affect Disord 2020; 260:214-221. [PMID: 31505399 DOI: 10.1016/j.jad.2019.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/09/2019] [Accepted: 09/01/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Evidence of the association between effort reward imbalance (ERI) and suicidal ideation is sparse. This study examined the influence of ERI at work on suicidal ideation and the mediating effect of depressive symptoms. METHODS There were 4963 workers aged 50+ without suicidal ideation at baseline in the Survey of Health, Aging and Retirement in Europe, these workers were followed-up for 8-years to detect incident suicidal ideation. ERI was measured by a short ERI questionnaire. Suicidal ideation was evaluated by one item derived from the 12-item Europe-depression scale, and depressive symptoms were assessed by the remaining 11 items in the scale. Cox models were employed to explore the relationship adjusting for potential confounders. Mediation analysis was used to test the mediating effect of depressive symptoms. RESULTS A significantly higher incidence of suicidal ideation was related with high effort (HR = 1.51) and low reward (HR = 1.42), respectively. A high effort-low reward imbalance was associated with even higher risk of suicidal ideation (HR = 1.96) as compared to low effort-high reward combination. The association was varied by gender, region, education and household income. Depressive symptoms mediated a modest proportion (natural indirect effect 14.4%) of the total association between ERI and suicidal ideation. LIMITATION Suicidal ideation definition based on self-administered questionnaires which could lead to false negatives. And some unmeasured confounders might have biased the results. CONCLUSIONS Efforts in promoting balanced effort-reward at work may reduce suicidal ideation among working population aged 50+. Avoiding depressive symptoms may further enhance such efforts.
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Affiliation(s)
- Lai-Bao Zhuo
- College of Public health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wu Yao
- College of Public health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhen Yan
- College of Public Health, Hainan Medical University, 3 Xueyuan Road, Haikou, China.
| | - Maria S T Giron
- Institute on Aging, National Institutes of Health, University of the Philippines, Philippines
| | - Jin-Jing Pei
- Stress Research Institute, Stockholm University, Frescati Hagväg 16A, 114 19 Stockholm, Sweden
| | - Hui-Xin Wang
- College of Public health, Zhengzhou University, Zhengzhou, Henan, China; Stress Research Institute, Stockholm University, Frescati Hagväg 16A, 114 19 Stockholm, Sweden; Aging Research Center, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
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Booniam S, Wongpakaran T, Lerttrakarnnon P, Jiraniramai S, Kuntawong P, Wongpakaran N. Predictors of Passive and Active Suicidal Ideation and Suicide Attempt Among Older People: A Study in Tertiary Care Settings in Thailand. Neuropsychiatr Dis Treat 2020; 16:3135-3144. [PMID: 33364770 PMCID: PMC7751683 DOI: 10.2147/ndt.s283022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/08/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study compared predictors of passive suicidal ideation (SI), active SI, and suicide attempt (SA) among elderly Thai patients in tertiary care settings. PATIENTS AND METHODS Psychiatric diagnoses and suicidality of 803 older people were assessed using the Mini-International Neuropsychiatric Interview and the Structured Clinical Interview for DSM-IV-TR. All participants completed the Montreal Cognitive Assessment, multidimensional scale of perceived social support (MSPSS), 15-item Thai geriatric depression scale (TGDS-15), 10-item perceived social scale and the Core Symptoms Index. The chi-square test, t-test and ANOVA were used for bivariate analysis of predictors of specific suicidality types. Multiple logistic regression was used to determine the predictors for each type of suicidality. RESULTS The patients' mean age was 69.24 ± 6.90 years, and the majority were female (69.74%). Passive SI, active SI and SA were found among 20.42%, 3.74% and 2.37%, respectively, of the patients. Major depressive disorder (MDD) was a predictor of both passive and active SI (OR = 2.06 and 3.74, respectively). Other predictors of passive SI included hypomania (OR = 8.27) and positive score on the TGDS-15 (OR = 1.29). Predictors of active SI included agoraphobia (OR = 6.84) and hypomania (OR = 7.10). Predictors of SA included a family history of alcohol dependence (OR = 14.16), a history of depression (OR = 4.78) and agoraphobia (OR = 19.89). Surprisingly, hypertension and self-reported anxiety symptoms were protective factors for passive SI (OR = 0.51 and 0.85, respectively). Likewise, MSPSS was a protective factor for SA (OR = 0.90). CONCLUSION Predictors of each type of suicidality differed. MDD was the main predictor for SI; however, agoraphobia and poor perceived social support were more pronounced among individuals with SA. Further investigation, especially in longitudinal fashion, should be warranted.
