Abstract
Introduction: As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors. Our aim was to describe the main socio-demographic and clinical features of a sample of suicide attempters aged 65 years and older, and to assess differences within the sample (men vs. women; patients with vs. without a previous history of suicide attempt; patients with vs. without a previous psychiatric history).Methods: Retrospective study conducted at the Maggiore della Carità University Hospital, Novara, Italy.Results: A higher percentage of female patients in our sample were treated by or referred to mental health services, while a greater percentage of male patients required a prolonged clinical observation in the Emergency Room (ER) or in non-psychiatric wards before psychiatric admission. The percentage of patients without previous psychiatric history taking anxiolytic and sedative medications was 25%.Conclusion: It is likely that different clusters and types of suicide attempters exist. Women in our sample appeared more proactive in asking for help, and more likely to be already treated by or referred to a psychiatric service, suggesting the need to facilitate the access to psychiatric services for the male population aged 65 years and older, or to offer support and care for the non-psychiatric reasons (comorbidities, pain, and loss of autonomy) possibly underlying suicidal behavior in this specific group. The use of medications deserves more attention considering the possible critical diagnostic issues in this age group.
Highlights
As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors
We analyzed a total of 1,651 discharge letters according to the criteria described in the methods, and we eventually included a sample of 28 suicide attempters aged 65 years and older
Further research is needed to deepen the role of organic comorbidities, pain, disability, loss of autonomy, and the burden of other social factors, in suicidal behavior of older adults, which could not be assessed in this study
Summary
As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors. Two peaks of overall suicidal behaviors can be identified: the first in young adults and the second in the older ones [6, 10, 11]; as older adults more frequently die by suicide compared with younger adults, they account for a disproportionately high number of suicide deaths [12] This is likely related to the evidence that suicide attempts among individuals aged 65 years and older are characterized by lower impulsivity and higher lethal intent [6, 10]. This gender difference largely depends on the choice of suicide method (men tend to use more violent and lethal ones, such as firearms and hanging, while women use drowning or self-poisoning) and reaches a peak among older adults [3, 5], where the male/female suicide death ratio is 6.63 for those aged 75–79 years and reaches up to 12.80 for people over the age of 85 years [3]
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