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Les motifs du suicide gériatrique: une étude exploratoire*

Published online by Cambridge University Press:  31 March 2010

Luc Legris
Affiliation:
Centre de recherche de l'Institut universitaire de gériatrie de Sherbrooke, Université de Sherbrooke
Michel Préville*
Affiliation:
Centre de recherche de l'Institut universitaire de gériatrie de Sherbrooke, Université de Sherbrooke
*
Les demandes de tirés à part doivent être addressées à : / Requests for offprints should be sent to: Dr Michel Préville, Centre de recherche de l'Institut universitaire de gériatrie de Sherbrooke, 840, rue Papineau, Sherbrooke, QC, Canada, J1E 1Z2. ([email protected])

Abstract

Five semi-structured interviews were conducted, using the psychological autopsy method, in order to document the causes of geriatric suicide and to describe the interaction among suicidal elderly persons, their personal and social environments, and health care professionals. The results of this study support our hypothesis that elderly persons view suicide as a means of alleviating the psychological suffering associated with the frustration they experience on account of their inability to satisfy their basic needs. Three types of basic needs that affect the suicidal tendency of elderly persons were identified: the need to self-actualize, the need to belong, and the need to feel safe. The results also show that the people who make up the social and personal environment of elderly persons have a limited role in the prevention of suicide. This is due to their unfamiliarity with the problems surrounding the fulfilment of the basic needs of the suicidal elderly. Furthermore, as revealed in the cases studied here, the intervention of the health care system has centred mainly on the use of medication as a treatment for symptoms of psychological distress. The health care system pays little attention to the dissonance associated with the frustration suicidal elderly persons experience on account of their inability to satisfy their basic needs. Finally, the outcome of this qualitative study suggests that understanding the basic needs of the elderly can be very useful in understanding geriatric suicide.

Résumé

Cinq entrevues semi-structurées ont été réalisées à l'aide de la méthode de l'autopsie psychologique pour documenter les motifs du suicide gériatrique et pour caractériser les interactions entre la personne âgée suicidaire, son entourage et le milieu professionnel. Les résultats de l'étude supportent l'hypothèse selon laquelle le suicide est envisagé pour soulager la souffrance psychologique associée à la frustration de besoins fondamentaux. Trois types de besoins impliqués dans la dynamique suicidaire des personnes âgées ont été identifiés : le besoin de se réaliser, le besoin d'appartenance et le besoin de sécurité. Nos résultats démontrent également que le rôle préventif de l'entourage est limité par sa méconnaissance des enjeux fondamentaux présents dans le processus suicidaire de la personne âgée. Par ailleurs, dans les cas étudiés, l'intervention du système de soins est presque exclusivement centrée sur le traitement pharmacologique des symptômes de détresse et peu d'attention a été accordée à la dissonance associée à la frustration des besoins fondamentaux des personnes âgées suicidaires. Les résultats de cette étude exploratoire suggèrent que la perspective des besoins fondamentaux peut être d'une grande utilité pour comprendre le suicide gériatrique.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2003

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Footnotes

*

Cette étude a été supportée financièrement par le Conseil québécois de la recherche sociale (N o: 952138), par l'Institut de recherche René-Cassin et par le groupe de recherche et d'intervention sur le suicide et d'euthanasie CRISE. Les auteurs remercient également madame Jade Bilodeau qui a accepté de réviser le manuscrit de ce rapport.