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Affiliation(s)
- Somboon Booniam
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Peerasak Lerttrakarnnon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Surin Jiraniramai
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Dong L, Kalesnikava VA, Gonzalez R, Mezuk B. Beyond Depression: Estimating 12-Months Prevalence of Passive Suicidal Ideation in Mid- and Late-Life in the Health and Retirement Study. Am J Geriatr Psychiatry 2019; 27:1399-1410. [PMID: 31353189 PMCID: PMC6842696 DOI: 10.1016/j.jagp.2019.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/21/2019] [Accepted: 06/26/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To provide valid estimates of the 12-month prevalence of passive suicidal ideation among older adults, without conditioning on depression status, using the Health and Retirement Study (HRS). METHODS Data come from the 2012 HRS (n = 17,434) and 2004/5 Baltimore Epidemiologic Catchment Area (ECA) Study (n = 755). In the HRS, passive suicidal ideation (i.e., thought a lot about death-your own, someone else's, or death in general) is only assessed on respondents who reported dysphoria/anhedonia; in the ECA, ideation is assessed on all respondents, regardless of depression. We compare two approaches to estimating the 12-month prevalence of passive suicidal ideation in the HRS without conditioning on depression symptoms: 1) a probit selection model within the HRS, and 2) a prediction model developed using appended ECA data applied to the HRS. RESULTS Using observed data alone on those who screened positive for depression, 6% of older adults reported passive suicidal ideation in the past year. Depending on the approach used, between 5.4% and 9.2% of HRS respondents who screened negative for depression would have reported passive suicidal ideation had they been assessed. Correcting for this selection bias, between 10.9% and 13.4% of U.S. adults over age 50 experienced passive suicidal ideation in 2012. CONCLUSIONS Population surveillance of suicidal ideation among older adults is biased by survey approaches that only assess ideation in the context of depression.
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Affiliation(s)
- Liming Dong
- Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI
| | - Viktoryia A Kalesnikava
- Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI
| | - Richard Gonzalez
- Research Center for Group Dynamics (RG, BM), Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychology (RG), University of Michigan, Ann Arbor, MI
| | - Briana Mezuk
- Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI; Research Center for Group Dynamics (RG, BM), Institute for Social Research, University of Michigan, Ann Arbor, MI.
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Qiao YM, Lu YK, Yan Z, Yao W, Pei JJ, Wang HX. Reciprocal associations between job strain and depression: A 2-year follow-up study from the Survey of Health, Ageing and Retirement in Europe. Brain Behav 2019; 9:e01381. [PMID: 31448560 PMCID: PMC6749471 DOI: 10.1002/brb3.1381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/23/2019] [Accepted: 07/18/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A growing number of people suffered from depression. This study examined the depression prevalence in workers across 10 European countries plus Israel and the reciprocal associations between job strain and depression. METHODS The study population consisted of 7,879 workers aged 50-63 years at baseline (2004) from the Survey of Health, Ageing, and Retirement in Europe (SHARE). Job demands (physical or psychosocial) and job control variables were derived from the Job Content Questionnaire (JCQ). Two 4-category job strains (physical and psychosocial) were obtained based on the cross-tabulation of these dichotomized demands and control variables. There were 4,284 depression-free, 3,259 high physical strain-free and 3,195 high psychosocial strain-free participants at baseline who were followed up for 2 years to detect incident depression, high physical job strain, or high psychosocial strain, respectively. The reciprocal associations between job strain and depression were analyzed by multivariate logistic regression and multivariate multilevel logistic regression adjusting for potential confounders. RESULTS The prevalence of depression varied from the lowest 12.5% in Germany to the highest 27.2% in France. Compared to individuals with low strain, a significantly higher risk of depression were found in individuals with high physical strain (OR = 1.39) and high psychosocial strain (OR = 1.55), after adjusting for potential confounders. Depression at baseline was not significantly associated with subsequent high job strain. Similar results were observed from multilevel models that took into consideration of the potential country-level influences. CONCLUSIONS The prevalence of depression varies across countries in Europe. Avoiding high job strain may be an effective preventive strategy to prevent depression epidemic.
