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Chattun MR, Amdanee N, Zhang X, Yao Z. Suicidality in the geriatric population. Asian J Psychiatr 2022; 75:103213. [PMID: 35917739 DOI: 10.1016/j.ajp.2022.103213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
Suicide in older adults is a major global concern in both public and mental health. With an ageing population on the rise, a surge in suicidal deaths is predicted in the coming years. The objectives of this paper are to review the risk factors, protective factors, assessment rating scales and current prevention strategies in the geriatric population. The identification of modifiable risk factors and strengthening of protective factors as well as staging according to suicidal ideation, behaviors and/or attempt(s) are necessary to devise appropriate personalized interventions in vulnerable older adults. A history or current psychiatric illness particularly depression, physical illnesses, previous suicide attempt, substance abuse, loneliness, marital status, financial stress, a family history of psychiatric illnesses or suicide in 1st degree relatives and low social support most commonly increase suicidal susceptibility in older adults. Conversely, factors that increase resilience in older adults include a good physical health and cognitive function, religiousness, good quality of life and life satisfaction, ability to perform activities of daily living, marital status, having friends and social connectedness. While the risk factors associated with suicide in the geriatric population are complex and multidimensional in nature, the current preventive strategies have provided no substantial decline in suicidal risk. Therefore, a combination of strategies applied via a multilevel prevention program at a primary, mental healthcare, societal and community level could mitigate suicidal risk. Further research and better preventive measures are warranted to diminish suicidal risk in older adults.
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Affiliation(s)
- Mohammad Ridwan Chattun
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing 210093, China.
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De Leo D, Giannotti AV. Suicide in late life: A viewpoint. Prev Med 2021; 152:106735. [PMID: 34538377 PMCID: PMC8443431 DOI: 10.1016/j.ypmed.2021.106735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/06/2021] [Accepted: 07/16/2021] [Indexed: 01/07/2023]
Abstract
Suicide in old age represents a sad public health concern. Despite the global decline in rates of suicide and the general amelioration of quality of life and access to health care for older adults, their rates of suicide remain the highest virtually in every part of the world. With the aging of the world population and the growing number of mononuclear families, the risk of an increase in isolation, loneliness and dependency does not appear ungrounded. The Covid-19 pandemic is claiming the life of many older persons and creating unprecedented conditions of distress, particularly for this segment of the population. This article briefly examines the main characteristics of suicidal behavior in late life, including observations deriving from the spread of the Sars-2 coronavirus and possible strategies for prevention.
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Hernandez SC, Overholser JC, Philips KL, Lavacot J, Stockmeier CA. Suicide among older adults: Interactions among key risk factors. Int J Psychiatry Med 2021; 56:408-421. [PMID: 33322985 DOI: 10.1177/0091217420982387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The present study aimed to understand how key risk factors of older adult suicide interact to ultimately lead to death by suicide using data collected post-mortem. METHOD A psychological autopsy was used to gather detailed information about psychiatric diagnosis, medical problems, social isolation, and negative attitudes expressed by the individual during the six months prior to their death. Interviews with next-of-kin, medical and psychiatric records, and the Cumulative Illness Rating Scale for Geriatrics were used. Subjects included 32 older adults who died by suicide and 45 older adults who died by natural causes. RESULTS Hopelessness, depression, and negative health attitudes were strongly correlated with suicide. Older age was associated with social isolation, suggesting an indirect relationship with suicide via hopelessness, depression, and negative health attitudes. Physical illness did not increase risk. Multivariate analyses suggested that hopelessness fully mediated the effects of social isolation, negative health attitudes, and depression on suicide. CONCLUSIONS Psychological factors played the largest role in suicide deaths compared to social isolation and physical illness. Suicide interventions aimed at older adults should ensure hopelessness, depression, and negative health attitudes are primary targets.
