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Self-poisoning by the older person: a review

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  01 August 2007

E A Sandilands  and
D N Bateman
E A Sandilands*
Affiliation:
Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
D N Bateman
Affiliation:
Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
*
Address for correspondence: E Sandilands, NPIS Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA.
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Extract

Suicide is a major health issue worldwide and is among the top ten causes of death in many countries. Much research, media attention and public health initiatives are focused on reducing the suicide rate among adolescents and young adults. In many countries, however, it is the elderly population with the greatest number of suicides, the majority of which die by drug overdose. This is commonly explained by an increased suicidal intent among older people due to co-morbidity and social isolation. The physical vulnerability of elderly people to potential toxins however is also likely to play an important role. This review examines the epidemiology of elderly suicide, considers commonly implicated drugs, and discusses associated risk factors in this complex and multifactorial problem.

Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 17 , Issue 3 , August 2007 , pp. 191 - 198
Copyright
Copyright © Cambridge University Press 2008

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References

1WorldHealth Organisation. 2006. at http://www.who.int/mental_health/prevention/suicide/suicideprevent/en./ Accessed 04.03.08.Google Scholar
2Cattell, H, Jolley, D. One hundred cases of suicide in elderly people. Br J Psychiat 1995; 166: 451–57.CrossRefGoogle ScholarPubMed
3De Leo, D, Padoani, W, Scocco, P et al. Attempted and completed suicide in older subjects: results from the WHO/EURO Multicentre study of suicidal behaviour. Int J Geriatr Psychiatry 2001; 16: 300–10.Google Scholar
4Eddleston, M, Dissanayake, M, Sheriff, MHR, Warrell, D, Gunnell, D. Physical vulnerability and fatal self-harm in the elderly. Br J Psychiatry 2006; 189: 278–79.Google Scholar
5Camidge, DR, Wood, RJ, Bateman, DN. The epidemiology of self-poisoning in the UK. Br J Clin Pharmacol 2003; 56: 613–19.CrossRefGoogle ScholarPubMed
6Linsley, KR, Schapira, K, Kelly, TP. Open verdict v. suicide – importance to research. Br J Psychiatry 2001; 178: 465–68.Google Scholar
7Lawrence, D, Almeida, O, Hulse, G, Jablensky, A, Holman, C, D'Arcy, J. Suicide and attempted suicide among older adults in Western Australia. Psychol Med 2000; 30: 813–21.CrossRefGoogle ScholarPubMed
8Hoxey, K, Shah, A. Recent trends in elderly suicide rates in England and Wales. Int J Geriatr Psychiatry 2000; 15: 274–79.Google Scholar
9Shah, R, Uren, Z, Baker, A, Majeed, A. Trends in suicide from drug overdose in the elderly in England and Wales, 1993–1999. Int J Geriatr Psychiatry 2002; 17: 416–421.Google Scholar
10National Statistics online. At http://www.statistics.gov.uk/CCI/nugget.asp?ID=1092&Pos=6&ColRank=2&Rank=1000. Accessed 17/03/08.Google Scholar
11Hawton, K, Zahol, D, Weatherall, R. Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. Br J Psychiatry 2003; 182: 537–542.CrossRefGoogle ScholarPubMed
12Hepple, J, Quinton, C. One hundred cases of attempted suicide in the elderly. Br J Psychiatry 1997; 171: 42–46.Google Scholar