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Affiliation(s)
- Ya-Mei Qiao
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China
| | - Ya-Ke Lu
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China
| | - Zhen Yan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Hainan Medical University, Haikou, China
| | - Wu Yao
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China
| | - Jin-Jing Pei
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Hui-Xin Wang
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China.,Stress Research Institute, Stockholm University, Stockholm, Sweden.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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28
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The relation between social isolation and increasing suicide rates in the elderly. QUALITY IN AGEING AND OLDER ADULTS 2019. [DOI: 10.1108/qaoa-06-2018-0026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeSuicidal attempts and thoughts are particularly relevant to the health of the elderly and can impact not only the individual, but family, friends and spouses as well. This topic is important for the gerontological research community, particularly as it relates to social isolation and the feeling of loneliness, common in this population group. The purpose of this paper is to investigate new knowledge about the relationship between an increased risk of suicide in the elderly and social isolation or loneliness.Design/methodology/approachAn extensive search was conducted to find relevant studies to answer the research question. Database research was done in PubMed and PsycINFO for relevant studies within the last 10 years. The title and abstract of relevant articles were screened before the full-text was acquired.FindingsIn PubMed 163 studies were identified, and in PsycINFO 66 studies were identified. After a thorough screening, nine studies were found to be appropriate for this study.Originality/valueIt is not clear which risk factor leads to an increase in suicidal thoughts and attempts, however most studies contemplated loneliness and isolation as a covariant. A causal link between the concepts is not simple. Nevertheless, loneliness and isolation seem to be relevant factors for suicidal ideations.
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Fässberg MM, Vanaelst B, Jonson M, Sterner TR, Ahlner F, Wetterberg H, Rydén L, Kern S, Sigström R, Zettergren A, Skoog I, Waern M. Epidemiology of suicidal feelings in an ageing Swedish population: from old to very old age in the Gothenburg H70 Birth Cohort Studies. Epidemiol Psychiatr Sci 2019; 29:e26. [PMID: 30929647 PMCID: PMC8061288 DOI: 10.1017/s2045796019000143] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 02/26/2019] [Accepted: 03/03/2019] [Indexed: 01/23/2023] Open
Abstract
AIMS The first aim of this study was to provide prevalence suicidal feelings over time (past week, past month, past year and lifetime) in a population-based sample of old to very old adults without dementia. Does prevalence change with rising age? The second aim was to examine the fluctuation of suicidal feelings over time. How does this coincide with depression status? METHODS Data were derived from the Gothenburg H70 Birth Cohort Studies (the H70 studies) which are multidisciplinary longitudinal studies on ageing. A representative sample of adults in Gothenburg, Sweden with birth years 1901-1944 were invited to take part in a longitudinal health study on ageing and participated at one or more occasions during 1986-2014. The sample consisted of 6668 observations originating from 3972 participants without dementia between the ages of 70 and 108, including 1604 participants with multiple examination times. Suicidal feelings were examined during a psychiatric interview using the Paykel questions (life not worth living, death wishes, thoughts of taking own life, seriously considered taking life, attempted suicide). RESULTS Prevalence figures for suicidal feelings of any severity were as follows: past week 4.8%, past month 6.7%, past year 11.2% and lifetime 25.2%. Prevalence rates increased with age in the total group and in women but not in men. Suicidal feelings were common in participants with concurrent major or minor depression, but over a third of the participants who reported suicidal feelings did not fulfil criteria for these diagnoses nor did they present elevated mean depressive symptom scores. The majority of participants consistently reported no experience of suicidal feelings over multiple examination times, but fluctuation was more common in women compared with men. CONCLUSION Suicidal feelings in late-life are uncommon in individuals without depression indicating that such behaviour is not a widespread, normative phenomenon. However, such feelings may occur outside the context of depression.
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Affiliation(s)
- M. M. Fässberg
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - B. Vanaelst
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - M. Jonson
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - T. R. Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - F. Ahlner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - H. Wetterberg
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - L. Rydén
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - S. Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - R. Sigström
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - A. Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - I. Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - M. Waern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
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Lam J, García-Román J. Solitary Day, Solitary Activities, and Associations With Well-Being Among Older Adults. J Gerontol B Psychol Sci Soc Sci 2019; 75:1585-1596. [DOI: 10.1093/geronb/gbz036] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Drawing on activity theory of aging, we examined whether solitary activities may be associated with negative well-being, as they may reflect social isolation. Using American Time Use Surveys, with information on “with whom” individuals engaged in activities over a 24 hr period, we created measures capturing solitary days and solitary activities to understand their prevalence and associations with well-being.
Methods
At the daily level, we examined associations between solitary days and proportion of the day in solitary activities with life satisfaction. At the activity level, we examined associations between engaging in an activity alone versus with others and emotional state during the activity.
Results
Solitary days and higher proportion of the day spent in solitary activities were associated with lower life satisfaction. These associations were attenuated controlling for individual covariates. Engagement in activities alone was associated with lower levels of happiness and higher levels of sadness and pain during the activity, and association with happiness remained even adjusting for covariates.
Discussion
A sizable proportion of older adults reported solitary days, and proportion of the day spent in solitary activities increases by age. Examining lived experiences of older adults and presence of others during activities could contribute to research on social isolation.