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Affiliation(s)
- Silvia C Hernandez
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - James C Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Kristie L Philips
- Veterans Affairs Northeast Ohio Healthcare System, Cleveland, OH, USA
| | - James Lavacot
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Craig A Stockmeier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MI, USA
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de Mendonça Lima CA, De Leo D, Ivbijaro G, Svab I. Suicide prevention in older adults. Asia Pac Psychiatry 2021; 13:e12473. [PMID: 34114355 DOI: 10.1111/appy.12473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Suicide among older adults is a multifactorial problem with several interrelated factors involved that vary with age, gender and culture. The number of suicides is highest in those aged 70 years or older in almost all regions of the world. With the increase in life expectancy, and the decrease in mortality due to other causes of death, we could expect the absolute number of older adults' suicide continue increasing. METHODS Review of the literature on suicide protective factors of suicide among older adults. RESULTS Improvements on social determinants of health and the timely detection and early treatment of affective disorders are key interventions. Prevention based on community actions and training of gatekeepers may have positive impact. Community programs that promote a sense of usefulness, belonging and that contribute to preserve social integration should be encouraged. Governments should develop the improvement of retirement programs and the development of support systems. The access to general health and mental health services should be facilitated and Primary Care professionals should receive proper training to detect and manage older persons at risk. Actively promoting a culture of coping to different stages of life and to the changes imposed by the advancing of age should form the essential part of a process bringing to better successful aging avenues. CONCLUSIONS Suicide prevention in older adults should broaden its focus and pay attention to the many socio-environmental conditions that may be relevant in older age, especially social isolation, financial security and physical health.
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Affiliation(s)
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia.,Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - Gabriel Ivbijaro
- NOVA University, Lisbon, Portugal.,Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Igor Svab
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
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Beghi M, Butera E, Cerri CG, Cornaggia CM, Febbo F, Mollica A, Berardino G, Piscitelli D, Resta E, Logroscino G, Daniele A, Altamura M, Bellomo A, Panza F, Lozupone M. Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides. Neurosci Biobehav Rev 2021; 127:193-211. [PMID: 33878336 DOI: 10.1016/j.neubiorev.2021.04.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022]
Abstract
In older age, several observational studies investigated risk factors for suicide attempts/completed suicides; however, contrasting evidence came from population-based setting. In the present systematic review, we described through a narrative synthesis the significant associations existing among risk factors and suicide attempts/completed suicides in subjects aged >65 years. From the 39 population-based studies selected in six different databases until February 15, 2021, we analyzed the most frequent 28 risk factors for suicidal behaviour. The risk factors more associated to suicide attempts than other variables frequently related to suicidal behavior in older age were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. In older age, efforts for suicide prevention should be based on strategies to assess and treat psychiatric disorders along with psychological interventions, particularly in males.
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Affiliation(s)
| | - Elisa Butera
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | | | | | - Francesca Febbo
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy; School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Emanuela Resta
- Translational Medicine and Management of Health Systems, University of Foggia, Foggia, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Panza
- Healthy Aging Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy.
| | - Madia Lozupone
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
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Carvalho MLD, Costa APC, Monteiro CFDS, Figueiredo MDLF, Avelino FVSD, Rocha SSD. Suicide in the elderly: approach to social determinants of health in the Dahlgren and Whitehead model. Rev Bras Enferm 2020; 73:e20200332. [PMID: 33174999 DOI: 10.1590/0034-7167-2020-0332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/13/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identify in literature the social determinants of health related to suicide in the elderly, according to the model proposed by Dahlgren and Whitehead. METHOD Integrative review of articles indexed in the databases BDENF, CINAHL, LILACS, and MEDLINE, with the following main descriptors: aged, suicide, social determinants of health, and risk factors. Primary studies were included which addressed social determinants of health and suicide in the elderly. RESULTS From the 19 articles analyzed, three categories emerged: proximal social determinants of health (male gender, mental disorders, physical illnesses, white race, 70-74 years old); intermediate social determinants of health (substance abuse, use of alcohol or psychotropic drugs, marital status, marital, social, and family problems, violence, previous suicide attempt, history of admission to psychiatric service); and distal social determinants of health (schooling, economic issues, sanitation, stressful events). CONCLUSION Proximal determinants have more effects on suicide. Intermediate determinants are composed mainly of changeable factors. Distal determinants showed lesser associations.
