Influencing and protective factors of suicidal ideation among older adults

Impact on mental health and well-being of the dialogic literary gathering among women in a primary healthcare centre

There is strong scientific evidence on the academic, cognitive, social, and emotional benefits of Dialogic Literary Gatherings (DLG) for diverse people in a wide range of settings. However, the transference of DLG to a primary healthcare centre has not yet been studied. To address this gap a case study was conducted on the impact of a DLG in a primary healthcare centre on participants' mental health and wellbeing from the perception of participants and professionals involved in it. To that end, four daily life stories and a focus group with women participating in the DLG, most of them over 75 years old with no higher education, were conducted, as well as two in-depth interviews, one with the DLG facilitator and one with the director of the health centre. Results show that participants perceived their mental health and wellbeing improved thanks to the functioning and type of dialogue in the DLG, promoting friendships, support and solidarity. Participants also reported that, by being aware of their capabilities in the DLG, they became agents of transformation within their families and environments, turning relationships between healthcare professionals and patients more egalitarian. These findings hold implications for public health and healthcare centres.

Epidemiological features of suicidal ideation among the elderly in China based meta-analysis

BACKGROUND

Studies on the prevalence of suicidal ideation (SI) and its associated factors among the elderly in China show considerable variability. This meta-analysis aims to clarify the epidemiological features of SI in this population.

METHODS

We systematically searched English and Chinese databases for relevant literature up to September 15, 2022. The extracted data facilitated the calculation of prevalence and odds ratios (ORs) for factors associated with SI among China's elderly.

RESULTS

We analyzed 31 cross-sectional studies, comprising a total of 79,861 participants from over 20 provinces and municipalities. The pooled prevalence of SI was found to be 11.47% [95% confidence interval (CI): 7.82-15.71%]. Significant variations in prevalence were influenced by residence, physical health (including chronic diseases and daily living capabilities), mental health (depressive symptoms and life satisfaction), economic status, and time-specific assessment tools. Notably, the prevalence from 2011-2020 (15.59%, 95% CI: 9.08-23.44%) was almost double that of 2001-2010 (7.85%, 95% CI: 5.08-11.16%). The SI prevalence in the eastern region (8.06%, 95% CI 5.59-10.94%) was significantly lower than in the central and western regions (16.97%, 95% CI 12.04-22.53%). Fourteen factors exhibited a significant pooled OR greater than 1 (p < 0.05), and two factors had ORs less than 1 (p < 0.05), indicating notable association with SI among the elderly.

CONCLUSION

SI among China's elderly showed relatively high prevalence and considerable heterogeneity across different characteristics and associated factors. This underscores the need for targeted intervention strategies and standardized temporal assessments of SI to effectively address suicide risk in this population.

Effectiveness of chronic disease self-management education (CDSME) programs to reduce loneliness

OBJECTIVES

With about half of older adults reporting feelings of loneliness, interventions are needed to improve connectedness among our aging population. The health benefits of Chronic Disease Self-Management Education (CDSME) programs are well documented, but workshops' ability to reduce loneliness remains unknown.

METHODS

Using the Campaign to End Loneliness Measurement Tool, we examined 295 CDSME participants' loneliness changes before and after the 6-week face-to-face workshops. Statistical analyzes used generalized estimating equations (GEE).

RESULTS

On average, participants were age 74.3(±8.9) years and self-reported 3.3(±2.2) chronic conditions. The majority of participants were female (83%) and attended workshops in English (77%). Significant reductions in loneliness scores were observed from baseline to post-workshop (p < 0.001).

DISCUSSION

Findings expand our understanding about the benefits of small-group CDSME workshops to reduce loneliness among participants. CDSME workshops may reduce loneliness because of their highly interactive and process-driven format and ability to create bonds between participants with chronic conditions and shared experiences.

Suicide ideation in older people: a qualitative review and Meta-aggregation of Asian studies

Aims

To appraise and synthesize qualitative studies examining older Asian people's experiences of suicidal ideation.

Design

Qualitative review and meta-aggregation.

Data sources

Four databases were accessed to retrieve papers published between 1990 and 2022 including the grey literature, hand-searching of reference lists of retrieved papers and key journals. The phenomenon of interest included participants older than 60 years old, must have experienced a form of suicidal ideation and/or an unsuccessful attempt, had actively thought about harming themselves and be of Asian ethnicity.

Review methods

This review was conducted according to Consolidated Criteria for Reporting Qualitative Research and the Joanna Briggs Institute's System for the Unified Management of the Assessment and Review of Information.

Results

Of the 289 potential studies, seven papers met the inclusion criteria. Two synthesized findings resulted from this review-The Suffering Situation: A Life without Meaning in Older Age and The Healing Situation: A Life Worth Living. The experiences of older Asian people varied from feelings of loneliness, despair and isolation to wanting to live a fruitful life into old age.

Conclusion

Suicidal ideation in the older person is a growing concern especially with the rise in suicide in this age group. Rising health care costs and erosion of traditional family values means that the older person views themselves as a burden. However, because of the limited number of qualitative studies from an Asian perspective it is difficult to ascertain the full extent of the issues surrounding suicide in older people.