References

Références

Angst, J. (1990). Depression and anxiety: A review of studies in the community and in primary health care. In Sartorius, N., Goldberg, D., de Girolamo, G., e Sylva, J. Costa, Lescubrier, Y., & Wittchen, U. (Eds.), Psychological disorders in general medical settings. Toronto: Hogrefe & Huber Publishers.Google Scholar
Baum, M., & Page, M. (1991). Care giving and multigenerational families. The Gerontologist, 31(6), 762769.CrossRefGoogle Scholar
Blumenthal, S.J. (1990). An overview and synopsis of risk factors, assessment, and treatment of suicidal patients over the live cycle. In Blumenthal, S.J. & Kupfer, D.J. (Eds.), Suicide over the life cycle: Risk factors, assessment and treatment of suicidal patients (pp. 685733). Washington, DC: American Psychiatric Press.Google Scholar
Blumenthal, S.J. (1988). Suicide: A guide to risk factors, assessment and treatment of suicidal patients. Medecine Clinic North America, 72, 937971.CrossRefGoogle ScholarPubMed
Burvill, P.W. (1990). The epidemiology of psychological disorders in general medical settings. In Sartorius, N., Goldberg, D., de Girolamo, G., e Sylva, J. Costa, Lescubrier, Y., & Wittchen, U. (Eds.), Psychological disorders in general medical settings (pp. 917). Toronto: Hogrefe & Huber Publishers.Google Scholar
Cattell, H.R. (1988). Elderly suicide in London: An analysis of coroners' inquests. International Journal of Geriatric Psychiatry, 3, 251261.CrossRefGoogle Scholar
Charron, M.-F. (1984). Bilan des connaissances sur la problématique du suicide au Québec. Service social, 33, 357395.Google Scholar
Clark, D.C., & Horton-Deutsch, S.L. (1992). Assessment in absentia: The value of the psychological autopsy method for studying antecedants of suicide and predicting future suicides. In Maris, R.W., Berman, A.L., Maltsberger, J.T., & Yufit, R.I. (Eds.), Assessment and prediction of suicide (pp. 144182). New York: Guilford Press.Google Scholar
Conwell, Y. (1994). Physician-assisted suicide: A mental health perspective. Suicide and Life-Threatening Behavior, 24(4), 326333.CrossRefGoogle ScholarPubMed
D'Aragon, N. (1998). L'approche familiale intergénérationnelle dans l'intervention auprès des personnes suicidaires et leur famille. Dans Valiquette, D.R. (dir.), Un Québec sans suicide ? Tout faire pour y arriver (pp. 2966). Montréal: Association québécoise de suicidologie.Google Scholar
Devon, C.A.J. (1996). Suicide in the elderly: How to identify and treat patients at risk. Geriatrics, 51(3), 6772.Google Scholar
Diekstra, R.F.W., & Egmond, M. (1989). Suicide and attempted suicide in general practice, 1979–1986. Acta Psychiatrica Scandinavica, 79, 268275.CrossRefGoogle ScholarPubMed
Duchesne, L. (1993). La situation démographique au Québec : édition 1993. Québec: Les publications du Québec.Google Scholar
Gendron, C. (1988). Les implications conjugales et familiales de la dépression chez les personnes âgées. Santé mental au Québec, 13(2), 154157.CrossRefGoogle Scholar
German, P.S., Shapiro, S., & Skinner, E.A. (1985). Mental health of the elderly. Journal of the American Geriatrics Society, 33(4), 246252.CrossRefGoogle ScholarPubMed
Glaser, B.G. & Strauss, A.L. (1967). The discovery of the grounded theory: Strategies for qualitative research. Chicago: Aldine.Google Scholar
Hinrichsen, G.A., Hernandez, N.A., & Pollack, S. (1992). Difficulties and rewards in family care of the depressed older adult. The Gerontologist, 32(4), 486492.CrossRefGoogle ScholarPubMed
Hinrichsen, G.A. (1991). Adjustment of caregivers to depressed older adults. Psychology and Aging, 6(4), 631639.CrossRefGoogle ScholarPubMed
Kirsling, R.A. (1986). Review of suicide among elderly persons. Psychological Reports, 59, 359366.CrossRefGoogle ScholarPubMed
Lapierre, S., Pronovost, J., Dubé, M. et Délisle, I. (1992). Facteurs de risque associés au suicide chez les personnes âgées vivant dans la communauté. Santé mentale au Canada, 40, 813.Google Scholar
L'écuyer, R. (1990). Méthodologie de l'analyse développementale de contenu : méthode GPS et concept de soi. Québec: Presse de l'Université du Québec.Google Scholar
