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Are gender and life attitudes associated with the wish to die in older psychiatric and somatic inpatients? An explorative study

Published online by Cambridge University Press:  03 July 2014

Anke Bonnewyn*
Affiliation:
University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
Ajit Shah
Affiliation:
University of Central Lancashire, Preston, UK
Ronny Bruffaerts
Affiliation:
University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
Koen Demyttenaere
Affiliation:
University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
*
Correspondence should be addressed to: Anke Bonnewyn, MA, University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Email: [email protected].

Abstract

Background:

Death wishes are not uncommon in older persons, and to date, several risk factors have been identified. The presence of these risk factors is insufficient to fully understand why some older people, who are exposed to them, develop a wish to die and why others do not. The purpose of the study was to explore whether Purpose in Life as well as other life attitudes are associated with a death wish in older males and females.

Methods:

The sample comprised 113 older inpatients (from a psychiatric and somatic ward) with a mean age of 74 years. Psychiatric diagnoses were assessed by the SCID-II. Logistic regression analyses estimated the unique contribution of (the interaction between) life attitudes and gender to the wish to die, controlling for sociodemographic variables, depressive disorder, and somatic symptoms.

Results:

We observed a statistically significant relationship between life attitudes and the wish to die. Purpose in Life and the Purpose in Life*Gender interaction explained significant additional variance in the prediction of the wish to die. Purposelessness in life might therefore be an important correlate of a wish to die, especially in older men, independently from sociodemographic and clinical features.

Conclusions:

