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Gender and age group differences in suicide risk associated with co-morbid physical and psychiatric disorders in older adults

Published online by Cambridge University Press:  08 September 2016

Helen-Maria Vasiliadis ,
Catherine Lamoureux-Lamarche  and
Samantha Gontijo Guerra
Helen-Maria Vasiliadis*
Affiliation:
Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada
Catherine Lamoureux-Lamarche
Affiliation:
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Samantha Gontijo Guerra
Affiliation:
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
*
Correspondence should be addressed to: Helen-Maria Vasiliadis, MSc, PhD, Université de Sherbrooke, Chercheure Centre de recherche – Hôpital Charles-Le Moyne, Campus Longueuil, 150 Place Charles-Le Moyne bureau 200, Longueuil (QC) J4K 0A8, Canada. Phone: +(450) 466-5000, ext. 3701; Fax: +(450) 670-4135. Email: [email protected].
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Abstract

Background:

It is unclear whether health service use influences the association between psychiatric and physical co-morbidity and suicide risk in older adults.

Methods:

Controls were older adults (n = 2,494) participating in a longitudinal study on the health of the elderly carried out between 2004 and 2007, in Quebec. The cases were all suicide decedents (n = 493) between 2004 and 2007, confirmed by the Quebec Coroner's office. Multivariate analyses were carried out to test the association between suicide and the presence of psychiatric and physical illnesses controlling for health service use and socio-demographic factors by gender and age group. Interaction terms were also tested between suicide and co-morbidity on outpatient service use.

Results:

The presence of physical illnesses only, was associated with a reduced risk of suicide across all sex and age groups. The presence of a mental disorder only was associated with an increased risk of suicide overall and specifically in females and those aged 70 to 84 years of age. Suicide risk was lower in those with a psychiatric and physical co-morbidity and consulting mental health services.

Conclusions:

Increased mental health follow-up in older adults with psychiatric illnesses is needed for the detection of suicidal behavior and reducing suicide risk in males. Further research should focus on the mitigating effect of the presence of physical illnesses on stigma and health service use and the presence of social support in the elderly.

Keywords

suicidechronic physical ilnessespsychiatric ilnessesco-morbidity
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 2 , February 2017 , pp. 249 - 257
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Ahmedani, B. K. et al. (2014). Health care contacts in the year before suicide death. Journal of General Internal Medicine, 29, 870–877.Google Scholar
Betancourt, M. T., Roberts, K. C., Bennett, T., Driscoll, E. R., Jayaraman, G. and Pelletier, L. (2014). Monitoring chronic diseases in Canada: the Chronic Disease Indicator Framework. Chronic Diseases and Injuries in Canada, 34, 11–30.Google Scholar
Bogner, H. R., Ford, D. E. and Gallo, J. J. (2006). The role of cardiovascular disease in the identification and management of depression by primary care physicians. The American Journal of Geriatric Psychiatry, 14, 71–78.CrossRefGoogle ScholarPubMed
Bolton, J. M., Walld, R., Chateau, D., Finlayson, G. and Sareen, J. (2015). Risk of suicide and suicide attempts associated with physical disorders: a population-based, balancing score-matched analysis. Psychological Medicine, 45, 495–504.Google Scholar
Boulard, R. and Dufour, D. (1983). The Politics of the Geographical Distribution of Medical Staff in Quebec [in French]. Cahiers québécois de démographie, 12, 83–105.CrossRefGoogle Scholar
Drapeau, C.W. and McIntosh, J.L. (2015) U.S.A. Suicide 2013: Official Final Data. Washington, DC: American Association of Suicidology. Available at: http://www.suicidology.org; last accessed 29 March 2015.Google Scholar
Erlangsen, A., Stenager, E. and Conwell, Y. (2015). Physical diseases as predictors of suicide in older adults: a nationwide, register-based cohort study. Social Psychiatry and Psychiatric Epidemiology, 50, 1427–1439.Google Scholar
Fässberg, M. et al. (2016). A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging & Mental Health, 20, 166–194.Google Scholar
Fegg, M., Kraus, S., Graw, M. and Bausewein, C. (2016) Physical compared to mental diseases as reasons for committing suicide: a retrospective study. BMC Palliative Care, 15, 14.Google Scholar
Menear, M. et al. (2015). The influence of comorbid chronic physical conditions on depression recognition in primary care: a systematic review. Journal of Psychosomatic Research, 78, 304–313.Google Scholar
Pompili, M. et al. (2015). Suicide in stroke survivors: epidemiology and prevention. Drugs Aging, 32, 21–29.Google Scholar
Préville, M. et al. (2008). The epidemiology of psychiatric disorders in Quebec's older adult population. Canadian Journal of Psychiatry, 53, 822–832.Google Scholar
Préville, M. et al. (2012). Correlates of potentially inappropriate prescriptions of benzodiazepines among older adults: results from the ESA study. Canadian Journal on Aging, 31, 313–322.Google Scholar
Public Health Agency of Canada. (2014). Chronic disease Infobase Data Cubes. Ottawa, ON: Government of Canada. Available at: http://www.infobase.phac-aspc.gc.ca; last accessed 3 June 2015.Google Scholar
Qin, P., Hawton, K., Mortensen, P. B. and Webb, R. (2014). Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study. The British Journal of Psychiatry: The Journal of Mental Science, 204, 430–435.CrossRefGoogle Scholar
Sachs-Ericsson, N. et al. (2013). Longitudinal study of differences in late- and early-onset geriatric depression: depressive symptoms and psychosocial, cognitive, and neurological functioning. Aging & Mental Health, 17, 1–11.Google Scholar
Shah, A., Bhat, R., Zarate-Escudero, S., DeLeo, D. and Erlangsen, A. (2016). Suicide rates in five-year age-bands after the age of 60 years: the international landscape. Aging & Mental Health, 20, 131–138.Google Scholar
Statistics Canada. (2012). Suicides and Suicide Rate, by Sex and by Age Group. Ottawa, ON: Government of Canada. Available at http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/hlth66f-eng.htm; last accessed 29 March 2016.Google Scholar
St-Laurent, D. and Bouchard, C. (2004). L'épidémiologie du suicide au Québec: que savons-nous de la situation récente? Institut national de santé publique du Québec, 281. Québec: Institut National de Santé Public du Québec, Gouvernement du Québec.Google Scholar
Tylee, A. T., Freeling, P. and Kerry, S. (1993). Why do general practitioners recognize major depression in one woman patient yet miss it in another? The British Journal of General Practice: The Journal of The Royal College of General Practitioners, 43, 327–330.Google Scholar
Värnik, P. (2012). Suicide in the world. International Journal of Environmental Research and Public Health, 9, 760–771.Google Scholar
Vasiliadis, H., Ngamini-Ngui, A. and Lesage, A. (2015). Factors associated with suicide in the month following contact with different types of health services in Quebec. Psychiatric Services, 66, 121–126.Google Scholar
Voaklander, D. C., Rowe, B. H., Dryden, D. M., Pahal, J., Saar, P. and Kelly, K. D. (2008). Medical illness, medication use and suicide in seniors: a population-based case-control study. Journal of Epidemiology and Community Health, 62, 138–146.CrossRefGoogle ScholarPubMed