Lester, D (1994). Suicide in the elderly: An overview. In Lester, D. & Tallmer, M. (Eds.), Now I lay me down: Suicide in the elderly (pp. 116). Philadelphia: Charles Press.Google Scholar
Liptzin, B. (1991). The treatment of depression in older suicidal persons. Journal of Geriatric Psychiatry, 24(2), 203215.Google Scholar
Lyons, M.J. (1985). Observable and subjective factors associated with attempted suicide in later life. Suicide and Life-Threatening Behavior, 15(3), 168183.CrossRefGoogle ScholarPubMed
Malavaud, S., Rouge, D., Malavaud, D. Alingrin, D., Bras, M. et Arbus, L. (1989). Le suicide chez les personnes âgées : principales caractéristiques épidémiologiques. La revue de gériatrie, 14(1), 2528.Google Scholar
Maslow, A.H. (1954). Motivation and personality. New York: Harper et Row.Google Scholar
McIntosh, J.L. (1995). Suicide prevention in the elderly (age 65–99). Suicide and Life-Threatening Behavior, 25(1), 180192.CrossRefGoogle ScholarPubMed
McIntosh, J.L. (1987). Suicide: Training and education needs an emphasis on the elderly. Gerontology and Geriatrics Education, 7(3–4), 125139.CrossRefGoogle ScholarPubMed
Miles, C.P. (1977). Conditions predisposing to suicide. Journal of Nervous et Mental Disease, 164(4), 231247.CrossRefGoogle ScholarPubMed
Miller, M. (1979). Suicide after sixty: The final alternative. New-York: Springer.Google Scholar
Murray, H.A. (1938). Explanations in personality. New York: Oxford University Press.Google Scholar
Osgood, N.J. (1985). Suicide in the elderly. Rockville: Aspen Systems.Google Scholar
Osgood, N.J. (1982). Suicide in the elderly. Postgraduate Medecine, 72(2), 123130.CrossRefGoogle ScholarPubMed
Osterweis, M. (1985). Bereavement and the elderly. Aging, 41, 813.Google Scholar
Petrie, K. (1989). Recent general practice contacts of hospitalized suicide attempters. New Zealand Medical Journal, 102, 130131.Google Scholar
Pirkis, J., & Burgess, P. (1998). Suicide and recency of health care contacts: A systematic review. British Journal of Psychiatry, 173, 462474.CrossRefGoogle ScholarPubMed
Richman, J. (1994). Family therapy for the suicidal elderly. In Lester, D. & Tallmer, M. (Eds.), Now I lay me down: Suicide in the elderly (pp. 7387). Philadelphia: Charles Press.Google Scholar
Saint-Laurent, D. et Tennina, S. (2000). Résultats de l'enquête portant sur les personnes décédées par suicide au Québec entre le 1er septembre et le 31 décembre 1996. Québec: ministère de la Santé et des Services sociaux et Bureau du coroner.Google Scholar
Saint-Laurent, D. (1999). Données de mortalité par suicide. Institut de la santé publique du Québec: document non publié.Google Scholar
Shneidman, E.S. (1999). Perturbation and lethality: A psychological approach to assesment and intervention. In Jacobs, D.G. (Ed.), The Harvard Medical School guide to suicide assessment and intervention (pp. 8397). San Francisco: Jossey-Bass.Google Scholar
Shneidman, E.S. (1993). Suicide as psychache. Journal of Nervous and Mental Disease, 181, 145147.CrossRefGoogle ScholarPubMed
Shneidman, E.S. (1985). Definition of suicide. New York: Wiley.Google Scholar
St-Arnaud, Y. (1983). Devenir autonome. Québec: Le jour.Google Scholar
Tallmer, M. (1994). Individual and group therapy for elderly suicidal patients. In Lester, D. & Tallmer, M. (Eds.), Now I lay me down: Suicide in the elderly (pp. 5672). Philadelphia: The Charles Press.Google Scholar
Tanney, B.L. (1992). Mental disorders, psychiatric patients and suicide. In Maris, R.W., Berman, A.L., Maltsberger, J.T., & Yufit, R.I. (Eds.), Assessment and prediction of suicide (pp. 277320). NY: Guilford Press.Google Scholar
Turner, R.M. (1982). Parasuicide in a urban general practice 1970–1979. Journal of the Royal College of General Practitioners, 32, 273281.Google Scholar
Vézina, J., Cappeliez, P. et Landreville, P. (1994). Psychologie gérontologique. Montréal: Gaëtan Morin.Google Scholar
AU :) Yin, R.K. (1994). Case study research: Designs and methods. Thousand Oaks, CA: Sage.Google Scholar
Zweig, R.A., & Hinrichsen, G.A. (1993). Factors associated with suicide attempts by depressed older adults: A perspective study. American Journal of Psychiatry, 150(11), 16871692.Google Scholar