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Kim SA, Kwon M, Seo K. Factors Influencing Depression: Comparison between Elders Living Alone and Elders Not Living Alone. ACTA ACUST UNITED AC 2019. [DOI: 10.17079/jkgn.2019.21.2.51] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Pan YF, Ma ZY, Zhou L, Jia CX. Psychometric Characteristics of Duke Social Support Index Among Elderly Suicide in Rural China. OMEGA-JOURNAL OF DEATH AND DYING 2018; 82:105-119. [PMID: 30286689 DOI: 10.1177/0030222818805356] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We recruited 242 elderly suicides and 242 controls above 60 years to conduct face-to-face interviews by psychological autopsy to examine the psychometric characteristics of the Duke Social Support Index (DSSI) in rural China. DSSI had high internal consistency, with Cronbach's αs of .89 and .90 in suicides and controls, respectively. DSSI was significantly and negatively correlated to loneliness in both samples. Confirmatory factor analysis basically supported the original structure of DSSI, but Item 4 had low factor loading in controls. In conclusion, DSSI has satisfactory reliability and acceptable validity in evaluating social support in the elderly suicide study in China.
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Affiliation(s)
- Yan-Fei Pan
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China
| | - Zhen-Yu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China
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Sousa GSD, Perrelli JGA, Botelho ES. Nursing diagnosis for Risk of Suicide in elderly: integrative review. Rev Gaucha Enferm 2018; 39:e20170120. [PMID: 30088601 DOI: 10.1590/1983-1447.2018.2017-0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/06/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the specialized literature regarding the risk factors in nursing diagnosis for suicide risks in elderly. METHOD This is an integrative literature review carried out during June 2015 in the following databases with no time limit: MEDLINE, PsycINFO and CINAHL. RESULTS A total of 80 full papers were analyzed. It was suggested the inclusion of 23 risk factors in NANDA-I taxonomy: apathy; unrest; low self esteem; carelessness with medication; Inability to ask for help; Inability to express feelings; suicidal plan; rigidity; functional disability; visual problems; sadness; hostility; anxiety; failure; frustration; unhappiness; dishonor; frequent visits to a physician with unclear symptoms; social deprivation; social devaluation; psychological violence; Interfamilial violence; and financial violence. CONCLUSION The risks for suicide presented in NANDA-I taxonomy need to be refined and adapted to the elderly reality. Furthermore, a review is also recommended for the risk factors not included in this classification.
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Affiliation(s)
- Girliani Silva de Sousa
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento. Recife, Pernambuco, Brasil
| | | | - Everton Sougey Botelho
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento. Recife, Pernambuco, Brasil
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Wang J, Ho E, Au P, Cheung G. Late-life suicide in Asian people living in New Zealand: a qualitative study of coronial records. Psychogeriatrics 2018; 18:259-267. [PMID: 30133942 DOI: 10.1111/psyg.12318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/28/2017] [Accepted: 01/15/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND There has been no previous study examining the phenomenon of suicide in older Asians in New Zealand. The aim of this study was to identify common factors and gain a better understanding of late-life suicide in Asian people living in New Zealand. METHODS New Zealand Coronial Services provided records of all closed cases of late-life suicides (age ≥ 65 years) between July 2007 and December 2012. Out of the total of 225 cases, 15 were recorded as being of Asian ethnicity. These cases were reviewed in their entirety using a qualitative thematic analysis approach. RESULTS Eight Asian men and seven Asian women completed suicide during this period. The majority (93%) lived with their families, and 80% were found by family after having completed suicide at home. Three main themes emerged from the thematic analysis: (i) suicide occurring in the context of a family; (ii) declining physical health; and (iii) a violent method of suicide. The role of the family has not been previously identified in other studies of late-life suicide in New Zealand. CONCLUSIONS Further research is needed to identify ways Asian families can access culturally appropriate and accessible support and mental health services for their older members at risk of suicide. There is also a need for developing post-suicide interventions specifically for Asian families. The findings of this study have added to the growing evidence of declining physical health acting as a drive for late-life suicide.
