Prevalence and Predictors of Suicide Ideation among Elderly Mentally Ill Population in a Tertiary Psychiatric Hospital

Sudha Srinivasa Ragavan, Saravana Jothi Ramalingam, Vanishree Gunasekaran
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Abstract

BACKGROUND Suicide attempts in elderly people has higher risk of mortality. The elderly are more vulnerable to depression and other psychological and social factors that may contribute to higher risk of suicide. Studies have suggested that suicide in elderly is strongly associated with depression and lack of social support. Factors that increase risk of suicide are also found to increase the risk for suicide ideation. Suicide ideation is an important predictor of suicide attempts and completed suicide. Aims: Our study aims at estimating the prevalence of suicide ideation among mentally ill geriatric population and identifying potential predictors of suicide ideation among elderly. METHODS A cross-sectional study involving 50 persons with mental illness aged above 60 years and 50 persons with no previous psychiatric history. The was conducted at a tertiary psychiatric hospital. Geriatric Suicide Ideation Scale, Geriatric Depression scale and other psychopathology assessment tools were used. RESULTS The GSIS scores were significantly higher among those elderly persons with mental illness and the scores were higher in our study when compared to the community-dwelling elderly persons without psychiatric illness. It was observed that geriatric depression was an important predictor of suicide ideation followed by previous suicide attempt. The study also finds significant difference in the subscales of GSIS and we constructed an ROC for optimal cut-off point for the Indian population. CONCLUSIONS Geriatric suicide ideation is a less studied area with suicide ideation in elderly person with mental illness having various determinants and risk factors. It is for further research to identify feasible means of assessing suicide ideation among the elderly person receiving care from primary care physicians.
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三级精神病院老年精神病患者自杀意念的患病率及预测因素
背景:老年人自杀未遂具有较高的死亡风险。老年人更容易受到抑郁症和其他可能导致更高自杀风险的心理和社会因素的影响。研究表明,老年人自杀与抑郁和缺乏社会支持密切相关。增加自杀风险的因素也会增加自杀意念的风险。自杀意念是自杀企图和自杀完成的重要预测因子。目的:本研究旨在评估老年精神疾病人群中自杀意念的患病率,并确定老年人自杀意念的潜在预测因素。方法采用横断面研究方法,对50例60岁以上精神疾病患者和50例既往无精神病史的患者进行研究。试验在一家三级精神病医院进行。采用《老年自杀意念量表》、《老年抑郁量表》等心理病理评估工具。结果有精神疾病的老年人的GSIS得分显著高于无精神疾病的社区居住老年人。我们观察到,老年抑郁症是自杀意念和既往自杀企图的重要预测因子。研究还发现GSIS的子量表存在显著差异,并为印度人口构建了ROC最佳分界点。结论老年自杀意念是一个研究较少的领域,老年精神疾病患者的自杀意念有多种决定因素和危险因素。在接受初级保健医生护理的老年人中,寻找评估自杀意念的可行方法有待进一步研究。
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