13Chan, J, Draper, B, Banerjee, S. Deliberate self-harm in older adults: a review of the literature from 1995 to 2004. Int J Geriatr Psychiatry 2007; 22: 720–732.Google Scholar
14Conwell, Y, Duberstein, PR, Caine, ED. Risk factors for suicide in later life. Biol Psychiatry 2002; 52: 193–204.Google Scholar
15Chiu, H, Lam, L, Pang, A, Leung, C, Wong, C. Attempted suicide by Chinese elderly in Hong Kong. Gen Hosp Psychiatry 1996; 18: 444–47.Google Scholar
16Hawton, K, Harriss, L. Deliberate self-harm in people aged 60 years and over: characteristics and outcome of a 20-year cohort. Int J Geriatr Psychiatry 2006; 21: 572–81.CrossRefGoogle ScholarPubMed
17Beautrais, A. A case control study of suicide and attempted suicide in older adults. Suicide Life-Threatening Beh 2002; 32: 1–9.Google Scholar
18Salib, E, Green, L. Gender in elderly suicide: analysis of coroners' inquests of 200 cases of elderly suicide in Cheshire 1989–2001. Int J Geriatr Psychiatry 2003; 18: 1082–1087.Google Scholar
19Harwood, D, Hawton, K, Hope, T, Jacoby, R. Suicide in older people: mode of death, demographic factors, and medical contact before death. Int J Geriatr Psychiatry 2000; 15: 736–43.Google Scholar
20Tadros, G, Salib, E. Age and methods of fatal self harm (FSH). Is there a link? Int J Geriatr Psychiatry 2000; 15: 848–52.Google Scholar
21Draper, B. Attempted suicide in old age. Int J Geriatr Psychiatry 1996; 11: 577–587.Google Scholar
22De Leo, D, Padoani, W, Lonnqvist, J et al. Repetition of suicidal behaviour in elderly Europeans: a prospective longitudinal study. J Affect Disord 2002; 72: 291–95.Google Scholar
23Hall, DJ, O'Brien, F, Stark, C, Pelosi, A, Smith, H. Thirteen-year follow-up of deliberate self-harm, using linked data. Br J Psychiatry 1998; 172: 239–42.CrossRefGoogle ScholarPubMed
24Bateman, DN, Bain, M, Gorman, D, Murphy, D. Changes in paracetamol, antidepressants and opioid poisoning in Scotland during the 1990s. Q J Med 2003; 96: 125–32.Google Scholar
25Schmidt, LE. Age and paracetamol self-poisoning. Gut 2005; 54: 686–90.Google Scholar
26Li Wan, PA, Zhang, WY. Systematic overview of co-proxamol to assess analgesic effects of addition of dextropropoxyphene to paracetamol. BMJ 1997; 315: 1565–71.Google Scholar
27Afshari, R, Good, AM, Maxwell, SRJ, Bateman, DN. Co-proxamol overdose is associated with a 10-fold excess mortality compared with other paracetamol-combination analgesics. Br J Clin Pharmacol 2005; 60: 444–47.Google Scholar
28Afshari, R, Maxwell, S, Dawson, A, Bateman, DN. ECG abnormalities in co-proxamol (paracetamol/dextropropoxyphene) poisoning. Clin Toxicol 2005; 43: 255–59.Google Scholar
29Henry, J, Alexander, C, Sener, E. Relative mortality from overdose of antidepressants. BMJ 1995; 310: 221–24.CrossRefGoogle ScholarPubMed
30Kapur, S, Mieczkowski, T, Mann, JJ. Antidepressant medications and the relative risk of suicide attempt and suicide. JAMA 1994; 268: 3441–45.Google Scholar
31Emslie, G, Judge, R. Tricyclic antidepressants and selective serotonin reuptake inhibitors: use during pregnancy, in children/adolescents and in the elderly. Acta Psychiatr Scan 2000; 403: 26–34.Google Scholar
32Juurlink, D, Mamdani, M, Kopp, A, Redelmeier, D. The risk of suicide with selective serotonin reuptake inhibitors in the elderly. Am J Psychiatry 2006; 163: 813–21.Google Scholar
33Ticehurst, S, Carter, GL, Clover, KA, Whyte, IM, Raymond, J, Fryer, J. Elderly patients with deliberate self-poisoning treated in an Australian general hospital. Int Psychogeriatr 2002; 14: 97–105.CrossRefGoogle Scholar