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Affiliation(s)
- Joanna Wang
- Auckland Regional Psychiatric Registrar Training Programme, University of Auckland, Auckland, New Zealand
| | - Elsie Ho
- Section of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Patrick Au
- Auckland District Health Board, Auckland, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
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Liu BP, Qin P, Jia CX. Behavior Characteristics and Risk Factors for Suicide Among the Elderly in Rural China. J Nerv Ment Dis 2018; 206:195-201. [PMID: 28825926 DOI: 10.1097/nmd.0000000000000728] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We examine the characteristics of suicide behavior and associated risk factors in the elderly in rural China, compared with the nonelderly. Paired case-control design and psychological autopsy were used for subject recruitment and data collection. The included cases were 104 suicides of the elderly aged 60 years or older, 86 suicides of the nonelderly, and sex- and age-paired controls from the same villages. Although the characteristics of suicide behavior were similar between the two age groups of victims, the elderly who died by suicide had a greater tendency to experience negative life events and not live with a spouse. Suicide of the nonelderly was associated with family history of suicide, poor social support, and impulsivity. The influence of negative life events on the risk of suicide was greater in the elderly. Thus, efforts for suicide prevention must be tailored to the needs of specific age groups.
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Karbeyaz K, Çelikel A, Emiral E, Emiral GÖ. Elderly suicide in Eskisehir, Turkey. J Forensic Leg Med 2017; 52:12-15. [PMID: 28772156 DOI: 10.1016/j.jflm.2017.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 06/16/2017] [Accepted: 06/24/2017] [Indexed: 12/20/2022]
Abstract
Old age should be examined separately from other stages of life in terms of ratio, method and motives for suicide. With some variation, epidemiological studies suggest suicides increase with age in virtually every society. This study examines demographic data (age, sex and marital status), and other factors related to 20-years (1997-2016) of completed elder suicides in Eskisehir, Turkey. The 74 cases of those 65 and over were evaluated with regard to method, tool and location of the suicide. Annual distributions illustrate gradual increases in this fatal self-harm over time. The vast majority of cases were male (74.3%), compared to female (25.6%). Elders in the 80-84 age range were most likely to kill themselves. Deaths were frequently caused by hanging, followed by other methods and took place in the home. Reasons associated with suicidal behavior included despair as a result of bereavement, mental illnesses, chronic physical conditions and living alone. The researchers cite potential prevention strategies through the use of early mental health treatment for elders, along with inclusion in social services and activities.
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Affiliation(s)
- Kenan Karbeyaz
- Eskişehir Osmangazi University Faculty of Medicine Department of Forensic Medicine, Eskisehir, Turkey.
| | - Adnan Çelikel
- Mustafa Kemal University Faculty of Medicine Department of Forensic Medicine, Hatay, Turkey.
| | - Emrah Emiral
- Council of Forensic Medicine, Eskisehir, Turkey.
| | - Gülsüm Öztürk Emiral
- Eskişehir Osmangazi University Faculty of Medicine Department of Public Health, Eskisehir, Turkey.
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Ceballos-Espinoza F. Aplicación forense de la autopsia psicológica en muertes de alta complejidad. ANUARIO DE PSICOLOGÍA JURÍDICA 2015. [DOI: 10.1016/j.apj.2015.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Sohn J, Cho J, Moon KT, Suh M, Ha KH, Kim C, Shin DC, Jung SH. Medical care expenditure in suicides from non-illness-related causes. J Prev Med Public Health 2014; 47:327-35. [PMID: 25475200 PMCID: PMC4263001 DOI: 10.3961/jpmph.14.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/29/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. METHODS Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. RESULTS Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. CONCLUSIONS Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.
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Affiliation(s)
- Jungwoo Sohn
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jaelim Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Mina Suh
- National Cancer Center, Goyang, Korea
| | - Kyoung Hwa Ha
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Chun Shin
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyuk Jung
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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