Factors Related to Suicidal Ideation and Prediction of High-Risk Groups among Youngest-Old Adults in South Korea

(1) Background: The suicide of older adults shows different factors between the youngest-old adults and the old-old adults. This study aimed to identify factors predicting suicidal ideation among youngest-old adults (ages 65 to 74 years) and predict high-risk groups’ characteristics. (2) Methods: The subjects of this study were 970 youngest-old adults who participated in the Korean National Health and Nutrition Examination Survey (KNHANES VIII Year 1, 2019). Logistic regression analysis identified factors related to suicidal ideation, and decision tree analysis identified combined characteristics among high-risk groups. Data were analyzed using SPSS 27.0. (3) Results: Suicidal ideation became more common among those with relatively lower income levels (OR = 1.48, 95% CI = 1.04−2.12), those whom had experienced depression (OR = 9.28, 95% CI = 4.57−18.84), those with relatively higher stress levels (OR = 2.42, 95% CI = 1.11−5.28), and those reporting a relatively worse perceived health (OR = 1.88, 95% CI = 1.23−3.11). Complex characteristics that combined depression, low personal income level, and low perceived health predicted a high risk of suicidal ideation (64.6%, p < 0.05). (4) Conclusions: The findings indicate that this high-risk group should be prioritized when developing suicide prevention strategies.

Establishment and psychometric characteristics of emotional words list for suicidal risk assessment in speech emotion recognition

BACKGROUND

Emotional disturbance is an important risk factor of suicidal behaviors. To ensure speech emotion recognition (SER), a novel technique to evaluate emotional characteristics of speech, precision in labeling emotional words is a prerequisite. Currently, a list of suicide-related emotional word is absent. The aims of this study were to establish an Emotional Words List for Suicidal Risk Assessment (EWLSRA) and test the reliability and validity of the list in a suicide-related SER task.

METHODS

Suicide-related emotion words were nominated and discussed by 10 suicide prevention professionals. Sixty-five tape-recordings of calls to a large psychological support hotline in China were selected to test psychometric characteristics of the EWLSRA.

RESULTS

The results shows that the EWLSRA consists of 11 emotion words which were highly associated with suicide risk scores and suicide attempts. Results of exploratory factor analysis support one-factor model of this list. The Fleiss' Kappa value of 0.42 indicated good inter-rater reliability of the list. In terms of criteria validities, indices of despair (Spearman ρ = 0.54, P < 0.001), sadness (ρ = 0.37, P = 0.006), helplessness (ρ = 0.45, P = 0.001), and numbness (ρ = 0.35, P = 0.009) were significantly associated with suicidal risk scores. The index of the emotional word of numbness in callers with suicide attempt during the 12-month follow-up was significantly higher than that in callers without suicide attempt during the follow-up (P = 0.049).

CONCLUSION

This study demonstrated that the EWLSRA has adequate psychometric performance in identifying suicide-related emotional words of recording of hotline callers to a national wide suicide prevention line. This list can be useful for SER in future studies on suicide prevention.

Factors Influencing Suicidal Ideation and Attempts among Older Korean Adults: Focusing on Age Discrimination and Neglect

This study was conducted to identify factors influencing the development of suicidal ideation and the transition from suicidal ideation to attempts by focusing on experiences of age discrimination and neglect among older Korean adults. This study analyzed data from 10,042 older adults from the 2017 National Survey of Older Koreans using national representative samples. Multiple logistic analyses were used to identify factors influencing the development of suicidal ideation and transition from suicidal ideation to attempts. While younger age, higher educational attainment, living alone, number of chronic diseases, depressive symptoms, social isolation, social support, experience of neglect, and age discrimination influenced the development of suicidal ideation, all of these did not influence the transition from ideation to attempts. Factors influencing this transition included male gender, less educational attainment, and experience of age discrimination. Thus, social efforts to reduce age discrimination are necessary to prevent suicide attempts among Korean older adults.

The relation between social isolation and increasing suicide rates in the elderly

Purpose

Suicidal 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/approach

An 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.

Findings

In 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/value

It 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.

Suicidal thoughts and behaviors and social isolation: A narrative review of the literature

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.

Religion and Suicide: New Findings

Suicide rates and risk and protective factors vary across religions. There has been a significant increase in research in the area of religion and suicide since the article, "Religion and Suicide," reviewed these issues in 2009. This current article provides an updated review of the research since the original article was published. PsycINFO, MEDLINE, SocINDEX, and CINAHL databases were searched for articles on religion and suicide published between 2008 and 2017. Epidemiological data on suicidality and risk and protective factors across religions are explored. Updated general practice guidelines are provided, and areas for future research are identified.

Freeing Chinese Abused Women From Stereotype: A Pretest-Posttest Comparison Study on Group Intervention in Refuge Centers

OBJECTIVE

The efficacy of heal-change group (HCG) intervention-brief trauma-recovery group intervention applying a gender-specific cognitive behavioral approach-for Chinese-abused women in refuge centers was examined in a pretest-posttest comparison study.

METHODS

A total of 100 women at three refuge centers in Hong Kong participated. Among them, 50 women from two centers joined the HCG and 50 women from the remaining center participated in a comparison mutual support group. Participants and interviewers were blinded to the group assignment. Both groups were six sessions long. Linear regression analyses were performed using the intention-to-treat framework.

RESULTS

Significant improvements in PTSD symptoms (overall mean change of -1.6, p < .001; subdomain scores; p < .001 to < .01) and depressive symptoms (BDI-II mean change; p < .01) were recorded in the intervention group.

CONCLUSION

The results suggest HCG is beneficial to Chinese-abused women. Further research is needed to determine the intervention's effectiveness in improving longer-term outcomes in these women.