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Determinants of thoughts of death or suicide in depressed older persons

Published online by Cambridge University Press:  09 August 2013

Ista C. H. M. Bogers ,
Marij Zuidersma ,
Marjolein L. Boshuisen ,
Hannie C. Comijs  and
Richard C. Oude Voshaar
Ista C. H. M. Bogers*
Affiliation:
Lentis/Dignis, Mental Health Organisation, Groningen, the Netherlands
Marij Zuidersma
Affiliation:
University Center of Psychiatry (UCP), and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
Marjolein L. Boshuisen
Affiliation:
Lentis/Dignis, Mental Health Organisation, Groningen, the Netherlands
Hannie C. Comijs
Affiliation:
GGZ inGeest/Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
Richard C. Oude Voshaar
Affiliation:
University Center of Psychiatry (UCP), and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
*
Correspondence should be addressed to: Ista C.H.M. Bogers, Lentis/Dignis, Post Office Box 128, Zuidlaren 9470AC, the Netherlands. Phone: 0031-50-4097911. Email: [email protected].
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Abstract

Background:

In depressed persons, thoughts of death and suicide are assumed to represent different degrees of a construct: suicidality. However, this can be questioned in older persons facing physical and social losses. Thoughts of death in depressed older persons are hardly examined in the absence of suicidal ideation. Furthermore, most depression instruments do not discriminate suicidal ideation from thoughts of death only. We examined whether determinants of thoughts of death differ from determinants of suicidal ideation in late life depression.

Methods:

Past month's thoughts of death and suicidal ideation were assessed with the Composite International Diagnostic Interview in 378 depressed older persons (>60 years of age). Multinomial logistic regression analyses adjusted for age and depression severity were used to identify socio-demographic, lifestyle, clinical and somatic determinants of past month's thoughts of death, and suicidal ideation.

Results:

Compared with patients without thoughts of death or suicide (n = 267), patients reporting thoughts of death but no suicidal ideation (n = 74) were older (OR (95% confidence interval) = 1.04 (1.00–1.08)) and more severely depressed (OR = 1.06 (1.04–1.08)), whereas patients with suicidal ideation (n = 37) were also more severely depressed (OR = 1.09 (1.06–1.13)), but not older. This latter group was further characterized by more psychiatric comorbidity (dysthymia OR = 2.28 (1.08–4.85)), panic disorder (OR = 2.27 (1.00–518)), at-risk alcohol use (OR = 4.10 (1.42–11.90)), lifetime suicide attempts (OR = 3.37 (1.46–7.75)), loneliness (OR = 1.24 (1.07–1.43)), and recent life events (OR = 3.14 (1.48–6.67)).

Conclusions:

In depressed older persons thoughts of death and suicide differ in relevant demographic, social, and clinical characteristics, suggesting that the risks and consequences of the two conditions differ.

Keywords

depressionsuicidepsychogeriatricsrisk factors
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 11 , November 2013 , pp. 1775 - 1782
Copyright
Copyright © International Psychogeriatric Association 2013 

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