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Affiliation(s)
- Jack Lam
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia
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Calati R, Ferrari C, Brittner M, Oasi O, Olié E, Carvalho AF, Courtet P. Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord 2019; 245:653-667. [PMID: 30445391 DOI: 10.1016/j.jad.2018.11.022] [Citation(s) in RCA: 289] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/27/2018] [Accepted: 11/03/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Social isolation is one of the main risk factors associated with suicidal outcomes. The aim of this narrative review was to provide an overview on the link between social isolation and suicidal thoughts and behaviors. METHODS We used the PubMed database to identify relevant articles published until April 13, 2018. We focused on: (a) systematic reviews, meta-analyses, and narrative reviews; (b) original observational studies with large samples (N ≥ 500); and (c) qualitative studies. We included all relevant suicidal outcomes: suicidal ideation (SI), suicidal planning, non-suicidal self-injury, deliberate self-harm, suicide attempt (SA), and suicide. RESULTS The main social constructs associated with suicidal outcomes were marital status (being single, separated, divorced, or widowed) and living alone, social isolation, loneliness, alienation, and belongingness. We included 40 original observational studies, the majority of them performed on adolescents and/or young adults (k = 23, 57.5%). Both the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) were strongly associated with suicidal outcomes, in particular with SA and SI. However, loneliness, which was investigated in most studies (k = 24, 60%), had a major impact on both SI and SA. These associations were transculturally consistent. LIMITATIONS Confounding factors can limit the weight of the results obtained in observational studies. CONCLUSIONS Data from the observational studies suggest that both objective social isolation and the subjective feeling of loneliness should be incorporated in the risk assessment of suicide. Interventional studies targeting social isolation for suicide prevention are needed.
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Affiliation(s)
- Raffaella Calati
- INSERM, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France; Department of Psychiatry, Mount Sinai Beth Israel, New York, USA.
| | - Chiara Ferrari
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Marie Brittner
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Osmano Oasi
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emilie Olié
- INSERM, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Philippe Courtet
- INSERM, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
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Chang Q, Sha F, Chan CH, Yip PSF. Validation of an abbreviated version of the Lubben Social Network Scale ("LSNS-6") and its associations with suicidality among older adults in China. PLoS One 2018; 13:e0201612. [PMID: 30071067 PMCID: PMC6072030 DOI: 10.1371/journal.pone.0201612] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/18/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This present study aims to estimate the structural validity, internal consistency reliability of the LSNS-6 and examine the associations between the LSNS-6 and suicidal outcomes among mainland Chinese older adults. METHODS This validation study used a big representative sample (N = 2819) of older adults in Beijing from the Sample Survey on Aged Population in Urban/Rural China. Confirmatory factor analyses (CFA) were applied to examine the factor structures of the Chinese version of LSNS-6. Internal consistency reliability of the LSNS-6 was examined by Cronbach's alpha coefficient and the corrected item-total correlation. Logistic regression analyses were used to explore the associations between the LSNS-6 and late-life death wishes, suicidal ideation in mainland Chinese. FINDINGS This present study showed good internal consistency and consistent factor structure of the LSNS-6 as well as its subscales. The present data demonstrated the LSNS-6 could be a useful tool for assessing social networks among older mainland Chinese. Interestingly, among the mainland Chinese, late-life suicidality was highly associated with the LSNS-6 family subscale, rather than the friends subscale. CONCLUSION The LSNS-6 could be a useful tool for assessing social networks among older mainland Chinese. In addition, suggestion is made to improve social networks, especially in family bonds and support, as a promising strategy in reducing late-life suicide risks in mainland China.
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Affiliation(s)
- Qingsong Chang
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Feng Sha
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Chee Hon Chan
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
- Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Paul S. F. Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
- Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
- * E-mail:
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Lee SY, Atteraya MS. Depression, Poverty, and Abuse Experience in Suicide Ideation Among Older Koreans. Int J Aging Hum Dev 2018; 88:46-59. [PMID: 29673253 DOI: 10.1177/0091415018768256] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examined to what extent the depression, poverty, and elder abuse experience affect suicide ideation among older Koreans. The data from the Survey of Living Conditions and Welfare Needs of Korean Older Persons were used. A sample of 10,279 members was analyzed. Logistic regression analysis revealed that younger old (65-69 years) were more likely to have suicide ideation that oldest old (80 years and older). After including all predicting variables such as depression, poverty, and abuse experience, results showed that depression, poverty, and abuse experience remained predictors for suicide ideation. Higher level of depression ( OR = 1.19) was positively associated with suicide ideation. Poor older person ( OR = 1.59) and those who experienced abuse ( OR = 2.37) were more likely to have suicide ideation than their counterparts. We conclude that suicide prevention policy needs to take a holistic approach, which integrates the mental health of the older people, family welfare, and economic well-being.
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Affiliation(s)
- Shin-Young Lee
- 1 Department of Social Welfare, Keimyung University, Daegu, South Korea
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