34Carlsten, A, Waern, M, Holmgren, P, Allebeck, P. The role of benzodiazepines in elderly suicides. Scand J Public Health 2003; 31: 224–28.Google Scholar
35Serafaty, M, Masterton, G. Fatal poisonings attributed to benzodiazepines in Britain during the 1980s. Br J Psychiatry 1993; 163: 386–93.Google Scholar
36Waern, M, Rubenowitz, E, Runeson, B, Skoog, I, Wilhelmson, K, Allebeck, P. Burden of illness and suicide in elderly people: case-control study. BMJ 2002; 324: 1355–57.Google Scholar
37Quan, H, Arboleda-Florez, J, Fick, G, Stuart, H, Love, E. Association between physical illness and suicide among the elderly. Soc Psychiatry Psychiatr Epidemiol 2002; 37: 190–97.Google Scholar
38Kendal, WS. Suicide and cancer: a gender-comparative study. Ann Oncol 2007; 18: 381–87.Google Scholar
39Camidge, DR, Stockton, DL, Frame, S, Wood, R, Bain, M, Bateman, DN. Hospital admissions and deaths relating to deliberate self-harm and accidents within 5 years of a cancer diagnosis: a national study in Scotland, UK. Br J Cancer 2007; 96: 752–57.Google Scholar
40Harwood, D, Hawton, K, Hope, T, Harriss, L, Jacoby, R. Life problems and physical illness as risk factors for suicide in older people: a descriptive and case-control study. Psychol Med 2006; 36: 1265–74.Google Scholar
41Juurlink, D, Herrmann, N, Szalai, J, Kopp, A, Redelmeier, D. Medical illness and the risks of suicide in the elderly. Arch Intern Med 2004; 164: 1179–84.Google Scholar
42Harwood, D, Hawton, K, Hope, T, Jacoby, R. Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study. Int J Geriatr Psychiatry 2001; 16: 155–65.Google Scholar
43Koponen, H, Viilo, K, Hakko, H et al. Rates and previous disease history in old age suicide. Int J Geriatr Psychiatry 2007; 22: 38–46.CrossRefGoogle ScholarPubMed
44Barraclough, B, Bunch, J, Nelson, B, Sainsbury, P. A hundred cases of suicide: clinical aspects. Br J Psychiatry 1974; 125: 355–73.CrossRefGoogle ScholarPubMed
45Waern, M, Rubenowitz, E, Wilhelmson, K. Predictors of suicide in the old elderly. Gerontology 2003; 49: 328–34.Google Scholar
46Pirkis, J, Burgess, P. Suicide and recency of health care contacts. Br J Psychiatry 1998; 173: 462–74.Google Scholar
47Tadros, G, Salib, E. Elderly suicide in primary care. Int J Geriatr Psychiatry 2007; 22: 750–56.Google Scholar
48Waern, M, Beskow, J, Runeson, B, Skoog, I. Suicidal feelings in the last year of life in elderly people who commit suicide. Lancet 1999; 354: 917–18.Google Scholar
49O'Connell, H, Chin, A, Cunningham, C, Lawlor, B. Recent developments: Suicide in older people. BMJ 2004; 329: 895–99.Google Scholar
50Hawton, K, Ware, C, Mistry, H et al. Why patients choose paracetamol for self-poisoning and their knowledge of its dangers. BMJ 1995; 310: 164.Google Scholar
51Hawton, K, Simkin, S, Deeks, J et al. UK legislation on analgesic packs: before and after study of long-term effect on poisonings. BMJ 2004; 329: 1076–81.Google Scholar
52Newsome, PN, Bathgate, AJ, Henderson, NC et al. Referral patterns and social deprivation in paracetamol-induced liver injury in Scotland. Lancet 2001; 358: 1612–13.Google Scholar
53Sandilands, EA, Bateman, DN. Coproxamol withdrawal has reduced suicide from drugs in Scotland. Br J Clin Pharmacol 2008 (in press.)Google Scholar
54Pritchard, C, Hansen, L. Comparison of suicide in people aged 65–74 and 75+ by gender in England and Wales and the major Western countries 1979– 1999. Int J Geriatr Psychiatry 2005; 20: 17–25.Google Scholar