Abstract
Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age <65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p < 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p < 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.
Highlights
Suicide is one of the leading causes of death worldwide [1]
No significant differences were found in sex (p = 0.342) and cohabitation with family (p = 0.770) but marital status (p < 0.001) and religion differed between the two groups (p = 0.022)
We found that the usual suspects for serious suicide attempts (SSA) in younger suicide attempters, such as age, sex, interpersonal stress, and impression of schizophrenia, were not applicable in older suicide attempters
Summary
Suicide is one of the leading causes of death worldwide [1]. Many risk factors and consequences constitute the complexity of suicidal behaviors. It is important to measure the lethality of the suicide attempt and prevent serious suicide attempts (SSA), defined as suicide attempt leading to a fatal outcome including death or hospitalization [4, 5] because the SSA cause both individual and social burden [4, 6]. Many factors are involved in SSA or suicide lethality, including medical severity [7, 8], previous attempts [9], suicidal intent and method [7, 10], male sex [10], previous history and severity of psychiatric diseases [11,12,13], alcohol use [14], and age [15]. A more comprehensive evaluation of SSA may include contextual information based on methods and circumstances of the suicide attempt because the lethality of the suicide attempt is associated with multiple variables
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