In assessing a wish to die in older adults, life attitudes need to be taken into account, besides the presence of a depressive disorder and/or somatic health. More specifically, finding or maintaining a purpose in later life might be an important feature in the prevention of the wish to die, especially in male persons.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Baltes, M. and Carstensen, L. L. (1996). The process of successful ageing. Ageing and Society, 16, 397422.Google Scholar
Beck, A. et al. (1988). Scale for Suicide Ideation: psychometric properties of a self-report version. Journal of Clinical Psychology, 44, 499505.Google Scholar
Bonnewyn, A. et al. (2014). Reflections of older adults on the process preceding their suicide attempt: a qualitative approach. Death Studies, doi: 10.1080/07481187.2013.835753.Google Scholar
Boyle, P. A., Barnes, L. L., Buchman, A. S. and Bennett, D. A. (2009). Purpose in life is associated with mortality among community-dwelling older persons. Psychosomatic Medicine, 71, 574579.Google Scholar
Derogatis, L. R. (1983). Misuse of the symptom checklist 90. Archives of General Psychiatry, 40, 11521153.Google Scholar
Derogatis, L. R., Lipman, R. S. and Covi, L. (1973). SCL-90: an outpatient psychiatric rating scale--preliminary report. Psychopharmacolical Bulletin, 9, 1328.Google Scholar
Dyer, C. B., Pickens, S. and Burnett, J. (2007). Vulnerable elders: when it is no longer safe to live alone. JAMA, 298, 14481450.Google Scholar
Edwards, M. J. and Holden, R. R. (2001). Coping, meaning in life, and suicidal manifestations: examining gender differences. Journal of Clinical Psychology, 57, 15171534.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Hedberg, P., Gustafson, Y., Alex, L. and Brulin, C. (2010). Depression in relation to purpose in life among a very old population: a five-year follow-up study. Aging & Mental Health, 14, 757763.Google Scholar
Heisel, M. J. and Flett, G. L. (2008). Psychological resilience to suicide ideation among older adults. Clinical Gerontologist, 34, 5170.Google Scholar
Hosmer, D. W. and Lemeshow, S. (2000). Applied Logistic Regression. New York: Wiley.Google Scholar
Ju, H., Shin, J. W., Kim, C. W., Hyun, M. H. and Park, J. W. (2013). Mediational effect of meaning in life on the relationship between optimism and well-being in community elderly. Archives of Gerontology and Geriatrics, 56, 309313.Google Scholar
Kaji, T. et al. (2010). Relationship between late-life depression and life stressors: large-scale cross-sectional study of a representative sample of the Japanese general population. Psychiatry and Clinical Neurosciences, 64, 426434.Google Scholar
Kim, Y. A., Bogner, H. R., Brown, G. K. and Gallo, J. J. (2006). Chronic medical conditions and wishes to die among older primary care patients. International Journal of Psychiatry in Medicine, 36, 183198.Google Scholar
Krause, N. (2009). Meaning in life and mortality. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 64, 517527.Google Scholar
Lapierre, S. et al. (2012). Daily hassles, physical illness, and sleep problems in older adults with wishes to die. International Psychogeriatrics, 24, 243252.Google Scholar
Lezak, M. D., Howieson, D. B. and Loring, D. L. (2004). Neuropsychological Assessment, 4th edn. New York: Oxford University Press.Google Scholar
Maxfield, M. et al. (2007). Age-related differences in responses to thoughts of one's own death: mortality salience and judgments of moral transgressions. Psychology and Aging, 22, 341353.Google Scholar
Moore, S. L. (1997). A phenomenological study of meaning in life in suicidal older adults. Archives of Psychiatric Nursing, 11, 2936.Google Scholar
Park, C. L. and Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115144.Google Scholar
Pinquart, M. (2002). Creating and maintaining purpose in life in old age: a meta-analysis. Ageing International, 27, 90114.CrossRefGoogle Scholar
Pinquart, M. and Sorensen, S. (2001). Gender differences in self-concept and psychological well-being in old age: a meta-analysis. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 56, P195–P213.Google Scholar
Pompili, M., et al. (2014). Sociodemographic and clinical differences between suicide ideators and attempters: a study of mood disordered patients 50 years and older. Suicide and Life-Threatening Behavior, 44, 3445.CrossRefGoogle ScholarPubMed
Reker, G. T. (2000). Theoretical perspectives, dimensions, and measurement of existential meaning. In Reker, G. T. and Chamberlain, K. (eds.), Exploring Existential Meaning: Optimizing Human Development Across the Life Span. Thousand Oaks: CA.Google Scholar
Reker, G. T. and Wong, P. T. P. (1988). Aging as an individual process: toward a theory of personal meaning. In Birren, J. E. and Begston, V. K. (eds.), Emergent Theories of Aging. New York: Springer.Google Scholar
Rowe, J. L., Bruce, M. L. and Conwell, Y. (2006). Correlates of suicide among home health care utilizers who died by suicide and community controls. Suicide and Life-Threatening Behavior, 36, 6575.Google Scholar
Rurup, M. L., Deeg, D. J., Poppelaars, J. L., Kerkhof, A. J. and Onwuteaka-Philipsen, B. D. (2011). Wishes to die in older people: a quantitative study of prevalence and associated factors. Crisis, 32, 194203.Google Scholar
Ryff, C. D., Singer, B. H., Love, G. D. and Essex, M. J. (1998). Resilience in adulthood and later life. Defining features and dynamic processes. In: Lomranz, J. (ed.), Handbook of Aging and Mental Health. An Integrative Approach. New York: Plenum Press.Google Scholar
Sjostrom, N., Hetta, J. and Waern, M. (2012). Sense of coherence and suicidality in suicide attempters: a prospective study. Journal of Psychiatric and Mental Health Nursing, 19, 6269.Google Scholar
Steger, M. F., Oishi, S. and Kashdan, T. B. (2009). Meaning in life across the life span: levels and correlates of meaning in life from emerging adulthood to older adulthood. The Journal of Positive Psychology, 4, 4352.Google Scholar
Szanto, K. et al. (2013). Research to reduce the suicide rate among older adults: methodology roadblocks and promising paradigms. Psychiatric Services, 64, 586589.Google Scholar
Yip, P. S. et al. (2003). A prevalence study of suicide ideation among older adults in Hong Kong SAR. International Journal of Geriatric Psychiatry, 18, 10561062.Google Scholar