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Prevalence and correlates of suicidal thought and self-destructive behavior among an elderly hospital population in Iran

Published online by Cambridge University Press:  14 March 2012

Sahra Ekramzadeh ,
Ali Javadpour ,
Brian Draper ,
Arash Mani ,
Adrienne Withall  and
Ali Sahraian
Sahra Ekramzadeh
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Ali Javadpour*
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Brian Draper
Affiliation:
School of Psychiatry, University of NSW, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
Arash Mani
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Adrienne Withall
Affiliation:
School of Psychiatry, University of NSW, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
Ali Sahraian
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
*
Correspondence should be addressed to: Ali Javadpour, MD, Research Centre for Psychiatry and Behavioral Sciences, Hafez Hospital, Shiraz, Iran. Phone: + 98 711 6273080; Fax: + 98 711 6273080. Email: [email protected].
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Abstract

Background: Few studies have examined suicidal ideation and behavior in hospitalized physically ill elderly patients, a group potentially at high risk. Our aim was to investigate the prevalence and risk factors for suicide ideation, and direct and indirect self-destructive behaviors among a sample of elderly inpatients.

Methods: A cross-sectional study was conducted in 2009; 650 inpatients aged 60 years and over were screened from various medical services in teaching hospitals affiliated to Shiraz University of Medical Sciences in Iran. Suicidal ideation and behavior were measured with the Beck Scale for Suicidal Ideation (BSSI) and the Harmful Behavior Scale (HBS). Depression was measured with the Geriatric Depression Scale (GDS), medical burden with the geriatric version of the Cumulative Illness Rating Scale (CIRS-G), life events with the Paykel Life Event Scale, and social support with the Perceived Social Support Scale.

Result: Of the 650 patients screened with a mean age of 70.5 years (SD ± 7.5), 570 met inclusion criteria and of these 123 (21.6%) reported suicidal ideation on the BSSI and 80 (14.4%) had at least one self-destructive behavior included in the HBS. There was a significant correlation between suicide ideation and harmful behaviors (r = 0.503, p = 0.001). In a regression analysis, depressive symptoms, increased burden of medical conditions, marital status, history of substance use, history of traumatic life events, lack of perceived social support, and poor education were associated with both suicide ideation and harmful behavior. From demographic variables, living without a spouse and unemployment were predictors of suicidal ideation and behavior.

Conclusion: Hospitalized, physically ill elderly patients have high rates of suicidal ideation and self-destructive behavior and these vary according to psychosocial and clinical factors. The general hospital is therefore a potential site for the recognition of suicidal individuals and implementation of proximal suicide prevention strategies.

Keywords

suicidal ideationindirect self-destructive behaviorgeneral hospital
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 9 , September 2012 , pp. 1402 - 1408
Copyright
Copyright © International Psychogeriatric Association 2012

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